💧Urology💧- Urological Cancers Flashcards
What are the types of kidney cancer?
Adenocarcinoma (85%)
Transitional cell carcinoma (10%)
Other types (5%)
What are the risk factors for kidney cancer?
Smoking
Renal failure and subsequent dialysis
Obesity
Hypertension
Genetic predisposition with Von Hippel-Lindau syndrome (50% of individuals will develop RCC)
What is a red flag symptom for kidney cancer (and any urological cancer)?
Painless haematuria/persistent microscopic haematuria
What is RCC?
Renal cell carcinoma
Apart from haematuria, what are the other clinical features of RCC?
Loin pain
Palpable mass
Metastatic disease symptoms - bone pain, haemoptysis
What are the main types of RCC?
Clear cell - 75%
Papillary - 15%
Chromophobe - 5%
What are the general symptoms of renal cancer?
Haematuria
Back pain that doesn’t go away
Unexplained weight loss/loss of appetite
Fatigue
Intermittent fever
Lump on side, belly or lower back
Anaemic
Hyperkalaemia
Hypertension
What are the investigations with painless visible haematuria?
Flexible cystoscopy
CT urogram
Renal function
What are the investigations with persistent non-visible haematuria?
Flexible cystoscopy
US KUB (kidney, ureter and bladder ultrasound)
What are the kidney cancer investigations in a patient with strongly suspected kidney cancer?
CT renal triple phase
Staging CT chest
Bone scan if symptomatic
What are the stages of kidney cancer?
What is the ideal management option for kidney cancer?
Excision via:
Partial nephrectomy (T1 tumours)
Radical nephrectomy
What are the types of bladder cancer?
Transitional cell carcinoma (>90%)
Squamous cell carcinoma (1-7%)
Adenocarcinoma (2%)
What are the risk factors for bladder cancer?
Smoking
Occupational exposure (aromatic hydrocarbons)
Chronic inflammation of bladder (bladder stones, schistosomiasis, long term catheter)
Drugs (cyclophosphamide)
Radiotherapy
What is the management for kidney cancer which has progressed to metastatic disease?
Receptor tyrosine kinase inhibitors
Immunotherapy
What is the management for patients with small kidney tumours who are unfit for surgery?
Cryosurgery