Urinary Cancers Flashcards
What cancers are found in the urinary system?
Renal cell carcinomas,
Transitional cell carcinomas,
Prostate adenocarcinoma.
What type of epithelium do renal cell carcinomas arise from?
As such, where are they found?
Tubular epithelium.
Found in the parenchyma of the kidney.
What are risk factors for renal cell carcinoma?
Age (60-70 years),
Dialysis,
Smoking,
Obesity.
How may renal cell carcinoma present?
Haematuria.
PTH secretion might lead to hypercalcaemia,
Varicoeles may be found.
How are renal cell carcinomas imaged?
Ultrasound or CT,
flexible cystoscopy.
How is renal cell carcinoma treated?
Partial or radical nephrectomy with removal of associated adrenal gland and paraaortic lymph nodes. Unforunately very resistant to chemotherapy and radiotherapy.
Medication can be given palliatively to inhibit angiogenesis.
How does transitional cell carcinoma present?
Haematuria,
Weight loss, loss of appetite,
Symptoms of obstruction.
Where do transitional cell carcinomas most commonly present?
How often he more severe symptoms?
The bladder.
Women.
What risk factors are there for bladder TCC?
analgesic misuse,
Exposure to aniline dyes,
Smoking (greatest risk factor).
How is bladder cancer diagnosed and treated?
Transurethral resection of bladder tumour +- chemoradiotherapy.
If muscle invasive - cystectomy + radiotherapy.
What is intravesical BCG treatment?
Modified BCG vaccine introduced to the bladder to stimulate a host immune response against the cancer
What is seeding?
The increased risk of developing bladder TCC after an uper urinary tract TCC. Treated with nephro-ureterectomy.
What gene mutation is prostate cancer associated with?
Which zone does it commonly occur in?
BRCA1/2
Peripheral zone.
How does prostate cancer typically present?
UTI like symptoms with a hard irregular feeling on digital rectal examination.
What tumour marker can be used to identify prostate cancer?
When may it also be raised?
PSA.
Also raised in infection, inflammation of the prostate and urinary retention.
Where does prostate cancer commonly metastasise to and what does it cause?
Bone - osteosclerotic lesions. Visible on X-ray.
What classification is used to grade prostate cancer?
What is used to stage it?
Gleason classification.
TNM staging.
How is prostate cancer treated?
Surgery, hormone therapy, radiotherapy.
What types of hormonal treatment can be done for those with prostate cancer?
Surgical castration,
Medical castration with LHRH and GnRH agonists (these initially increase testosterone before dramatically decreasing it).
What is poly cystic kidney disease?
Autosomal dominant disease resulting in multiple cysts that develop anywhere in the kidney during childhood. May only become symptomatic in adulthood. Lead to hypertension and CKD.
How might polycystic kidney disease present?
Hypertension,
Acute loin pain,
Haematuria,
Often history of traumatic incident causing rupture eg contact sports.
Where might cysts be found outside of the kidney in PKD?
The liver
What management is there for PKD?
Control of blood pressure with antihypertensives,
Dialysis and renal transplants if CKD develops.
