Washington & Leaver: Principles and Practice of Radiation Therapy, Chapter 37: Male Reproductive and Genitourinary Tumors

Washington & Leaver: Principles and Practice of Radiation Therapy,

Chapter 37: Male Reproductive and Genitourinary Tumors

a. Prostate

b. Testicle

c. Penis

d. All of the above

A total dose of 7200 cGy in fractions of 180 cGy is used to treat which male

reproductive cancer?

ANS: A

• Prostate doses typically range from 72 to 80 Gy at 1.8 to 2.0 Gy per day.

• REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 832

A total dose of 2500 cGy in fractions of 160 cGy is used to treat which male reproductive cancer?

a. Prostate

b. Testicle

c. Penis

d. Bladder

ANS: B

• The recommended dose to retroperitoneal and pelvic lymphatics for stages I and IIA disease is 2500 cGy in fractions of 160 to 180 cGy or 2000 cGy in 10 fractions with AP/PA fields given 5 days per week and both fields treated daily.

REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 853

Which cancer can be treated using a water bath to provide dose homogeneity by compensating for the irregular surface with tissue equivalent material?

a. Prostate

b. Testicle

c. Penis

d. Bladder

ANS: C

• The water used, which is tissue equivalent, will compensate for the cylindrical presentation of the penis and ensure even dose distribution over the volume of interest.

• REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 843, Figure 37-14

Cancer of which urinary organ is most common?

a. Kidney

b. Ureter

c. Bladder

d. Urethra

ANS: C

• Approximately 67,160 new cases and 13,750 deaths from bladder cancer will be reported in the United States annually. The incidence peaks in the seventh decade, and in men this cancer is the fourth most prevalent malignant disease.


Cancer of which of the following male reproductive system component is most common?

a. Penis

b. testicle

c. Prostate

d. urethra

ANS: C

• Carcinoma of the prostate is the most common malignancy in males in the United States.


What is the most common form of kidney cancer?

a. adenocarcinoma

b. transitional cell carcinoma

c. squamous cell carcinoma

d. renal cell carcinoma

ANS: D

• The most common type of kidney cancer — renal-cell carcinoma — accounts for 85% of kidney tumors and occurs twice as often in men as in women. It is most frequently diagnosed in people between the ages of 50 and 70

• REF: Chapter 37, Male Reproductive and Genitourinary Tumors,

What is the most common form of bladder cancer?

a. adenocarcinoma

b. transitional cell carcinoma

c. squamous cell carcinoma

d. renal cell carcinoma

ANS: B

• Approximately 92% of bladder tumors are transitional cell carcinomas, 6% to 7% are squamous cell carcinomas, and 1% to 2% are adenocarcinomas.


What is the standard dose used when irradiating the entire bladder?

a. 3000 to 3500 cGy

b. 4500 to 5000 cGy

c. 5000 to 6000 cGy

d. 6500 to 7000 cGy

ANS: B

• The larger pelvic field to include the bladder and pelvic lymph nodes is generally treated to a dose of 45 to 50 Gy at 180 cGy per day, which requires 5 to 5 1/2 weeks of treatment.


What is the most common form of testicular cancer?

a. squamous cell carcinoma

b. Germ cell tumors

c. Adenocarcinomas

d. Stromal tumors

ANS: B

• About 95% of testicular neoplasms originate in germinal elements.


What is the most common form of penile cancer?

a. squamous cell carcinoma

b. germ cell tumors

c. Adenocarcinomas

d. stromal tumors

ANS: A

• Most malignant penile tumors are well-differentiated squamous cell carcinomas.


What region might receive prophylactic radiation therapy for advanced right sided testicular cancer?

a. right SCV nodes

b. left SCV nodes

c. para-aortic nodes

d. left inguinal nodes

ANS: B

• The lymphatic pathways associated with the entire lower section of the body are associated with drainage into the thoracic duct, which is associated with the left side inlet in the supraclavicular region.


What is the primary treatment option for kidney cancer?

a. surgery

b. Chemotherapy

c. radiation therapy

d. immunotherapy

ANS: A

• Radiation and chemotherapy have limited roles in the management of kidney cancers.

• REF: Chapter 37, Male Reproductive and Genitourinary Tumors, pp. 857-859

What is the most common symptom of testicular cancer?

a. night sweats

b. Fever

c. dysuria

d. Painless mass

ANS: D

• Usually, a testicular tumor appears as a painless swelling or nodular mass in the scrotum and is sometimes noted incidentally by the patient or a sexual partner.


What is the first treatment a male will receive for testicular cancers?

a. surgery

b. Chemotherapy

c. radiation therapy

d. immunotherapy

ANS: A• The initial management goal for a suspected

malignant germ cell tumor of the testis is to obtain serum AFP and beta-HCG measurements and, after staging procedures, to perform a radical inguinal orchiectomy with high ligation of the spermatic cord. Further management depends on the pathologic diagnosis of the stage and extent of the disease.


Who has the most significant risk of developing prostate cancer?

a. 45-year-old black male

b. 50-year-old white male

c. 70-year-old black male

d. 81-year-old black female

ANS: C

• The incidence increases with each decade of life; more than 65% of prostate carcinomas occur in men 65 years and older. African-American men in the United States have one of the highest incidences, of prostate cancer in the world, significantly higher than that of white men of comparable age.


Which of the following cancers is most likely to occur in a 27-year-old male?

a. penis

b. Testicle

c. Prostate

d. Bladder

ANS: B

• Although testicular tumors are relatively rare, they are the most common malignancy in men between 20 and 34 years of age.


Which of the following is least likely to be used in the management of a patient with prostate

cancer?

a. watchful waiting

b. Hormone therapy

c. Radiation therapy

d. Chemotherapy

ANS: D

• Prostate cancer is noted as having several pathways associated with disease management, including surgery, hormone therapy, watchful waiting, and radiation therapy as mainline options. Chemotherapy is used often after hormone therapy has not yielded an acceptable response and for palliation.


Which lymph node chains will be treated if a man is diagnosed with

right-sided testicular cancer that has not spread outside the testicle?

I. right SCV nodes II. para-aortic nodes III. right inguinal nodes

a. I and II

b. I and III

c. II and III

d. I, II, and III

ANS: C

• The most commonly applied treatment for patients with stage I seminoma is radical orchiectomy and postoperative irradiation of the para-aortic or para-aortic and ipsilateral pelvic nodes.


Which of the following treatment techniques can be used to treat the

prostate?

a. 4-field box

b. IMRT

c. brachytherapy

d. All of the above

ANS: D

• All are viable treatment options for prostate cancer.


REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 841

Documents

Washington & Leaver: Principles and Practice of Radiation Therapy, Chapter 37: Male Reproductive and Genitourinary Tumors