Urological cancer Flashcards
Bladder, penile, testicular
What’s the most common type of bladder cancer?
Other types?
Transitional cell carcinoma (urothelial)
Adenocarcinoma
Squamous cell
Risk factors for bladder cancer?
Age
Smoking
Male
Exposure to aromatic amines (TCC)
Schistosomiosis (SCC)
Clinical features of bladder cancer?
Often just painless haematuria
Acute urinary retention caused by clots
Suprapubic pain
LUTS
Weight loss
Anaemia
Investigations of bladder cancer?
Bloods
MSU (rule out UTI)
Transurethral flexible cystoscopy with biopsy
Imaging: CT, USS, XR KUB
Management of bladder cancer depends on how advanced it is.
Describe?
Non-invasive (not into muscle):
- transurethral resection of bladder tumour
- Intravesical chemo (mitomycin + BCG)
Locally invasive (into muscle): radical cysto(prostat)ectomy
Locally advanced (into surrounding structures: as above +/- chemo
Metastatic: palliative chemo or radio
What type of cancer is renal cell carcinoma?
Adenocarcinoma of renal cortex
Arising from the proximal convoluted tubule
Risk factors for RCC?
Smoking Obesity Hypertension Polycystic kidney Von Hippel Lindau (defect in tumour suppressor gene)
Presentation of RCC?
Triad of:
Haematuria
Loin pain
Abdominal mass on palpation
Also fatigue, weight loss, PUO, hypertension
Where does RCC spread?
Locally into adjacent structures: liver, spleen, colon, pancreas
Into IVC via renal vein
Lungs
Bones
Investigations of RCC?
Urinalysis
FBC: iron deficiency anaemia or polycythaemia (due to EPO release)
Imaging: CT, MRI, USS
Percutaneous renal biopsy
Look for mets in lungs and bones
Management of RCC?
Surgery +/- chemo and radio
Partial/total nephrectomy
Biologics: angiogenesis targeted agents (sunitinib)
Why could polycythaemia show on bloods of RCC patient?
Sometimes EPO is released as a result of tumour
What type of cancer is penile cancer?
Squamous cell carcinoma
Risk factors for penile cancer?
Elderly
HPV
Phimosis (narrow foreskin)
Poor personal hygiene
Presentation of penile cancer?
Non-healing penile ulcer
Palpable mass
Discharge
Enlarged inguinal lymph nodes
