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Knowledge Rehab > Testicular and Bladder Cancer > Flashcards

Testicular and Bladder Cancer Flashcards

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1
Q

Which of the following is FALSE about testicular cancer?
A. Most common solid tumor in men 20-34 y/o
B. Most are germ cell tumors
C. Cryptorchidism increases risk of testicular cancer
D. Pre-pubertal orchiopexy hasnotshown to decrease risk of cancer

A

D. It does decrease risk

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2
Q

T/F:Seminomasare radiation sensitive.

A

True

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3
Q

T/F: Pure seminomas produce alpha fetoprotein (AFP)

A

False. Theyneverproduce AFP

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4
Q

T/F: Seminomas grow slower than NSGCT

A

True

NSGCT doubling time = 10-30 days

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5
Q

What are the 3 types of the seminomas?

A

Typical (classic) - 85%
Anaplastic - 5-10%
Spermatocytic - 2-12%

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6
Q

What type of seminoma?
Seen in older patients
Favorable prognosis

A

Spermatocytic

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7
Q

What type of seminoma?
Greater metastatic potential
Higher bHCG production

A

Anaplastic

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8
Q

Seminomas produce ____

A

beta-human chorionic gonadotropin (bHCG)

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9
Q

What are the 4 types of NSCGT?

A

Teratoma
Embryonal
Choricarcinoma
Yolk Sac

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10
Q

What type of testicular cancer is NOT chemosensitive?

A

Teratoma (NSGCT)

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11
Q

What kind of testicular cancer spreads hematogenously?

A

Choricarcinoma (NSGCT)

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12
Q

What type of testicular cancer is most common in children?

A

Yolk Sac (NSCGT)

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13
Q

What type of testicular cancer may hemorrhage?

A

Choricarcinoma

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14
Q

Regional spread nodes in what direction?

A

Right to left

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15
Q

Right testis spread to ____

A

interaortocaval area

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16
Q

Left testis spreads to ____

A

para-aortic area

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17
Q

T/F: Patients typically present with painful enlarged testis.

A

False.Painless

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18
Q

Alpha-fetoprotein is produced by (2)

A 
Yolk sac tumors (NSGCT)
Embryonal cancer (NSGCT)
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19
Q

Human chorionic gonadotropin (hCG) produced by (2)

A

Choriocarcinoma

15% of seminoma

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20
Q

Best imaging modality to diagnose testicular cancer

A

Scrotal ultrasound

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21
Q

T/F: Testicular mass biopsy should be performed in order to confirm diagnosis of testicular cancer.

A

False. NEVER perform a testicular mass biopsyAny solid intratesticular mass is neoplastic until proven otherwise

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22
Q

T/F: Advanced testicular cancer has a high mortality rate due to its rapid progression.

23
Q

Radiation is used to treat ____

24
Q

Most serious long term SE of chemotherapy

Study These Flashcards
A

Second malignancy

25
T/F: Retroperitoneal Lymph Node Dissection (RPLND) causes erectile and ejaculatory problems. 
False. No erection problems. Ejaculation problems. 
26
T/F: Retroperitoneal Lymph Node Dissection (RPLND) is an effective treatment of low stage seminoma.
False. Not used b/c seminoma is "sticky" | Low stage seminoma treated w/ adjuvant radiotherapy 
27
High stage seminoma is treated with ____
Cisplatin-based chemotherapy
28
Stage 1 NSGCT treated with ____
Orchiectomy Retroperitoneal Lymph Node Dissection (RPLND) Surveillance Chemotherapy
29
What should you do if tumor markers are still elevated after orchiectomy as treatment for NSGCT?
Sign of distant mestastasis --> treat with chemotherapy
30
High stage NSCGT treated with ____
Chemotherapy Postchemotherapy residual masses treated w/ RPLND  *Teratoma is NOT responsive to chemotherapy
31
T/F: Bladder cancer is predominently in old men. 
True. Peak age 70-80 y/o
32
Which of the following is NOT a risk factor of bladder cancer? A. Smoking B. Rubber, textile, dye exposure C. Being a hair dresser D. Pesticide exposure E. Chronic cystitis (indwelling catheter)  F. Schistosomiasis 
D. Pesticide is NOT a significant risk factor  
33
T/F: Family history is a significant contributor to getting bladder cancer.
False. Only 8% contribution. However RR increases 2x w/ FHx. 
34
Most common histological type of bladder cancer
``` Urothelial carcinoma (95%) Squamous cell carcinoma (5%) ```
35
2004 grading classification of bladder cancer 
PUNLMP = papillary urothelial neoplasm of low malignant potential Low grade High grade 
36
What stage? | Muscle invasive bladder cancer 
T2 = stage of invasion
37
T/F: Stage T3 bladder cancer is treated by resection of the tumor. 
False. T3 has invaded into perivescal fat. Can't resect into the fat.
38
T/F: Stage T4 bladder cancer is treated by resection of the tumor. 
True. T4 = prostatic stromal invasion 
39
Regional lymphatic spread of bladder cancer spreads to _____
pelvic lymph nodes
40
Advanced disease of bladder cancer spreads to the _____ lymph nodes
retroperitoneal 
41
Most common clinical sign of bladder cancer
Intermittent, gross, painless hematuria (80-90% of cases)
42
T/F: AUA guideline requires 2 out of 3 positive dipstick tests for hematuria to diganose asymptomatic microhematuria in association with bladder cancer. 
False. Require only 1 + UA Requring more than 1 lowers cancer detection rate b/c hematuria associated with bladder cancer is highly intermittent.
43
T/F: Patients with bladder cancer have positive PE findings, including palpable bladder/pelvic mass.
False. PE is normal unless in advanced disease
44
T/F: Urine cytology is highly sensitive to detecting bladder cancer.
False. Highly specific (ruling in bladder cancer diagnosis)
45
Best imaging modality for bladder cancer
CT abd/pelvis +/- contrast = CT urogram
46
Alternative imaging modality for patients who can't get contrast due to allergy or azotemia 
Retrograde pyelogram  or MRI
47
T/F: A positive finding on the CT urogram is diagnostic of bladder cancer.
False. All curent imaging studies are inadequate to clear bladder 
48
Gold standard for bladder cancer diagnosis
Cystoscopy (w/ biopsy if necessary)
49
Treatment of primary bladder tumor 
Transurethral resection of bladder tumor (TURBT) Diagnostic and therapeutic modality for superficial disease Visually confirms diagnosis Tissue recovery for histology Ablation of lesion 
50
When should repeat resection be performed prior to additional intravesical therapy? 
patients w/ lamina propria invasion (T1) but without muscularis propria in specimen
51
T/F: An intitial single dose of BCG should be administered immediately postoperatively for bladder cancer according to AUA recommendation.
False. Can’t give BCG immediately postop d/t risk of infection and deathHowever, you should give an initial single dose of intravesical chemotherapy.
52
``` Indications of intravescical therapy for bladder cancer include all of the following EXCEPT: A. Multiple/rapid recurrence B. Carcinoma in situ C. Stage T2 cancer D. High grade disease ```
C. NOT for T2 or greater disease. Grade =/= stage 
53
Preferred treatment for muscle invasive bladder cancer
``` Radical cystectomy (bladder removal) Radical TURBT rarely effective  ```

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