GU Cancer

Question 1

What is renal cell carcinoma?

Answer 1

PCT epithelium carcinoma
MC renal cancer
Uncommon <40

Question 2

RF?

Answer 2

smoking*
haemodialysis (15% chance)
hereditary
VONHIPPELLINDAN (auto dom, loss of tumour suppressor gene)

Question 3

Sx of vonhippellindan?

Answer 3

RCC (50%) Bilaterally + renal + pancreatic cysts + cerebellum cancers

Question 4

Sx?

Answer 4

often aSx, metastasised cases at Px
Triad = flank pain, haematuria, abdo mass (may have left sided varicocele)

May also have htn - tumour releases renin
anemia - low EPo

Question 5

Dx?

Answer 5

1st line - USS
GS - CT Chest/abdo/pelvis (more sensitive)

Question 6

Staging for RCC?

Answer 6

ROBSON STAGING 1-4

Question 7

Tx for RCC?

Answer 7

Nephrectomy (full/partial if bilateral)
If met = IFN alpha or biologics eg. sunitinib

Question 8

what is wilms tumour?
seen in?

Answer 8

aka nephroblastoma
Renal mesenchymal stem cell tumour
SEEN IN CHILDREN (<3y/o)
Much rarer

Question 9

Bladder cancer
Mc subtype of?
If Px has schistosomiasis, more likely to have what type of carcinoma?

Answer 9

transitional (urothelium) - lines renal pelvis to bladder

squamous cell than transitional

Question 10

What is bladder cancer?

Answer 10

transitional cell carcinoma (TCC) of bladder

Question 11

Bladder cancer RF?

Answer 11

Occupational exposure to dyes/paints/rubber
(painters, hairdresser, mechanic working with tyres)
smoking, chemo/radio therapy, age (mean age at Px=73) + male

Question 12

Sx of bladder cancer?

Answer 12

painless haematuria (macro/microscopic)

Question 13

Dx of bladder cancer?

Answer 13

Flexible cystoscopy + biopsy (GS)

Question 14

Tx of bladder cancer?

Answer 14

Conservative = supportive eg. specialist nurse
medical = chemo/radio
Surgery = TURBT (Transurethral resection of bladder tumour or cystectomy - remove bladder (last resort)

Question 15

What is the MC male malignancy ?

Answer 15

prostate cancer

Question 16

what is prostate cancer?

Answer 16

Outer zone of peripheral prostate (adenocarcinoma) neoplastic, malignant proliferation

Question 17

Rf of Pros cancer?

Answer 17

Genetics - BRCA 12, HOXB13
increased age
afrocarribean ethnicity
fHx

Question 18

Sx of prostate cancer

Answer 18

LUTS (like BPH) But with systemic cancer sx (weight loss, fatigue, night pain) + bone pain

Question 19

Why do u get bone pain in prostate cancer?

Answer 19

typically metastasises to bone (lumbar back pain) - sclerotic lesions

also to liver, lung, brain

Question 20

Dx of prostate cancer?

Answer 20

DRE + PSA in community
transrectal US (+ biopsy) = diagnostic GS

Question 21

What’s the grading system used for prostate cancer?

Answer 21

GLEASON SCORE
higher = worse prognosis - based on biopsy

Question 22

Tx for prostate cancer?

Answer 22

local = prostatectomy
Metastatic = hormone therapy (low testosterone = low cancer growth/even death)
Radio/chemo

Best = Bilateral orchiectomy (both testickles removed)
GnRH receptor agonist eg. Goserelin

Question 23

SE + How GnRH receptor agonist work?

Answer 23

Agnoises GnRH which increases LH + FSH but results in exogenous suppression of the HPG axis

Erectile dysfunction, libido loss

Question 24

This cancer is the most..

Answer 24

hormone sensitive cancer