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Cancer Care > Urological Malignancy > Flashcards

Urological Malignancy Flashcards

1
Q

Is the incidence of bladder carcinoma increasing or decreasing?

A

Decreasing

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2
Q

Who is more likely to get bladder cancer? Males or females?

A

Males

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3
Q

What ethnicity is at a higher risk of bladder cancer?

A

White

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4
Q

What risk factors are there for bladder cancer?

A 
Smoking- 4* risk
Occupational exposure (up to 20 years latent period):
Rubber or plastics manafacture, handling of carbon, crude oil, combustion, painters, mechanics, printers, hairdressers
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5
Q

What is the histology of bladder cancer?

A

Transitional cell carcinoma

20% are squamous cell carcinoma

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6
Q

What are the risk factors for developing squamous cell carcinoma of the bladder>

A

Long term catheters, recurrent UTIs, bladder stones

Schistosomiasis in endemic areas

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7
Q

What are the treatment options for bladder cancer?

A

Initial assessment- TURBT- transurethral resection, allows assessment of histological type, grade and stage. If tumour is superficial, a single dose of intravesical mytomycin is given

Low risk, non muscle invasive- check cystoscopies
Intermediate/ high risk-intravesicular chemotherapy/ BCG
Muscle invasive- either neoadjuvant chmmo and radical cystectomy with formation of ileal conduit or palliative chemo

Metastatic- palliative systemic chemotherapy or biological therapies- PDL1 inhibitors

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8
Q

What percentage of upper urinary tract tumours does Renal cell carcinoma make up?

A

95%

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9
Q

Is the incidence of renal cell carcinomas increasing or decreasing?

A

Increasing

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10
Q

Who is most likely to get renal cell carcinoma?

A

White males

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11
Q

What are the risk factors for renal cell carcinoma?

A

Heavy smoking, obesity, positive family history

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12
Q

What is the histology of renal cell carcinoma?

A

Its an adenocarcinoma, can be either clear cell- commonest, papillary, chromophobe, collecting duct (Von hippel Lindau) or medullary- sickle cell anaemia

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13
Q

What percentage of patients have mets on presentation with renal cell carcinoma?

A

30%

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14
Q

How does renal cell carcinoma present?

A

Haematuria
Incidental finding
Palpable mass- rare

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15
Q

What are the treatment options for renal cell carcinoma?

A

ablation, surveillance, partial nephrectomy, radical nephrectomy
Tyrosine kinase inhibitors can be given if metastatic

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16
Q

How might upper urinary tract TCC present?

A

Visible haematuria

17
Q

What investigations might be required for upper urinary tract TCC/

A

CT urogram, ureteroscopy +- biopsy

18
Q

What is the standard treatment for upper urinary tract TCC?

A

Small, low grade- laser ablation

Most- nephro ureterectomy- kidney, fat, ureter and cuff of bladder

19
Q

What is the common age range for testicular cancer?

A

15-45

20
Q

What is one of the main risk factors for testicular cancer?

A

Undescended testes

21
Q

What types of testicular cancer are there?

A

Leydig cell tumours - klinefelters syndrome
Germ cell tumours- can be seminoma or teratoma
Lymphoma (older men)

22
Q

How does testicular cancer present?

A

Lump- solid mass, inseperable from testis on clinical examination
Systemic sx if mets

23
Q

How are testicular cancers diagnosed?

A

USS- biopsy if necessary

24
Q

What tumour markers are available for testicular cancer?

A

Alpha fetoprotein- specific to non seminomatous testicular cancer

Beta HCG- raised in NSGCT

LDH- marker of tumour bulk

25
Q

What are the treatment options for testicular cancer?

A

Inguinal orchidectomy
Adjuvant chemo if high volume mets, sometimes use retroperitoneal lymph node dissection for residual NSGCT masses after chemo

Radiotherapy used in seminoma

Sperm banking is offered to all under 55

26
Q

What percentage of penile cancers present under 50 years old?

A

20%

27
Q

What clinical features might lead you to suspect penile cancer>?

A

Persistent lump despite treatment and exclusion of STI

28
Q

What are the risk factors for penile cacner?

A

HPV 16+18 infection

Phimosis, poor hygiene, smegma build up

29
Q

What histological tissue type are penile cancers?

A

Squamous cell carcinoma

30
Q

What is the prognosis for penile cancer?

A

If untreated most die within 2 years. All die within 5.

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