Urological Cancer Flashcards
Most common–> least common
Prostate Renal Testicular Bladder Penile
Renal cell cancer epidemiology
7000 per year
Renal cell cancer RFs
Men>women (1.5x) Smoking (1.4-2.3x) Renal failure + dialysis (x30) Hypertension (1.4-2x) Obesity
Renal cell carcinoma genetic factors
Von Hippel Lindau (VHL) syndrome- around 50% develop RCC
Renal tumours- histological subtypes
Clear cell carcinoma (80%)- VHL mutation seen
Papillary type 1 +2 (10-15%)
Chromophobe (5%)
Rare forms- collecting duct, medullary cell
Renal cell carcinoma presentation
50% no symptoms- incidentally diagnosed
Renal cell carcinoma- symptomatic
Haematuria (50%) Flank pain (40%) Mass (30%) Sign of metastases (25%)- bone pain, anorexia, pyrexia of unknown origin Acute varicocele Lower limb oedema
Renal cell carcinoma- classic triad
Macroscopic haematuria
Palpable mass
Flank pain <10%
Renal cell carcinoma- Investigations
Renal ultrasound CT of abdo with contrast CT chest Bone scan Ultrasound scan renal tract Bloods- FBC/U+E/Calcium/LFT
Renal cell carcinoma management
Localised- radical or partial nephrectomy (open, laparoscopic)
Locally advanced- Radial nephrectomy + adjuvant treatment
Metastatic- Immunotherapy
Renal cell carcinoma prognosis
Depends on staging: -Organ-‐confined T1: 70-‐94% Organ-‐confinedT2: 65-‐75% Locallyadvanced T3: 40-‐70% N1: 40-‐70% Locally advanced T4,N2 or M1:10-‐40%
Bladder cancer- epidemiology
2nd most common urological malignancy
Bladder cancer RFs
Men>women (2.5x)
Increasing age
Smoking (2-5x)
Occupation (rubber/paint and dye manufacture)
Chronic inflammation of bladder mucosa
Schistosomiasis (squamous cell carcinoma)
Malignant bladder tumours
Transitional cell carcinoma- >90%
Squamous cell carcinoma- 1-7%
Adenocarcinoma 2%
Bladder tumour clinical presentation
Painless macroscopic haematuria (85%)- age>50 34% have TCC bladder, age<50 10% have TCC bladder
Microscopic haematuria- age>50 7-13% have TCC, age<50 5% have TCC
LUTS
UTIs
Pain
Lower limb swelling