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Uro > Urological cancers > Flashcards

Urological cancers Flashcards

1
Q

Types of blood in the urine

A

Microscopic haematuria
Visible haematuria (more serious)

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2
Q

How to analyse urine

A

urine dipstick
microscopy to exclude infections

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3
Q

What are three examples of kidney cancer?

A

85% Renal Cell Carcinoma,
10% Transitional Cell Carcinoma,
5% Sarcoma/other types

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4
Q

What are the risk factors of kidney cancer?

A

Smoking,
Age
hep C
Obesity,
Dialysis,
BP,
Genes

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5
Q

What are the red flag symptoms of kidney cancer?

A

Painless (visible) haematuria // Persistent Microscopic Haematuria

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6
Q

What are the additional features of renal cell carcinoma?

A

Loin pain,
palpable mass,
metastatic symptoms, paraneoplastic symptoms where tumours can release certain hormones. can also result in bone pain

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7
Q

Symptoms of renal cancer

A

Haematuria
back pain
weight loss
loss of appetite
fatigue
fever
anaemia
night sweats

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8
Q

What are the investigations for painless visible haematuria?

A

Flexible cytoscopy, CT urogram

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9
Q

What are the investigations of persistent non-visible haematuria?

A

Flexible Cystoscopy, (not typically used for those under 40)
Ultrasound KUB (with Xray)

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10
Q

What grading can you do for kidney cancer?

A

Fuhrman Grade

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11
Q

Describe the fuhrman grading process

A

Fuhrman Grade: 1-4 (1 - well-differentiated / 4 - poorly differentiated)

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12
Q

What staging can you do for kidney cancer

A

TNM- tumour, node, metastasis

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13
Q

What is the most common management process for kidney cancer?

A

Excision via:
partial nephrectomy - preserve kidney function
radical nephrectomy

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14
Q

What is the management for patients with small tumours unfit for surgery?

A

Cryosurgery (cold probe to freeze and destroy tumour)

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15
Q

What is the management for patients with metastatic disease?

A

Receptor Tyrosine Kinase Inhibitors

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16
Q

What are three examples of bladder cancer?

A

90% Transitional Cell Carcinoma,
8% Squamous Cell Carcinoma, High incidence in areas where schistosomiasis is endemic
2% Adenocarcinoma

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17
Q

What are the risk factors of bladder cancer?

A

Smoking,
Bladder Inflammation,
Chronic infection,
Catheterisation,
Radiotherapy,
Drugs (Cyclophosphamide)

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18
Q

What are the red flag symptoms of bladder cancer?

A

Painless (macroscopic) haematuria
Persistent Microscopic Haematuria

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19
Q

What are the additional features of bladder cancer?

A

Suprapubic pain,
UTI,
metastatic symptoms - bone pain, lower limb swelling

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20
Q

Symptoms of bladder cancer

A

Haematuria
irritative symptoms - dysuria, nocturia
obstructive symptoms

21
Q

What is the classification of bladder cancer?

A

TNM, WHO Classification

22
Q

Investigations for bladder cancer

A

Cystoscopy
Ct urogram

23
Q

WHO classification process

A

G1 - G3 (G1 - well differentiated // G3 - poorly differentiated)

24
Q

What is the problem with CT scans when diagnosing bladder cancer

A

Cannot differentiate between blood clot and tumour
the resolution is poor .: cystoscopy is used

25
Q

How can you remove a visible bladder tumour?

A

Transurethral Resection - uses heat to cut out tumour via cystoscopy

26
Q

What are the two types of bladder cancer?

A

Muscle-invasive // Non muscle-invasive

27
Q

What is the management protocol for non-muscle invasive bladder cancer?

A

Cystoscopy, Intravesicular chemotherapy

28
Q

What is the management protocol for muscle invasive bladder cancer?

A

Cystectomy, Radiotherapy, Palliative treatment

29
Q

Uretic TCC symptoms

A

Obstruction to the bladder
renal issues

30
Q

Main type of prostate cancer

A

Adenocarcinoma

31
Q

Risk factors of prostate cancer

A

age
scandinavian countries
ethnicity - african
family history
obesity
diet

32
Q

What is the chronicity of prostate cancer like?

A

Asymptomatic usually until metastatic

33
Q

What blood test can you do for prostate cancer?

A

PSA (prostatic specific antigen)
age specific ranges as it increases in size with age

34
Q

What is the problem with using PSA?

A

PSA is only prostate-specific (not cancer specific), so elevated in UTI, prostatitis, BPH (benign prostatic hypertrophy)

35
Q

What imaging would you use for prostate cancer investigations?

A

MRI
look at diffusion of contrast to show volume of prostate and highlight focal areas of abnormality

36
Q

What biopsy do you use in prostate cancer investigations?

A

Trans-perineal Prostate Biopsy
- low risk of infection, allows sample of all areas of the prostate

37
Q

Classification of prostate cancer

A

TNM, Gleason Score

38
Q

Describe the gleason score grading process?

A

Gleason Score: 2-6 (well differentiated - bad) // 8 - poorly differentiated

39
Q

Describe the T grades of TNM staging of prostate cancer?

A

T1 - too small to seen on scan, just felt (1a,b,c based on prevalence in tissue) // T2 - inside of prostate gland (2a,b,c - which side of prostate gland or both) // T3 - broken through prostate capsule (3a,b - just capsule or into seminal vesicles) // T4 - spread into nearby organs or pelvis wall

40
Q

Describe the N grades of TNM staging of prostate cancer?

A

N0 - not spread to lymph nodes // N1 - spread to lymph nodes

41
Q

Describe the M grades of TNM staging of prostate cancer?

A

M0 - not spread to other parts of the body // M1 - spread outside pelvis (1a,b,c - lymph, bone)

42
Q

What are the two elements of patient classification that influence management of prostate cancer?

A

Age/Fitness & Grade of Cancer

43
Q

What is the management of a young and fit patient with low grade cancer?

A

Surveillance - PSA, MRI and bone surveillance

44
Q

What is the management of a young and fit patient with high grade cancer?

A

Radical prostatectomy & Radiotherapy

45
Q

What is the management of an old and unfit patient with low grade cancer?

A

Surveillance - regular PSA

46
Q

What is the management of an old and unfit patient with high grade cancer?

A

Hormone Therapy

used for mets/recurrence

47
Q

What are the two structures that can be damaged in prostatectomy?

A

Removal of proximal urethral sphincter - results in shorter urethra (risk of utis, urinary retention)
Damage to cavernous nerves - ED, lower bladder innervation issues

48
Q

Mnemonic for Cancer red flags

A

Fever
Lethargy
Anorexia
Weight loss
Sweats (at night)

Uro (7 decks)

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