Urological Cancers

Question 1

What are the RF of kidney cancer?
How does kidney cancer present?
What are the red flag symptoms of kidney and bladder cancer?

Answer 1

RF: smoking, obesity, genetics, dialysis, HBP

red flags: painless haematuria, persistent microscopic haematuria
Loin pain
Palpable mass
Bone pain- metastatic symptoms

Question 2

How do we investigate kidney red flag symptoms?
How do we investigate general kidney and bladder cancer?

Answer 2

Painless haematuria: cystoscopy, CT urogram
Persistent microscopic haematuria: cystoscopy, US
ALL PATIENTS SHOULD UNDERGO CYSTOSCOPY AND IMAGING
Renal function tests
Renal CT
Cystoscopy for bladder as CT cannot see it

Question 3

How do we stage kidney cancer?
What is the most common management for kidney cancer?
What if the tumour is too small for surgery?

Answer 3

Furham Grade
Excision via partial or radical nephrectomy
If unfit for surgery, do cryotherapy (freezing the tumour)

Question 4

How does bladder cancer present?

Answer 4

Haematuria
Suprapubic pain
UTI symptoms
Metastasis symptoms

Question 5

How do we stage bladder cancer?
What are the two types of bladder cancer?
How are the two treated?

Answer 5

Non Muscle invasive: Cytoscopy followed via chemo
muscle invasive: cystectomy followed by radio or palliative treatment

Question 6

What is blood test is PSA?
What is the problem with it?
What other imaging can be done to check for prostate cancer?
Should all patients be given this imaging investigation?
What biopsy is done in prostate cancer?

Answer 6

Prostatic specific antigen
Enzyme cancer marker
Not only elevated by cancer can be elevated by trauma so not a direct marker
MRI- YES
Trans perineal prostate biopsy as it has a lower infection rate

Question 7

What are the staging grades for prostate cancer?

Answer 7

Question 8

What is the management for prostate cancer in a young and fit with low grade cancer?
Young and fit with high grade cancer?
Old and unfit with low grade cancer?
Old and unfit with high grade cancer?

Answer 8

1. Surviellance via PSA, MRI and bone
2. Radical prostatectomy and radio
3. Surveillance via PSA
4. Hormone therapy

Question 9

What are the side effects of prostate cancer surgery management?

Answer 9

Can cause erectile dysfunction- damage to cavernous nerve
Incontinence of urine- removal of proximal urethral sphincter
More prone to UTIS