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BRS Y2 > Urological Cancers > Flashcards

Urological Cancers Flashcards

1
Q

What is the trend in incidence and mortality for kidney cancer?

A

Both incidence and mortality are increasing

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2
Q

What is the most common type of kidney cancer?

A

Renal cell carcinoma

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3
Q

What are some aetiological risk factors for kidney disease?

A

Smokers
Overweight
Hypertension
Genetic risk factors

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4
Q

What is a red flag for kidney cancer?

A

Painless/microscopic/persistent haematuria

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5
Q

What are some clinical features of kidney cancer?

A

Haematuria
Loin pain
Palpable mass
If metastases are presetn bone pain, haemoptysis

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6
Q

What are the investigations for painless visible haematuria?

A

Flexible cystoscopy
CT urogram
Renal function

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7
Q

What are the investigations for non visible haematuria?

A

Flexible cystoscopy

US KUB

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8
Q

What are the investigations for suspected kidney cancer?

A

CT renal triple phase
Staging CT chest
Bone scan if symptomatic

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9
Q

Describe T1-T4 for renal cell carcinoma

A 
T1= tumor less than 7cm
T2= tumor greater than 7cm
T3= Extends outside kidney but not beyond ipsilateral adrenal or perinephric fascia
T4= Tumour beyond perinephric fascia into surrounding structures
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10
Q

Describe N1-N2 for renal cell carcinoma

A 
N1= met in single regional LN
N2= met in more than 2 regional LN
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11
Q

What does M1 signify in renal cell carcinoma

A

Distant metastases

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12
Q

How does Fuhrman’s grade for kidney cancer work?

A

1 = well differentiated
2 = moderate differentiated
3 + 4 = poorly differentiated

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13
Q

What is gold standard treatment for renal cell carcinoma?

A

Excision via partial nephrectomy or radical nephrectomy

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14
Q

What is treatment for patients with small kidney tumors who aren’t fit for surgery?

A

Cryosurgery

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15
Q

What is treatment for patients with metastatic kidney cancer?

A

Receptor tyrosine kinase inhibitors

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16
Q

What is the most common type of bladder cancer?

A

Transitional cell carcinoma

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17
Q

What is a red flag for bladder cancer?

A

Painless/microscopic/persistent haematuria

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18
Q

What are clinical features of bladder cancer?

A

Haematuria
Suprapubic pain
Lower urinary tract symptoms
Metastatic disease symptoms –bone pain, lower limb swelling

19
Q

Describe Ta-T4 for bladder cancer

A

Ta – non invasive papillary carcinoma
Tis – carcinoma in situ
T1 – invades subepithelial connective tissue
T2 – invades muscularis propria
T3 – invades perivesical fat
T4 – prostate, uterus, vagina, bowel, pelvic or abdominal wall

20
Q

Describe N1-N3 for bladder cancer

A

N1 – 1 LN below common iliac birufication
N2 - >1 LN below common iliac birufication
N3 – Mets in a common iliac LN

21
Q

What does M1 mean for bladder cancer

A

Distant mets are present

22
Q

Describe the WHO classification for bladder cancer

A 
G1 = well differentiated
G2 = moderate differentiated
G3 = poorly differentiated
23
Q

How are bladder tumors resected?

A

A transurethral resection of bladder lesion uses heat to cut out all visible bladder tumour.
This provides histology and also can be curative.

24
Q

How is non muscle invasive bladder cancer treated?

A

If low grade and no CIS then consideration of cystoscopic surveillance +/- intravesicular chemotherapy/BCG

25
Q

How is muscle invasive bladder cancer treated?

A

Cystectomy
Radiotherapy
+/- chemotherapy
Palliative treatment

26
Q

What is the most common type of prostate cancer?

A

Adenocarcinoma

27
Q

What are risk factors for prostate cancer?

A

Increasing age
Western nations(Scandinavian countries)
Ethnicity(African Americans)

28
Q

What are clinical features of prostate cancer?

A

Usually asymptomatic unless metastatic

29
Q

What blood test is done to investigate prostate cancer? Describe what it indicates

A

PSA is prostate-specific but no prostate-cancer specific, can be elevated in UTI, prostatitis etc

30
Q

How is prostate cancer managed?

A

Imaging prior to biopsy testing via MRI

31
Q

What is the type of biopsy method used for prostate investigation?

A

Trans perineal prostate biopsy

32
Q

Describe what T1-T4 means in prostate cancer staging?

A

T1 – non palpable or visible on imaging
T2 – palpable tumour
T3 – beyond prostatic capsule into periprostatic fat
T4 – tumour fixed onto adjacent structure/pelvic side wall

33
Q

Describe what N1 means in prostate cancer staging

A

Regional LN in pelvis

34
Q

Describe what M1a-M1x means in bladder cancer staging

A

M1a- non regional LN
M1b- bone
M1x- other sites

35
Q

What is the Gleason score in bladder cancer staging? Describe what it means

A

Since the cancer is multifocal two scores based on level of differentiation can be used
2-6 = Well differentiated
7 = Moderately differentiated
8 – Poorly differentiated (as number gets higher cancer is worse)

36
Q

How is prostate cancer treated if the patient is young and fit and has a high grade cancer?

A

Radical prostatectomy/Radiotherapy

37
Q

How is prostate cancer treated if the patient is young and fit and has a low grade cancer?

A

Active surveillance ( Regular PSA, MRI and Bx)

38
Q

What must be done post prostatectomy?

A

Monitor PSA

39
Q

What should PSA be post prostatectomy? What value indicates relapse?

A

Should be undetectable or <0.01ng/ml).

If >0.2ng/ml then relapse

40
Q

How is prostate cancer treated if the patient is old and unfit and has a high grade cancer/ met disease?

A

Hormone therapy

41
Q

How is prostate cancer treated if the patient is old and unfit and has a low grade cancer?

A

Watchful waiting with regular PSA testing

42
Q

What are side effects of treatment for prostate cancer?

A

Prostatectomy removes the proximal urethral sphincter and changes urethral length.
Risk of damage to cavernous nerves (innervation to bladder and urethra
causes erectile dysfunction

43
Q

What must be done if there is haematuria and why?

A

Cystoscopy and imaging

BRS Y2 (85 decks)

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