Urological cancers Flashcards
Name some risk factors for kidney cancer.
smoking
obesity
chemotherapy
hypertension
genetics
What type of cancer are the majority of kidney cancers?
renal cell carcinoma (adenocarcinoma)
Apart from renal cell carcinoma (adenocarcinoma), what other types of kidney cancers are there?
transitional cells carcinoma
Sarcoma / Wilms tumour + other types
Name some clinical features of kidney cancer.
painless haematuria (visible or microscopic)
loin pain
palpable mass
metastatic disease symptoms
What are some investigations we can do for painless visible haematuria?
flexible cystoscopy
CT urogram (can’t see bladder very well, so use contract and look at ureters)
renal function (proteinurea, haematuria, urine cytology)
What are some investigations we can do for painless non-visible haematuria?
Flexible cystoscopy
US KUB
What are some investigations we can do for suspected kidney cancer?
CT renal triple phase
staging CT chest
bone scan if symptomatic
Memorise
What is The Fuhrman Nuclear Grade?
a pathology component of renal cell cancers and an independent predictor of cancer-specific survival.
How is the Fuhrman grade scored?
What is the management for kidney cancer?
patient specific
gold standard is excision via:
- partial nephractomy
or
- radical nephrectomy
What is nephron/renal sparing surgery?
in a partial nephrectomy — also called kidney-sparing (nephron-sparing) surgery — the surgeon removes a cancerous tumor or diseased tissue and leaves in as much healthy kidney tissue as possible
What is a partial nephrectomy aka?
kidney/nephron-sparing surgery
How do we manage kidney cancer patients who have small tumours, but are unfit for surgery?
cryosurgery
freeze and follow up w/ regular scans
How can we manage kidney cancer patients with metastatic disease?
receptor tyrosine kinase inhibitors
What is the most common type of bladder cancer?
transitional cell carcinoma
(epithelium)
What type of bladder cancer is very aggressive, but is only about 1-7% of cases?
squamous cell carcinoma
Under what specific circumstance is 75% of squamous cell carcinoma of bladder seen?
where schistosomiasis is endemic
Name the 3 types of bladder cancer.
transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma
Name some clinical features of bladder cancer.
painless haematuria / persistent microscopic haematuria
Suprapubic pain
Lower urinary tract symptoms and UTI
Metastatic disease symptoms
What condition of the kidney can occur in advanced bladder cancer?
hydronephrosis
How should we continue investigations in a bladder cancer that has been proven to invade the muscle?
staging investigations
How does WHO classify bladder cancers?
Describe the TNM staging of bladder cancer.
What procedure can provide histology as well as be curative for a bladder lesion?
Cystoscopy + transurethral resection of bladder lesion
We can divide bladder cancer into non-muscle invasive and muscle invasive.
How do we manage each type?