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BRS - Year 2 > 💧Urology💧- Urological Cancers > Flashcards

💧Urology💧- Urological Cancers Flashcards

(42 cards)

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1
Q

What are the types of kidney cancer?

A

Adenocarcinoma (85%)
Transitional cell carcinoma (10%)
Other types (5%)

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2
Q

What are the risk factors for kidney cancer?

A

Smoking
Renal failure and subsequent dialysis
Obesity
Hypertension
Genetic predisposition with Von Hippel-Lindau syndrome (50% of individuals will develop RCC)

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3
Q

What is a red flag symptom for kidney cancer (and any urological cancer)?

A

Painless haematuria/persistent microscopic haematuria

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4
Q

What is RCC?

A

Renal cell carcinoma

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5
Q

Apart from haematuria, what are the other clinical features of RCC?

A

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

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6
Q

What are the main types of RCC?

A

Clear cell - 75%
Papillary - 15%
Chromophobe - 5%

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7
Q

What are the general symptoms of renal cancer?

A

Haematuria
Back pain that doesn’t go away
Unexplained weight loss/loss of appetite
Fatigue
Intermittent fever
Lump on side, belly or lower back
Anaemic
Hyperkalaemia
Hypertension

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8
Q

What are the investigations with painless visible haematuria?

A

Flexible cystoscopy
CT urogram
Renal function

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9
Q

What are the investigations with persistent non-visible haematuria?

A

Flexible cystoscopy
US KUB (kidney, ureter and bladder ultrasound)

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10
Q

What are the kidney cancer investigations in a patient with strongly suspected kidney cancer?

A

CT renal triple phase
Staging CT chest
Bone scan if symptomatic

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11
Q

What are the stages of kidney cancer?

A
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12
Q

What is the ideal management option for kidney cancer?

A

Excision via:
Partial nephrectomy (T1 tumours)
Radical nephrectomy

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13
Q

What are the types of bladder cancer?

A

Transitional cell carcinoma (>90%)
Squamous cell carcinoma (1-7%)
Adenocarcinoma (2%)

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14
Q

What are the risk factors for bladder cancer?

A

Smoking
Occupational exposure (aromatic hydrocarbons)
Chronic inflammation of bladder (bladder stones, schistosomiasis, long term catheter)
Drugs (cyclophosphamide)
Radiotherapy

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15
Q

What is the management for kidney cancer which has progressed to metastatic disease?

A

Receptor tyrosine kinase inhibitors
Immunotherapy

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16
Q

What is the management for patients with small kidney tumours who are unfit for surgery?

A

Cryosurgery

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17
Q

What are the clinical features of bladder cancer?

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A

Painless haematuria/persistent microscopic haematuria is a red flag
Suprapubic pain
Lower urinary tract symptoms (flow of urine, frequency etc…) and UTIs
Metastatic disease symptoms –bone pain, lower limb swelling

18
Q

What is the staging for bladder cancer?

19
Q

Give the surgical option for removal of a bladder tumour/lesion

20
Q

What does the management protocol for bladder cancer tell us should be done with a non muscle invasive tumour?

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A

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

21
Q

What does the management protocol for bladder cancer tell us should be done with a muscle invasive tumour?

Study These Flashcards
A

Cystectomy
Radiotherapy
+/- chemotherapy
Palliative treatment

22
Q

What are the types of prostate cancer?

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A

> 95% of prostate cancer is adenocarcinoma

23
Q

What are the risk factors for prostate cancer?

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A

Increasing age
Western nations (particularly Scandinavia)
Ethnicity (African-English, African-American)

24
Q

What are the presenting features of prostate cancer?

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A

Usually asymptomatic unless metastatic

25
What is PSA?
PSA is an enzyme (serine protease) normally produced by the glandular tissue of the prostate. It is produced at detectable levels only by prostate tissue PSA may be increased by trauma to the prostate (such as occurs after biopsy or cystoscopy), infection, benign enlargement, or prostate cancer
26
What does an elevated PSA mean?
Prostatic enlargement or increased activity **NOT NECESSARILY prostate cancer**
27
How can PSA be used diagnostically?
PSA is prostate-specific but not prostate-cancer specific (Can be elevated in: UTI, prostatitis, Benign prostatic hyperplasia)
28
What investigation should be done to confirm the presence of prostate cancer?
Transperineal prostate biopsy
29
Describe the staging of prostate cancer
30
Describe the Gleason grading scale
31
What is the management for high grade prostate cancer if young and fit?
Radical prostactectomy /radiotherapy /Focal
32
What is the management for low grade prostate cancer if young and fit?
Active surveillance Regular PSA, MRI and Bx
33
How is prostate cancer monitored post prostatectomy?
Monitor PSA ( should be undetectable or <0.01ng/ml) If >0.2ng/ml then relapse
34
What is the management for high grade prostate cancer if old/unfit?
Hormone therapy
35
What is the management for low grade prostate cancer if old/unfit?
Watchful waiting (regular PSA testing)
36
What are the treatment side effects for prostate cancer?
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) Damage to **cavernous nerves** causes ED
37
What should be considered a red flag symptom for all urological cancers?
Painless visible haematuria
38
What should happen to patients with suspected prostate cancer?
MRI imaging
39
What investigation should be done to confirm the presence of prostate cancer after positive imaging results?
Transperineal prostate biopsy
40
What is the Gleason score?
A grading system used to assess the aggressiveness of prostate cancer based on how abnormal the cancer cells look under a microscope
41
How does the Gleason score work?
Prostate cancer cells are graded on a scale from 1 to 5, with: Grade 1 = Cells look almost normal (least aggressive) Grade 5 = Cells look very abnormal (most aggressive)
42
What is Gleason score 3+4 vs 4+3?
The first number represents the most common pattern of cancer cells in the sample The second number represents the second most common pattern These two are added together to give the final Gleason Score First score, majority of cells are Grade 3 Second score, majority of cells are Grade 4 Same Gleason score, but 2nd score is more aggressive

BRS - Year 2 (75 decks)

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