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BRS Y2 > Urological Cancers > Flashcards

Urological Cancers Flashcards

(43 cards)

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1
Q

What is the trend in incidence and mortality for kidney cancer?

A

Both incidence and mortality are increasing

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2
Q

What is the most common type of kidney cancer?

A

Renal cell carcinoma

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3
Q

What are some aetiological risk factors for kidney disease?

A

Smokers
Overweight
Hypertension
Genetic risk factors

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4
Q

What is a red flag for kidney cancer?

A

Painless/microscopic/persistent haematuria

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5
Q

What are some clinical features of kidney cancer?

A

Haematuria
Loin pain
Palpable mass
If metastases are presetn bone pain, haemoptysis

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6
Q

What are the investigations for painless visible haematuria?

A

Flexible cystoscopy
CT urogram
Renal function

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7
Q

What are the investigations for non visible haematuria?

A

Flexible cystoscopy

US KUB

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8
Q

What are the investigations for suspected kidney cancer?

A

CT renal triple phase
Staging CT chest
Bone scan if symptomatic

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9
Q

Describe T1-T4 for renal cell carcinoma

A 
T1= tumor less than 7cm
T2= tumor greater than 7cm
T3= Extends outside kidney but not beyond ipsilateral adrenal or perinephric fascia
T4= Tumour beyond perinephric fascia into surrounding structures
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10
Q

Describe N1-N2 for renal cell carcinoma

A 
N1= met in single regional LN
N2= met in more than 2 regional LN
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11
Q

What does M1 signify in renal cell carcinoma

A

Distant metastases

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12
Q

How does Fuhrman’s grade for kidney cancer work?

A

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

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13
Q

What is gold standard treatment for renal cell carcinoma?

A

Excision via partial nephrectomy or radical nephrectomy

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14
Q

What is treatment for patients with small kidney tumors who aren’t fit for surgery?

A

Cryosurgery

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15
Q

What is treatment for patients with metastatic kidney cancer?

A

Receptor tyrosine kinase inhibitors

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16
Q

What is the most common type of bladder cancer?

A

Transitional cell carcinoma

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17
Q

What is a red flag for bladder cancer?

A

Painless/microscopic/persistent haematuria

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18
Q

What are clinical features of bladder cancer?

Study These Flashcards
A

Haematuria
Suprapubic pain
Lower urinary tract symptoms
Metastatic disease symptoms –bone pain, lower limb swelling

19
Q

Describe Ta-T4 for bladder cancer

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A

Ta – non invasive papillary carcinoma
Tis – carcinoma in situ
T1 – invades subepithelial connective tissue
T2 – invades muscularis propria
T3 – invades perivesical fat
T4 – prostate, uterus, vagina, bowel, pelvic or abdominal wall

20
Q

Describe N1-N3 for bladder cancer

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A

N1 – 1 LN below common iliac birufication
N2 - >1 LN below common iliac birufication
N3 – Mets in a common iliac LN

21
Q

What does M1 mean for bladder cancer

Study These Flashcards
A

Distant mets are present

22
Q

Describe the WHO classification for bladder cancer

Study These Flashcards
A 
G1 = well differentiated
G2 = moderate differentiated
G3 = poorly differentiated
23
Q

How are bladder tumors resected?

Study These Flashcards
A

A transurethral resection of bladder lesion uses heat to cut out all visible bladder tumour.
This provides histology and also can be curative.

24
Q

How is non muscle invasive bladder cancer treated?

Study These Flashcards
A

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

25
How is muscle invasive bladder cancer treated?
Cystectomy Radiotherapy +/- chemotherapy Palliative treatment
26
What is the most common type of prostate cancer?
Adenocarcinoma
27
What are risk factors for prostate cancer?
Increasing age Western nations(Scandinavian countries) Ethnicity(African Americans)
28
What are clinical features of prostate cancer?
Usually asymptomatic unless metastatic
29
What blood test is done to investigate prostate cancer? Describe what it indicates
PSA is prostate-specific but no prostate-cancer specific, can be elevated in UTI, prostatitis etc
30
How is prostate cancer managed?
Imaging prior to biopsy testing via MRI
31
What is the type of biopsy method used for prostate investigation?
Trans perineal prostate biopsy
32
Describe what T1-T4 means in prostate cancer staging?
T1 – non palpable or visible on imaging T2 – palpable tumour T3 – beyond prostatic capsule into periprostatic fat T4 – tumour fixed onto adjacent structure/pelvic side wall
33
Describe what N1 means in prostate cancer staging
Regional LN in pelvis
34
Describe what M1a-M1x means in bladder cancer staging
M1a- non regional LN M1b- bone M1x- other sites
35
What is the Gleason score in bladder cancer staging? Describe what it means
Since the cancer is multifocal two scores based on level of differentiation can be used 2-6 = Well differentiated 7 = Moderately differentiated 8 – Poorly differentiated (as number gets higher cancer is worse)
36
How is prostate cancer treated if the patient is young and fit and has a high grade cancer?
Radical prostatectomy/Radiotherapy
37
How is prostate cancer treated if the patient is young and fit and has a low grade cancer?
Active surveillance ( Regular PSA, MRI and Bx)
38
What must be done post prostatectomy?
Monitor PSA
39
What should PSA be post prostatectomy? What value indicates relapse?
Should be undetectable or <0.01ng/ml). | If >0.2ng/ml then relapse
40
How is prostate cancer treated if the patient is old and unfit and has a high grade cancer/ met disease?
Hormone therapy
41
How is prostate cancer treated if the patient is old and unfit and has a low grade cancer?
Watchful waiting with regular PSA testing
42
What are side effects of treatment for prostate cancer?
Prostatectomy removes the proximal urethral sphincter and changes urethral length. Risk of damage to cavernous nerves (innervation to bladder and urethra causes erectile dysfunction
43
What must be done if there is haematuria and why?
Cystoscopy and imaging

BRS Y2 (85 decks)

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