Urological Cancers Flashcards
types of kidney cancer
renal cell carcinoma
transitional cell carcinoma
sarcoma/Wills tumour/other types
clinical features of kidney cancer
haematuria (visible painless or persistent microscopic)
loin pain
palpable mass
metastatic disease symptoms - bone pain, haemoptysis
investigations for painless visible haematuria
flexible cystoscopy
CT urogram
renal function
investigations for persistent non visible haematuria
flexible cystoscopy
US KUB
investigations for suspected kidney cancer
CT renal triple phase
staging CT chest
bone scan if symptomatic
staging and grading of kidney cancer
TNM staging
Funhrman grade
kidney cancer management
patient specific: comorbidities, classification of lesion
gold standard is excision via partial or radical nephrectomy
kidney cancer management in patients with small tumours unfit for surgery
cryosurgery
kidney cancer management in metastatic disease
receptor tyrosine kinase inhibitors
types of bladder cancer
transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma
risk factors for bladder cancer
smoking
radiotherapy
chronic inflammation
occupational exposure
risk factors for kidney cancer
smoking obesity genetic risk hypertension previous kidney issues
staging and grading of bladder cancer
TNM
WHO classification
types of prostate cancer
adenocarcinoma
risk factors for prostate cancer
increasing age
Western nations (scandinavia)
ethnicity (African)
clinical features of prostate cancer
usually asymptomatic unless metastatic
investigations for prostate cancer
blood test - PSA
MRI
trans perineal prostate biopsy
PSA levels are not prostate cancer specific, can also be elevated in?
UTI
prostatitis
BPH
staging and grading of prostate cancer
TNM
Gleason score
management of prostate cancer
young + fit > high grade > radical prostatectomy/radio
> low grade > active surveillance
old/unfit > high grade > hormone therapy
> low grade > watchful waiting
at what PSA level is relapse determined post prostatectomy?
> 0.2ng/ml
side effects from prostate cancer management: surgery
what is the reason for them?
removal of proximal sphincter > incontinence
risk of damage to cavernous nerves > erectile dysfunction
side effects from prostate cancer management: hormone therapy
gynecomastia
what is the main red flag symptom for urological malignancy?
painless visible haematuria
investigation for painless visible haematuria for bladder cancer
flexible cystoscopy
CT urogram
renal function
investigation for persistent microscopic haematuria for bladder cancer
flexible cystoscopy
US KUB
biopsy for bladder cancer is used to determine?
shows if the cancer is muscle invasive or non muscle invasive > this helps to determine management
transurethral resection of bladder lesion
uses heat to cut out all visible bladder tumour > provides histology + can be curative
Fuhrman grade
1 = well differentiated
2 = moderate differentiated
3 + 4 = poorly differentiated
Gleason score
Since multifocal two scores based on level of differentiation
2-6 = Well differentiated
7 = Moderately differentiated
8 – Poorly differentiated
WHO classification
G1 = well differentiated G2 = moderate differentiated G3 = poorly differentiated
