Urinary 11 - Malignancy Flashcards
Name the most common cancer in men:
Prostate cancer
Name the 2nd most common cause of death in men by cancer:
Prostate cancer
Name the most common cause of death by cancer in men:
Lung cancer
Give some risk factors of prostate cancer:
- Increasing age
- Family history (4x)
- Black > White > Asian
Give some explanations of raised PSA:
- Prostate cancer
- Urine infection
- Acute urine retention
- Benign prostatic hyperplasia
- Catheterization
What is the typical presentation of Prostate cancer?
- Typically asymptomatic
- May have bone pain and urinary symptoms
What symptom of prostate cancer shows advanced disease?
Haematuria
How is prostate cancer diagnosed?
- Digital Rectal Examination
- Raised serum PSA
- TRUS = Transurethral ultrasound-guided biopsy of prostate
What is the treatment for urinary symptoms caused by enlarged prostate?
TURP = Transurethral resection of prostate
How is Prostate cancer classified?
Gleason score
= Tumour growth pattern of biopsy tissue scored 1-6
= 2 most common growth patterns combined to give score out of 10
Where does prostate cancer typically metastasise to?
Bone
Liver
Lung
Adrenal glands
What does PSA stand for?
Prostate Specific Antigen
Name the tumours which release PSA:
- Benign prostatic hyperplasia
- Malignant prostate cancer
What percentage of patients with visible haematuria have a malignancy?
~ 20%
List some causes of haematuria:
- Cancer
- Stones
- Glomerular disease
- Infection
- Benign prostatic hyperplasia
- Inflammation
Name the cancers which commonly cause haematuria:
- Renal carcinoma
- Bladder carcinoma
- Prostate cancer (advanced)
- upper tract Transition Cell Carcinoma (TCC)
What is a varicocele?
Collection of enlarged/dilated veins in the scrotum, usually on left side due to faulty valves.
Is bladder cancer more common in Men or Women?
Men 2:1
Give some risk factors of bladder cancer:
- Chemical exposure (painters/mechanics/hairdressers/printers)
- Smoking (4x)
- Schistosomiasis
What is the typical presentation of a patient with bladder cancer?
- Dysuria
- Pain in lower abdo/back
- Haematuria
- Polyuria
What is the treatment of superficial bladder carcinoma? (75% cases)
TUR - Transurethral resection of tumour
What are the treatment options for bladder cancer?
- TUR (Transurethral resection)
- Intravesical chemotherapy
- Neoadjuvant chemotherapy + Radical cystectomy
- Neoadjuvant chemotherapy + Radiotherapy
What is a radical cystectomy?
Removal of bladder and part of urethra, and associated lymph nodes and organs affected by the cancer
Where does bladder cancer typically metastasise to?
Bone
Liver
Lung
Name the cancer responsible for 95% of upper tract tumours:
Renal cell carcinoma
Is renal cell carcinoma more common in men or women?
Men 3:2
List some risk factors of renal cell carcinoma:
Obesity
Smoking (2x)
Dialysis
Give the 3 modes of metastasis for renal cell carcinoma:
1) Haematogenous
2) Lymphatic
3) Perinephrically
What are the treatment options for Renal Cell Carcinoma?
- Surveillance
- Partial/Radical nephrectomy
- Radiofrequency ablation
- Cryotherapy ablation
- Arterial embolisation
What are the palliative treatment options for renal cell carcinoma?
Monoclonal antibody therapies targeting angiogenesis:
- Sunitib
- Sorafenib
- Pazopanib
Where does Renal Cell Carcinoma typically metastasise to?
Bone
Brain
Liver
Lung
Give some risk factors of upper tract Transitional Cell Carcinoma:
Smoking
Balkan nephropathy
Phenacetin abuse (analgesic)
What is the treatment of upper tract Transition Cell Carcinoma?
Nephro-ureterectomy
= Removal of kidney, surrounding fat, ureter and cuff of bladder
What is a nephro-ureterectomy, and why is it performed?
Removal of kidney, surrounding fat, ureter and cuff of bladder, to improve outlook of patient with upper tract Transitional Cell Carcinoma
