Urological Cancerous

Question 1

What types of cancer are there ?

Answer 1

Renal cell carcinoma
Transitional cell carcinoma

Question 2

What are the clinical features of kidney cancer

Answer 2

Painless haematuria / persistent microscopic haematuria is a red flag symptom and can reflect urological malignancies

Question 3

What are the features of RCC?

Answer 3

Loin pain
Palpable mass
Metastatic disease symptoms - bone pain, haemoptysis

Question 4

What are the investigations I f you have painless visible haematuria?

Answer 4

Flexible cystoscopy (to look into the bladder)
CT urogram
Renal function

Question 5

What are the investigations for persistent non visible haematuria

Answer 5

Flexible cystoscopy
US KUB

Question 6

What are the investigations for suspected kidney cancer

Answer 6

CT renal triple phase
staging CT chest
bone scan if symptomatic

Question 7

What are the TNM staging of RCC

Question 8

What is the Furhman Grade for kidney cancer

Question 9

What is the management for kidney cancer

Question 10

What are types of bladder cancer

Answer 10

Transitional cell carcinoma
Squamous cell carcinoma
Adenocarcinoma

Question 11

What is the aetiology for bladder cancer*

Answer 11

Smoking

Question 12

What is the aetiology for kidney cancer*

Question 13

What are the clinical features for bladder cancer

Answer 13

Painless haematuria/persistent microscopic haematuria can is a red flag symptom and can reflect any of these urological malignancies

Additional Features of bladder cancer include
Suprapubic pain
Lower urinary tract symptoms and UTI
Metastatic disease symptoms –bone pain, lower limb swelling

Question 14

What are investigations for painless visible haematuria

Answer 14

Flexible cystoscopy
CT urogram
Renal function

Question 15

What are the investigations for persistent microscopic haematuria

Answer 15

Flexible cystoscopy
US KUB

Question 16

What do you do if biopsy proves muscle invasive

Answer 16

Staging investigations

Question 17

How does the TNM staging work for bladder cancer

Question 18

What is the WHO classification for bladder cancer when grading

Question 19

How does a transurethral resection of bladder lesion work and what does it show*

Answer 19

A transurethral resection of bladder lesion uses heat to cut out all visible bladder tumour.

This provides histology and also can be curative.

Question 20

What does the management protocol for bladder cancer depend on?

Answer 20

Whether it is muscle invasive or non muscle invasive

Question 21

What is the management protocol for non muscle invasive

Answer 21

• If low grade and no CIS then consideration of cystoscopic surveillance +/- intravesicular chemotherapy/BCG

Question 22

What is the management for invasive muscle bladder cancer

Answer 22

Cystectomy
Radiotherapy
+/- chemotherapy
Palliative treatment

Question 23

What are the types of prostate cancer

Answer 23

Mostly adenocarcinoma

Question 24

What is the aetiology for prostate cancer

Answer 24

Increasing age
Western nations(Scandinavian countries), Ethnicity(African Americans)
Family genetics

Question 25

What are screening tests for prostate cancer

Answer 25

Blood tests for Prostatic Specific Antigen Increase - could happen due to infection / cancer / enlarged / prostatitis / Benign prostatic hyperplasia Prostate examination

Question 26

MRI*

Question 27

Trans perineal prostate biopsy:*

Question 28

What is the TNM staging for prostate cancer

Question 29

What is the Gleason score for grading prostate cancer(

Question 30

What does the management of prostate cancer depend on

Question 31

What are the side effects for treatment of prostate cancer

Answer 31

The prostate contains the proximal sphincter Prostatectomy removes the proximal urethral sphincter and changes urethral length. Risk of damage to cavernous nerves ( innervation to bladder and urethra)(7) Damage to cavernous nerves causes ED Urinary incontinence

Question 32

What is the management of stage 1 testicular cancer ?

Question 33

What is the WHO classification of testicular tumours

Question 34

What do you if someone presents with testicular cancer

Answer 34

History - breast enlargement/ weight loss/ history of undescended testicles/ surgery / fertility issues Examine

Question 35

What tests do you do for testicular cancer*

Answer 35

Serum tumour markers: - e.g. Alpha fetoprotein Ultrasound of testicle to see if there is a mass / inflammation

Question 36

How to treat testicular cancer

Question 37

What is the prognosis for testicular cancer