The NCCPA™ PANCE Genitourinary Content Blueprint GU neoplastic diseases
Bladder cancer | Patient will present as → an 85-year-old man who comes to his primary care provider after a week of hematuria. He has not been ill lately and has had no complaints of pain on urination. A CT scan with contrast is ordered demonstrating a variable filling defect.
Treatments include surgery, biological therapy, and chemotherapy |
Penile cancer | Patient will present as → a 63-year-old uncircumcised male with a painless lump on the head of his penis. Over the last two weeks, the lesion has been increasing in size and three days ago he began to notice a new foul-smelling discharge. On physical examination, you notice a 2 cm lesion on the prepuce and palpable inguinal lymphadenopathy. The diagnosis of penile carcinoma should be suspected in men who present with a penile mass or ulcer, particularly in those who are uncircumcised DX: The diagnosis requires biopsy for tissue confirmation TX: Treatment involves surgery for all stages of penile cancer. Other options include radiation and chemotherapy |
Prostate cancer | ReelDx Virtual Rounds (Prostate cancer)Patient will present as → a 71-year-old male who presents with nocturia, urgency, weak stream, terminal dribbling, hematuria, and lower back pain over the past four months. He has also experienced weight loss and fatigue. Symptoms include difficulty with urination, but sometimes there are no symptoms at all
The tumor marker is PSA (also elevated in BPH)
Prostate cancer screening (lots of debate here)
USPSTF recommendations for prostate cancer screening:
Prostate-specific Antigen, Digital Rectal Examination, and Transrectal Ultrasonography
Some types of prostate cancer grow slowly. In some of these cases, monitoring is recommended
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Testicular cancer | Patient will present as → a 32-year-old male who noticed a mass on his right testicle while showering. He reports this has never happened before and denies any pain or discomfort. On physical examination, there is a firm and fixed mass on the left testicle. Bilateral scrotal ultrasound is performed, and significant findings are seen here. A 22-year-old male who develops a firm, painless, non-tender testicular mass with elevated serum β-HCG
DX: Diagnostic studies include ultrasound. Tumor markers: AFP, β-HCG, and LDH TX: Treatments include surgery, radiation, and chemotherapy |