Urinary tract tumours Flashcards
(25 cards)
What is the presentation of prostate cancer?
Can be asymptomatic.
Painful and slow micturition, retention, haematuria, UTII
What are risk factors for prostate cancer?
> 65, high testosterone levels (e.g. 5 alpha reductase deficiency), family history.
How is prostate cancer diagnosed?
Digital rectal exam: hard, irregular prostate
Bloods: raised PSA levels
US: transrectal ultrasound and biopsy.
How are prostate cancers classified?
Grading: Gleason system (well, mod, or poor differentiation)
Staging: TNM
What is the most common type of prostate cancer?
Primary adenocarcinoma arising in the peripheral prostate.
How is localised prostate cancer treated?
Radiotherapy +/- LNRH analogue.
Prostatectomy/TURP.
How is metastatic prostate cancer treated?
Androgen ablation therapy with LNRH analogue (medical castration)
Orchidectomy (surgical castration)
Chemotherapy.
What are metastatic complications of prostate cancer?
Spinal cord compression: need decompression.
Ureteric complications.
What are the risk factors for bladder cancer?
Age, environmental exposure e.g. rubber, smoking
Chronic inflammation e.g. renal stones, UTI, catheter
Drugs e.g. cyclophosphamide, pioglitazone
What is the presentation of bladder cancer?
Painless frank haematuria
How is bladder cancer diagnosed?
Cystoscopy and biopsy
What is the main type of bladder cancer?
Transitional cell carcinoma.
How is bladder cancer classified?
What should be done in everyone?
Low grade superficial: only in mucosa.
High grade superficial: only in lamina propria.
Muscle invasive
Urgent TURBT and CT for any other involvement.
How is low grade superficial bladder cancer treated?
6 weekly mitomycin treatments
Check flexible cystoscopy every 3 months
How is high grade superficial bladder cancer treated?
6 weekly BCG immunotherapy treatments.
Cystectomy if this fails. May progress to muscle invasive
How is muscle invasive bladder cancer treated?
Cystectomy +/- radiotherapy
How is metastatic bladder cancer treated?
MVAC chemo
Methotrexate, vincristine, doxorubicin, cisplatin.
What are risk factors for renal cell carcinoma?
Male, smoking, obesity, hypertension
renal cystic disease and haemodialysis
What is presentation of RCC?
Haematuria, loin pain, and abdominal mass.
Can also be paraneoplastic syndrome.
What blood changes in RCC?
Increased renin, polycythaemia due to increased EPO
How is RCC diagnosed?
US
How is RCC treated?
Partial nephrectomy or RFA: nephron sparing.
Radical nephrectomy: large mass.
What are risk factors for testicular cancer?
aged 25-40, cryptorchidism, HIV
What is clinical features of testicular cancer?
Painless lump
