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Year Two - Urinary System > Renal Cancer > Flashcards

Renal Cancer Flashcards

1
Q

What is renal cancer?

A

It is usually a malignant, adenocarcinoma growth originating from cells lining the proximal convoluted tubule

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2
Q

What renal cells are involved in renal cancer?

A

Clear cells

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3
Q

What are the six risk factors of renal cancer?

A

Gender, with males having an increased risk

Age, with the risk of renal cancer increasing with age – specifically after the age of 50

Family History

Congenital Syndromes, such as von Hippel-Lindau disease are associated with the development of renal cancer

Smoking

Obesity

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4
Q

What is the most important risk factor of renal cancer?

A

Obesity

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5
Q

Why is smoking a risk factor of renal cancer?

A

It increases the harmful chemicals the kidneys are required to filter

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6
Q

How does renal cancer tend to present?

A

Asymptomatically and and is therefore diagnosed incidentally on imaging for unrelated symptoms

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7
Q

What are the six clinical features of renal cancer?

A

Haematuria, which is the presence of blood within urine resulting in pink-coloured urine

Loin Pain, which is defined pain in one side of the body between the upper abdomen and the back

Weight Loss

Fatigue

Nausea & Vomiting

Paraneoplastic syndrome

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8
Q

What are the three types of haematuria?

A

Visible

Microscopic

Dipstick positive

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9
Q

What is microscopic haematuria?

A

It is defined as more than three RBCs per high power field

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10
Q

What is paraneoplastic syndrome?

A

A group of rare disorders in which a neoplasm triggers an abnormal immune system response, resulting in the nervous system being attacked

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11
Q

What are the five clinical features of paraneoplatic syndrome?

A

Hypertension

Hypercalcaemia

Cachexia, which is defined as a wasting disorder that causes extreme weight loss and muscle wasting

Anaemia

Polycythaemia, which refers to an increase in the number of red blood cells in the body

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12
Q

What four investigations are used to diagnose renal cancer?

A

Blood & Urine Tests

CT Scan

Renogram

Renal Biopsy

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13
Q

How are blood and urine tests used to diagnose renal cancer?

A

They indicate the underlying cause of the renal cancer, allowing the most appropriate treatment to be determined

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14
Q

What specific CT scan is used to treat renal cancer?

A

Triple phase scan of the abdomen and chest

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15
Q

What is the standard investigation used to diagnose renal cancer?

A

CT scan

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16
Q

How is a CT scan used to diagnose renal cancer?

A

It allows the kidneys to be visualised, therefore enabling diagnosis and staging of renal cancer

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17
Q

What is a renogram?

A

A scan of the kidneys to determine how well each kidney is functioning, and whether urine from the kidneys pass down into the bladder without obstruction

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18
Q

How is renogram scan used to diagnose renal cancer?

A

It is used to guide treatment options, as it allows us to determine the function of the unaffected kidney and therefore whether removal of the cancerous kidney is feasible

19
Q

What is a renal biopsy?

A

It involves the insertion of a thin needle into the kidneys to collect a tissue sample

The tissue sample is analysed in a lab to determine whether cancer cells are present

20
Q

What is staging?

A

The assessment of a cancer’s spread

21
Q

What is staging based on?

A

Clinical assessment

Radiological assessment

22
Q

What is staging used to determine?

A

Prognosis outcome

To guide treatment

23
Q

How is renal cancer staged?

A

TNM staging

24
Q

What is the T stage in TNM staging?

A

It considers how big the tumour is and how far it has spread

25
Q

What is the N stage in TNM staging?

A

It considers whether the cancer cells have spread into the lymph nodes

26
Q

What is the M stage in TNM staging?

A

It considers whether the tumour has spread anywhere else in the body

27
Q

What six locations does renal cancer tend metastasise to?

A

Brain

Adrenal glands

Liver

Lungs

Bone

Paracaval lymph nodes

28
Q

What three treatments are used to treat renal cancer?

A

Surgical Treatment

Pharmacological Treatment

Immunotherapy Treatment

29
Q

What two surgeries are used to treat renal cancer?

A

Radical nephrectomy

Partial nephrectomy

30
Q

What is the most effective surgical management option of renal cancer?

A

Radical nephrectomy

31
Q

What is a radical nephrectomy?

A

It involves removing the entire kidney, a border of healthy tissue and occasionally additional nearby tissues, such as the lymph nodes, adrenal gland or other structures

32
Q

In what cases can radical nephrectomy be conducted laproscopically?

A

When the renal cancer is staged between T1-T3a

33
Q

In what cases can radical nephrectomy be conducted openly?

A

When the renal cancer is staged greater than T3b

34
Q

What is a partial nephrectomy?

A

It involves removal of the tumour and a small margin of healthy tissue that surrounds it

35
Q

When is partial nephrectomy used to treat renal cancer?

A

Small renal cancers

If the patient has one kidney

36
Q

What is the first line treatment option of renal cancer?

A

Surgery

37
Q

What is pharmacological treatment of renal cancer?

A

It involves the prescription of drugs which target specific abnormalities present within cancer cells

By blocking these abnormalities, targeted drug treatments cause cancer cells to die

38
Q

When is pharmacological treatment used to treat renal cancer?

A

Metastatic disease

It is used with other treatment options

39
Q

What pharmacological treatment is used to treat renal cancer?

A

Tyrosine kinase inhibitors

40
Q

What are three tyrosine kinase inhibitors used to treat renal cancer?

A

Sunitinib

Sorafenib

Pazopanib

41
Q

What is immunotherapy?

A

It uses the body’s own immune system to fight the cancer

The body’s immune system may not attack the cancer physiologically due to the cancer cells producing proteins that help them hide from the immune system cells

Immunotherapy works by interfering with this process.

42
Q

What two immunotherapies are used to treat renal cancer?

A

Interferon alpha

Interleukin-one

43
Q

What is the first line prophylactic treatment choice?

A

Thiazide diuretic

Year Two - Urinary System (15 decks)

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