Ch. 35 Male Reproductive Tumors

Which of the following cancers is most likely to occur in a 27-year-old male? a. Penis b. Testicle c. Prostate d. Urethra

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

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

Kidney carcinoma can be attributed to which of the following? I. Cigarette use II. Obesity III. Betel nut chewing a. I and II b. I and III c. II and III d. I, II, and III

ANS: A Cigarette and tobacco use, obesity, and analgesic drug abuse are correlated with an increased risk and incidence of kidney cancer.

Gleason's grading system is based on the tumor's _______________. a. morphology b. histology c. extent d. size

ANS: A Gleason devised a quantitative histologic grading system based on the morphologic tumor characteristics.

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.

Which of the following treatment techniques are most frequently used when irradiating the prostate? I. Supine positioning II. Prone positioning III. Full bladder IV. Empty bladder a. I and III b. I and IV c. II and III d. II and IV

ANS: A Patients are most often simulated in the supine position. Patients should be treated with a full bladder to minimize the amount of bladder in the treatment portals.

A total dose of 7200 cGy in fractions of 180 cGy is used to treat which male reproductive cancer? a. Prostate b. Testicle c. Penis d. All of the above

ANS: A Prostate doses typically range from 72 to 80 Gy at 1.8 to 2 Gy per day.

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.

What is the 5-year survival of all stages of testicular cancer combined? a. 50% b. 70% c. 90% d. 100%

ANS: A Rates of disease-free survival for stage I testicular seminoma are in the 95% to 97% range at 5 years according to multiple studies. Corresponding cause-specific survival is 100%. For patients with stage IIA and IIB disease, rates of disease-free and cause-specific survival are 90% and 95%, respectively.

What is the treatment of choice for testicular cancers? a. Surgery b. Chemotherapy c. Radiation therapy d. Watchful waiting

ANS: A The initial management goal for a suspected malignant germ cell tumor of the testis is to obtain serum alpha-fetoprotein and beta- human chorionic gonadotropin 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.

To which surface of the prostate gland do the seminal vesicles attach? a. Posterior superior b. Anterior lateral c. Superior anterior d. Inferior posterior

ANS: A The seminal vesicles pierce the posterosuperior aspect of the prostate gland.

Which cancer can be treated using a water bath to provide dose homogeneity by compensating for the irregular surface with tissue-equivalent material? a. Penis b. Testicle c. Prostate d. Bladder

ANS: A 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.

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 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 weeks of treatment.

What region might receive prophylactic radiation therapy for advanced right-sided testicular cancer? a. Right supraclavicular (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 SVC region.

A total dose of 2500 cGy in fractions of 160 cGy is used to treat which male reproductive cancer? a. Penis b. Testicle c. Prostate 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 anteroposterior/posteroanterior fields given 5 days per week and both fields treated daily.

What is the most common form of kidney cancer? a. Adenocarcinoma b. Transitional cell carcinoma c. Squamous cell carcinoma d. Renal cell carcinoma

ANS: B Transitional cell carcinoma accounts for more than 90% of malignant tumors of the renal pelvis and ureter, and squamous cell carcinoma accounts for 7% to 8%.

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 are 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 components 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.

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 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.

What is the 5-year survival of all stages of prostate cancer combined? a. 39% b. 59% c. 79% d. 99%

ANS: D Overall survival is a poor measure of treatment outcome for prostate cancer therapy because this is a slowly progressive disease and many men die with but not because of prostate cancer.

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.

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.