urological malignancies Flashcards
investigations of visible haematuria
2ww pathway
Hx, examination, FBC, Us+Es
urine dip
USS
flexible / ridgid (if current visible haematuria)
CT urogram
most common type of RCC and associated condition
clear cell
von hipple lindau
risk factors for renal cell carcinoma
smoking
obesity
HTN
end stage renal failure
paraneoplastic syndromes which may arise from renal cell carcinoma
polycythaemia (increased EPO)
hypercalcaemia (ectopic PTH)
HTN (increased renin and RBCs)
stauffers syndrome (abnormal LFTs w/out liver mets)
investigations for RCC
USS initially
CT w/contrast for staging
biopsy (if non cystic changes)
management for RCC
partial/ radical nephrectomy
+/- chemo therapy
for unsuitable surgical candidates:
watch and wait, artery embolisation, cyrotherapy, ablation
most common form of bladder cancer and RFxs
TCC : smoking, aromatic dyes
SCC less common: schistosomiasis, long term catheter, recurrent UTI, bladder stones
most common sign of bladder cancer
painless haematuria
initial management of bladder cancer
TURBT, also aids in assessment of how invasive disease is
management of superficial bladder cancer
TURBT
intravesical mitomycin
followed by either surveillance or repeat
BCG regime (reduces progression
management of muscle invasive bladder cancer
neo adjuvant chemo therapy
radical cystectomy and lymph node dissection
+/- chemo/radio
mets - pallative
what are the options for urinary outlet following cystectomy
urostomy / ileal conduit
continent urinary diversion (with intermittent self catheterisation)
neobladder reconstruction
what is a complication to be aware of in those with reconstructed urinary outlets
hyperchloremic metabolic acidosis
bowel may absorb chloride
managed with fluid resus and catheter
what type of cancer is prostate cancer
adenocarcinoma
RFxs for prostate cancer
age >70
FHx
genetics (BRCA1, HPC1)
ethnicity
