Tumors of the urinary system

Lecture 10.2 Malignancy of the Urinary Tract
By the end of this session, you should be able to describe the following common
malignancies of the urinary tract, prostate cancer, renal cell carcinoma (RCC), TCC
of the renal calyces, pelvis, ureter and bladder. In addition, you should understand
the aetiology of prostate cancer as it is the commonest cancer in men and the
second commonest cause of death from cancer in men. Males with prostate cancer
frequently present following a raised serum prostate specific antigen (PSA) test
and/or abnormal digital rectal examination. RCC and TCCs often present with
haematuria.
Specific Aim
For patients with prostate cancer, you should understand
? the usual presentation
? the diagnostic pathway
? the natural history
? the principles of treatment
For patients with urological haematuria of malignant origin, you should understand
A) the differential diagnosis
B) the aetiology
C) the principles of investigation
D) the principles of treatment
Key Points
? All patients with microscopic or macroscopic haematuria in the absence of
infection require urological investigation
? All solid renal masses require excision and not biopsy
? Smoking predisposes to TCC
? In the absence of screening most patients with newly diagnosed caner are
incurable
? Most men die with prostate cancer than of prostate cancer
? Most clinically organ-confined prostate cancers requires treatment in men
whose life expectance exceeds 10 years
? Serum PSA is elevated by many benign conditions including hyperplasia and
infection