UROLOGIC CANCER- RCC, Bladder, Prostate, Testicular, Penile

Question 1

RCC
- mc in?
- RFs
- triad Sx

Answer 1

• mc kidney cancer in adults
• RFs: smoking, obesity, HTN
• triad Sx: hematuria, flank pain, palpable mass

Question 2

von hippel lindau syndrome

Answer 2

inherited genetic mutation that inc risk of developing benign and malignant tumors in diff parts of the body

Question 3

RCC
- other signs
- imaging
- tx

Answer 3

other signs
- paraneoplastic syndromes (ex: polycythemia, hypercalcemia)

imaging
- CT abdomen

tx
- localized: partial or radical nephrectomy
- advanced: immunotherapy (checkpoint inhibitors), targetered therapy (TKIs)

Question 4

bladder cancer
- mc type
- RFs

Answer 4

MC type
- urothelial carcinoma (transitional cell)

RFs
- SMOKING
- exposure to aniline dyes
- chronic catheter use

Question 5

bladder cancer
- Sx
- Dx
- Tx (non invasive v. invasive)

Answer 5

Sx
- painless, gross hematuria

Dx
- urinalysis–> cytology
- cystoscopy + biopsy

tx
- non muscle invasive: TURBT (transurethral resection) + intravesical BCG
- muscle invasive: cystectomy, chemo, or radiation

Question 6

prostate cancer
- RFs
- screening
- dx

Answer 6

MC cancer in men (often slow growing)

RFs
- age, FHx, african ancestry

Screening
- PSA+ digital rectal exam (DRE)

Dx
- elevated PSA—> MRI—> Bx (transrectal or transperineal)

Question 7

prostate cancer
- tx (low v. high risk)
- metastatic ds tx

Answer 7

tx
- low risk: active surveillance
- high risk: radical prostatectomy, radiation, ADT (androgen deprivation therapy)

metastatic ds tx
- bone mets common —> tx w/ ADT + new hormonal agents or chemo

Question 8

testicular cancer
- mc age group
- types
- sx

Answer 8

age: mc cancer in men age 15-35

types
- germ cell tumors (seminomas v. non-seminomas)

Sx
- painless testicular mass

Question 9

testicular cancer
- tumor markers
- imaging
- tx

Answer 9

tumor markers
- AFP, Beta HCG, LDH (for non-seminomatous)

imaging
- scrotal US

tx
- radical inguinal orchiectomy (NEVER Bx)
- +/- chemo/rad depend on type/stage

Question 10

penile cancer
- patho
- RFs

Answer 10

• rare, usually squamous cell carcinoma
• RFs: uncircumcised, HPV infx, poor hygiene

Question 11

penile cancer
- presentation
- tx

Answer 11

• presentation: lesion or ulcer on glans or foreskin
• tx: local excision, partial/total penectomy, LN dissection