Urological cancers Flashcards
Prostate cancer: assessment
a) Consider a PSA blood test and DRE to assess for prostate cancer in men with…
- LUTS (storage and voiding), such as nocturia, urinary frequency, hesitancy, urgency or retention
- Erectile dysfunction
- Visible haematuria
Prostate cancer: referral
a) 2-week wait criteria
b) PSA - what can cause falsely low reading?
c) PSA - what can cause falsely high reading?
a) Prostate feels malignant on DRE; PSA levels are above the age-specific reference range (highest normal value is generally 4, but referral can be made at lower levels for younger men)
b) 5-ARIs (finasteride) or alpha-blockers (tamsulosin)
c) Catheter, BPH, prostatitis
Prostate cancer: tertiary investigations
?
Prostate cancer: management
?
Gleason score
Haematuria: two-week referral (bladder/renal/other Ca)
a) Aged over 45, with…?
b) Aged 60 and over with…?
c) Non-urgent (standard) referral for…?
a) Unexplained visible haematuria without UTI or,
Visible haematuria that persists or recurs after successful treatment of UTI
b) Unexplained non-visible haematuria, plus either… dysuria OR a raised white cell count on a blood test.
c) Aged 60 and over with recurrent or persistent unexplained UTI
Bladder cancer: investigations
Cystoscopy?
Bladder cancer: management
?
Testicular cancer: referral
a) Men with non-painful enlargement or change in shape or texture of the testis
Testicular cancer: investigations
?
Testicular cancer: management
?
Penile cancer: two-week referral
a) Regional centre
b) Referral criteria
a) Leeds?
b) A penile mass or ulcerated lesion, where STI has been excluded as a cause, or a persistent penile lesion after treatment for an STI has been completed.
Renal cancer.
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