Week 9 - Malignacys Of The Urinary Tract Flashcards
What are the risk factors for prostate cancer?
Age (most men have enlarged prostate by 80)
Family history (BRCA2 gene mutation)
Ethnicity (black>white>asian)
What are the issues with prostate cancer screening?
Overdiagnisis
Over treatment
Cost effectiveness
What is the clinical presentation of prostate cancer?
Can be asymptomatic
Urinary symptoms
Bone pain (often spreads to bone a lymph)
Sometimes haematuria (rare)
How can prostate cancer be diagnosed?
Digital rectal examination
Serum PSA (prostate specific antigen)
TRUS guided biopsy
Transurethral resections of prostate
What are the stagings of prostate cancer?
T1/2 - localised, T2 starting to feel nodules
T3 - locally advanced, very rough on examination
T4 - advanced, rock hard on examination
What is the treatment for localised prostate cancer?
Surveillance
Robotic radical prostatectomy
Radiotherapy
How is metastatic prostate cancer treated?
Hormone and chemotherapy, surgical or medical castration, palliative care
Describe the bone metastases seen in prostate cancer?
Sclerotic (osteoblastic)
Unlikely if PSA <10 mg/ml
How is locally advanced prostate cancer treated?
Surveillance
Hormones
Radiotherapy
What is haematuria?
Blood in urine
May be visible or non-visible
What may cause haematuria
Cancer Stones Infection Inflammation Nephrological/glomerular problems
If a patient presents with haematuria what investigations might we do?
Blood - FBC, U and E
Ultrasound
Urine culture
Endoscopy
What is the most common type of cancer in the bladder?
Transitional cell carcinoma
What are the risk factors for bladder cancer?
Smoking
Occupational exposure
Schistosomiasis (parasitic worm infection)
What is the staging for bladder cancer?
T1 - epithelium
T2 - subepithelial connective tissue
T3 - muscle
T4 - perivesical fat
