Urology cancers Flashcards
what is the type of majority of kidney cancer?
renal cell carcinoma (adenocarcinoma)
then transitional cell carcinoa
then sarcoma
what are the risk factor for kidney cancer?
- Smoking
- Renal failure
- Dialysis
- Obesity
- Hypertension
- Genetic predisposition- Von Hippel Lindau syndrome (50% individuals will develop RCC)
what are the clinical features of kidney cancer?
- Painless haematuria/persistent microscopic haematuria can is a red flag symptom and can reflect any of these urological malignancies
- Additional Features of RCC include
- Loin pain
- Palpable mass
- Metastatic disease symptoms –bone pain, haemoptysis
what are the investigations for painless visible haematuria?
- Flexible cystoscopy
- CT urogram
- Renal function
what are the investigations for persistent non-visible haematuria
- Flexible cystoscopy
- US Kidneys (KUB)
what are the investigations for suspected kidney cancer?
CT renal triple phase
staging CT chest
bone scan if symptomatic
what is the TNM staging of renal cell carcinoma?
what is the grading of RCC?
what is the management of kidney cancer?
- Patient specific ( depends on the ASA status, comorbidities, classification of lesion)
- Gold standard is excision either via:
- Partial nephrectomy (single kidney, bilateral tumour, multifocal RCC in patients with VHL, T1 tumours (up to 7cm)
- Radical Nephrectomy
- In patients with small tumours unfit for surgery- cryosurgery
- Metastatic disease
- Receptor tyrosine kinase inhibitors
what is the epidemiology of bladder cancer?
11th most common in UK
incidence and mortality declining
what are the types of bladder cancer?
- >90% of bladder cancer is transitional cell carcinoma,
- 1-7% squamous cell carcinoma (75% SCC where schistosomiasis is endemic),
- Adenocarcinoma(2%)
what are the risk factors of bladder cancer?
- Smoking
- Occupational exposure (aromatic hydrocarbons)
- Chromic inflammation of bladder (bladder stones, schistosomiasis, long term catheter)
- Drugs (cyclophosphamide)
- Radiotherapy
what are the clinical feature of bladder cancer?
- Painless haematuria/persistent microscopic haematuria can is a red flag symptom and can reflect any of these urological malignancies
- Additional Features of bladder cancer include
- Suprapubic pain
- Lower urinary tract symptoms
- Metastatic disease symptoms –bone pain, lower limb swelling
what is the staging of bladder cancer?
what is the grading of bladder cancer?
what can be done to determine stage/grade of bladder cancer?
Cystoscopy and transurethral resection of bladder lesion:
- A transurethral resection of bladder lesion uses heat to cut out all visible bladder tumour.
- This provides histology and also can be curative.
- However, if the tumour extends beyond muscle then the resection is incomplete due to the risk of perforating the bladder
what is the management of non-muscle invasive bladder cancer?
if low grade and no CIS then consideration of cystoscopic surveillance +/- intravesicular chemotherapy/BCG
what is the management for muscle-invasive bladder cancer?
cystectomy
radiotherapy
+/- chemotherapy
palliative treatment
what is the epidemiology of prostate cancer?
most common cancer in men in UK
incidence risking but mortality rates declining
what are the types of prostate cancer?
>95% adenocarcinoma
what are the risk factors for prostate cancer?
increasing age
western nations (Scandinavian countries)
ethnicity (African american)
what are the clinical features of prostate cancer?
usually asymptomatic unless metastatic
what are the investigations of prostate cancer?
blood tests
MRI
transperineal prostate biopsy
what are the blood tests for prostate cancer?
- PSA is prostate-specific but not prostate-cancer specific
- Can be elevated (UTI, prostatitis)
