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Y4 Cancer Care > Urological Cancers > Flashcards

Urological Cancers Flashcards

1
Q

What are the risk factors for prostate cancer?

A

Increasing age
Family history
Genetic conditions (BRCA2 mutation)
Black-African ethnicity
Tall stature
Anabolic steroids

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2
Q

What are the presenting features of prostate cancer?

A

Typically asymptomatic
Nocturia, frequency, urgency, hesitancy
Bone pain, cauda equina (advanced disease / mets)
Weight loss
Less common: haematuria, ED

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3
Q

What are some common causes of raised PSA?

A

Prostate cancer
Benign prostate hyperplasia
Prostatitis / urinary infection
Vigorous exercise (inc cycling)
Recent ejaculation

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4
Q

What are the examinations and investigations for suspected prostate cancer?

A

DRE
PSA
Multiparametric MRI prostate (first-line investigation)
Biopsy: transrectal ultrasound scan (TRUS) / transperineal biopsy

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5
Q

What score is used to assess a multiparametric MRI of the prostate in suspected cancer?

A

Likert score
1 - very low suspicion
2 - low suspicion
3 - equivocal
4 - probable cancer
5 - definite cancer

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6
Q

What grading score is used to assess prostate biopsies?

A

Gleeson score (1-normal to 5-most abnormal)

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7
Q

What criteria must be met for a prostate biopsy to be undertaken?

A

Multiparameter MRI Likert score of 3 or more

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8
Q

What are the management options for localised prostate cancer?

A

Curative:
- Active surveillance
- Radical prostatectomy
- Radiotherapy (external beam / brachytherapy)
Palliative:
Deferred hormones (+watchful waiting)

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9
Q

What are the management options for metastatic prostate cancer?

A

Surgical castration (BL orchidopexy)
Medical castration (hormone therapy) e.g. LHRH agonist (bicalutamide) or GnRH agonists (goserelin)
Palliation: single dose RT, zoledronic acid

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10
Q

How should LHRH agonists be used to treat metastatic prostate cancer?

A

First 28 days: in combination with anti-androgen (prevent testosterone flare and exacerbation of spinal mets > compression)
If resistance occurs: add in anti-androgen (= combined androgen blockade)

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11
Q

What are the potential side effects of hormone therapy for the management of prostate cancer?

A

Gynaecomastia
Hot flushes
Osteoporosis
Fatigue
Sexual dysfunction

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12
Q

What is the purpose of zoledronic acid in palliative management of prostate cancer?

A

Combats tumour-induced hypercalcaemia (TIH) and pain from bone mets

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13
Q

What are the potential side effects of radical prostatectomy?

A

ED
UI

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14
Q

Which area of the prostate is prostate cancer most likely to develop?

A

Peripheral zone (75%)

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15
Q

What are the risk factors and epidemiological factors associated with bladder cancer?

A

M:F 3:1
White ethnicity
Smoking
Occupational exposure (arylamines, polyaromatic hydrocarbons)

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16
Q

What job will lead to exposure to arylamines?

A

Plastics / rubber manufacturing

17
Q

What job will lead to exposure to polyaromatic hydrocarbons?

A

Crude oil
Carbon handling
Combustion
Smelting

18
Q

What jobs are associated with bladder cancer?

A

Plastics / rubber
Oil / combustion / smelting
Painters
Hairdressers
Printers
Mechanics

19
Q

What symptoms are associated with bladder cancer?

A

Haematuria

20
Q

What investigations should be completed in suspected bladder cancer?

A

Urinalysis (+ cytology)
Flexible cystoscopy
USS
(+ eGFR, Albumin/creatinine ratio, MSU - Primary care)

21
Q

What management is indicated for non-muscle invasive bladder cancer?

A

TURBT + intravesical mitomycin C

22
Q

What management is indicated for intermediate risk of muscle invasion of bladder cancer?

A

TURBT + intravesical mitomycin C
Intravesical chemotherapy (BCG)

23
Q

What management is indicated for muscle-invasive bladder cancer?

A

Radical cystectomy (ileal conduit) + neoadjuvant chemotherapy
Palliative: chemotherapy / RT

24
Q

What management is indicated for metastatic bladder cancer?

A

Systemic chemotherapy
Biological therapies (Immunotherapy)

25
Q

What is the most common type of bladder cancer?

A

TCC

26
Q

What is the typical presentation of Renal cell carcinoma?

A

Haematuria
Incidental finding on imaging
Palpable mass (rare)

27
Q

What are the risk factors and epidemiological factors associated with RCC?

A

White ethnicities
M:F 3:2
Smoking
Obesity
Dialysis

28
Q

What is indicated for the management of localised RCC?

A

Surveillance
Excision (open / laparoscopic radical / partial nephrectomy)

29
Q

What is indicated for the management of metastatic RCC?

A

Palliative chemotherapy / RT
Biological therapies

30
Q

What is the management of testicular cancer?

A

Inguinal orchidectomy

31
Q

What cytological change is associated with penile cancer?

A

SCC

32
Q

What risk factors are associated with penile cancer?

A

Phimosis
Poor hygiene (smegma)
HPV 16 & 18

Y4 Cancer Care (6 decks)

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