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Renal and GU > Genitourinary Neoplasms > Flashcards

Genitourinary Neoplasms Flashcards

1
Q

What is the peak age of incidence for renal cell carcinoma?

A

55 y.o. (50-70 years)

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2
Q

What are the risk factors of renal cell carcinoma?

A

Cigarette Smoking**
Obesity
Hypertension
Dialysis related acquired cysts
Several autosomal dominant familial causes

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3
Q

What type of cancer is renal cell carcinoma?

A

Adenocarcinoma

Other less common types: clear cell, papillary, chromophobe

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4
Q

Although RCC doesn’t typically metastasis, when it does what is the more common location?

A

Lungs

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5
Q

About 15% of patients with RCC will have this triad of presenting symptoms?

A

Hematuria
Flank or abdominal pain
Flank or abdominal mass

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6
Q

True or False: Any solid renal masses should be considered malignant until proven otherwise

A

True

*Why biopsies are rare

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7
Q

Are biopsies typically done to diagnose RCC?

A

No not commonly performed in practice although considered to be the gold standard. There are no tumor markers specific for RCC and the risk of seeding is too great

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8
Q

What is the standard workup for RCC?

A
  • CT of abdomen/pelvis or MRI
  • CXR (unless mets are suspected then do a CT)
  • Urinanlysis
  • Urine cytology
  • Labs: CBC, BMP, LFT’s
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9
Q

What is the treatment for localized RCC?

A
  • Radical or partial nephrectomy
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10
Q

What is the treatment for metastatic disease?

A

Surgery and chemo have a limited role in the treatment

Radiation for palliation of bone or brain metastases

Palliative care

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11
Q

What are the risk factors for bladder cancer?

A
  • Smoking
  • Occupational exposure to chemicals (hairdressers, workers with rubber, dye, leather etc.)
  • Arsenic in well water in New England
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12
Q

What is the most common presenting symptom with bladder carcinoma?

A

Gross or microscopic hematuria

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13
Q

What is the test of choice for working up bladder carcinoma?

A

Cystoscopy (+/- biopsy of any tumors seen)

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14
Q

Due to the high reoccurrence rate of bladder cancer what is the follow-up cytoscopy schedule after cessation of treatment?

A
  • Every 3 months for one year
  • Then every 6 months x1 year
  • Then annually thereafter
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15
Q

What is the first line treatment for bladder carcinoma in situ and large high grade, recurrent Ta or T1 masses?

A

Bacille Calmette-Guerin (attenuated strain of mycobacterium bovis) given weekly for 6-12 weeks

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16
Q

What are the risk factors for prostate cancer?

A
  • African American
  • Age
  • Fhx
    • FH of breast, ovarian cancer
  • High fat diet
  • Perhaps environmental carcinogenic influences
17
Q

Does early prostate cancer typically present with symptoms?

A

No, usually identified via PSA screening

18
Q

Is BPH a risk factor for prostate cancer?

A

No, but it does cause elevated PSA levels on screening which then leads to biopsy for cancer

19
Q

With metastasis present in prostate cancer what are some of the presenting symptoms?

A
  • Weight loss
  • Anemia
  • Bone pain (commonly the lumbosacral area)
  • Acute neurologic deficit in the lower limbs
  • Urinary retention
20
Q

What is the way to definitively diagnose prostate cancer?

A

Transrectal ultrasound-guided biopsy

21
Q

What is the treatment of localized prostate cancer?

A

Radical prostatectomy + radiation therapy

or Surgery open, lap or robotic

22
Q

What is the most common cancer in men age 20 to 35?

A

Testicular cancer

23
Q

What is the average age of testicular cancer?

A

33

24
Q

What are the two classifications of testicular cancer?

A

Seminomas and non-seminomas

25
Q

What are the types of non-seminoma testicular cancer?

A
  • Embryonic cell carcinoma
  • Teratoma
  • Choriocarcinoma
  • Mixed cell type (m/c)
26
Q

What is the most common testicular cancer in kids?

A

Yolk sac (responds to chemo)

27
Q

What is secreted by seminomas?

A

HCG

28
Q

Are mets common at presentation with testicular cancer?

A

Yes, 50% of patients will have metastases when first evaluated

29
Q

What is the most common presenting symptom of testicular cancer?

A

Painless mass or diffuse enlargement of the testicle

30
Q

What sites are lymphadenopathy common in testicular cancer?

A

Supraclavicular or inguinal

31
Q

What are some symptoms with advanced testicular cancer?

A
  • Palpable retroperitoneal or supraclavicular nodes, particulary on the left side
  • Cough, SOB, hemoptysis of lung mets
  • LE edema from vena caval obstruction
  • Back pain from retroperitoneal mets
32
Q

What labs should be ordered in working up testicular cancer?

A
  • Alpha-fetoprotein (AFP)
  • hCG (not normally detectable in men)
  • Lactate dehydrogenase (LDH)
33
Q

What lab level maybe slightly elevated in those who use mariguana heavily?

A

hCG

34
Q

What is the imaging modality of choice in working up testicular cancer?

A

Scrotal ultrasound

35
Q

What is the gold standard treatment of testicular cancer?

A

Inguinal Orchiectomy

36
Q

Is testicular associated with a high rate of recurrence?

A

Yes, recurrence in 20-30% of pats on active surveillance (usually w/in first 2 years)

37
Q

What are some risk factors for penile cancer?

A
  • Lack of circumcision
  • HPV
  • HIV
  • Poor hygiene
  • Number of sexual partners
  • Smoking
  • Increased age
38
Q

What are some of the presenting symptoms of penile cancer?

A
  • Lesion
  • Pain
  • Discharge
  • Irritative voiding symptoms
  • Bleeding
  • Enlarged, palpable inguinal lymph nodes

Renal and GU (14 decks)

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