Urological Cancers

Question 1

types of kidney cancer

Answer 1

renal cell carcinoma
transitional cell carcinoma
sarcoma/Wills tumour/other types

Question 2

clinical features of kidney cancer

Answer 2

haematuria (visible painless or persistent microscopic)
loin pain
palpable mass
metastatic disease symptoms - bone pain, haemoptysis

Question 3

investigations for painless visible haematuria

Answer 3

flexible cystoscopy
CT urogram
renal function

Question 4

investigations for persistent non visible haematuria

Answer 4

flexible cystoscopy

US KUB

Question 5

investigations for suspected kidney cancer

Answer 5

CT renal triple phase
staging CT chest
bone scan if symptomatic

Question 6

staging and grading of kidney cancer

Answer 6

TNM staging

Funhrman grade

Question 7

kidney cancer management

Answer 7

patient specific: comorbidities, classification of lesion

gold standard is excision via partial or radical nephrectomy

Question 8

kidney cancer management in patients with small tumours unfit for surgery

Answer 8

cryosurgery

Question 9

kidney cancer management in metastatic disease

Answer 9

receptor tyrosine kinase inhibitors

Question 10

types of bladder cancer

Answer 10

transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma

Question 11

risk factors for bladder cancer

Answer 11

smoking
radiotherapy
chronic inflammation
occupational exposure

Question 12

risk factors for kidney cancer

Answer 12

smoking
obesity
genetic risk
hypertension
previous kidney issues

Question 13

staging and grading of bladder cancer

Answer 13

TNM

WHO classification

Question 14

types of prostate cancer

Answer 14

adenocarcinoma

Question 15

risk factors for prostate cancer

Answer 15

increasing age
Western nations (scandinavia)
ethnicity (African)

Question 16

clinical features of prostate cancer

Answer 16

usually asymptomatic unless metastatic

Question 17

investigations for prostate cancer

Answer 17

blood test - PSA
MRI
trans perineal prostate biopsy

Question 18

PSA levels are not prostate cancer specific, can also be elevated in?

Answer 18

UTI
prostatitis
BPH

Question 19

staging and grading of prostate cancer

Answer 19

TNM

Gleason score

Question 20

management of prostate cancer

Answer 20

young + fit > high grade > radical prostatectomy/radio
> low grade > active surveillance

old/unfit > high grade > hormone therapy
> low grade > watchful waiting

Question 21

at what PSA level is relapse determined post prostatectomy?

Answer 21

> 0.2ng/ml

Question 22

side effects from prostate cancer management: surgery

what is the reason for them?

Answer 22

removal of proximal sphincter > incontinence

risk of damage to cavernous nerves > erectile dysfunction

Question 23

side effects from prostate cancer management: hormone therapy

Answer 23

gynecomastia

Question 24

what is the main red flag symptom for urological malignancy?

Answer 24

painless visible haematuria

Question 25

investigation for painless visible haematuria for bladder cancer

Answer 25

flexible cystoscopy CT urogram renal function

Question 26

investigation for persistent microscopic haematuria for bladder cancer

Answer 26

flexible cystoscopy | US KUB

Question 27

biopsy for bladder cancer is used to determine?

Answer 27

shows if the cancer is muscle invasive or non muscle invasive > this helps to determine management

Question 28

transurethral resection of bladder lesion

Answer 28

uses heat to cut out all visible bladder tumour > provides histology + can be curative

Question 29

Fuhrman grade

Answer 29

1 = well differentiated 2 = moderate differentiated 3 + 4 = poorly differentiated

Question 30

Gleason score

Answer 30

Since multifocal two scores based on level of differentiation 2-6 = Well differentiated 7 = Moderately differentiated 8 – Poorly differentiated

Question 31

WHO classification

Answer 31

``` G1 = well differentiated G2 = moderate differentiated G3 = poorly differentiated ```