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

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

3. 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

4. A total dose of 2500 cGy in fractions of 160 cGy is used to treat which male reproductive cancer?
Prostate
Testicle
Penis
Bladder

5. 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

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

7. 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

8. Cancer of which urinary organ is most common?
Kidney
Ureter
Bladder
Urethra

9. 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.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 845

10. Cancer of which of the following male reproductive system component is most common?
Penis
testicle
Prostate
urethra

11. ANS: C
Carcinoma of the prostate is the most common malignancy in males in the United States.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 823

12. What is the most common form of kidney cancer?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
renal cell carcinoma

13. 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,

14. What is the most common form of bladder cancer?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
renal cell carcinoma

15. ANS: B
Approximately 92% of bladder tumors are transitional cell carcinomas, 6% to 7% are squamous cell carcinomas, and 1% to 2% are adenocarcinomas.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 846

16. What is the standard dose used when irradiating the entire bladder?
3000 to 3500 cGy
4500 to 5000 cGy
5000 to 6000 cGy
6500 to 7000 cGy

17. 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.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 849

18. What is the most common form of testicular cancer?
squamous cell carcinoma
Germ cell tumors
Adenocarcinomas
Stromal tumors

19. ANS: B
About 95% of testicular neoplasms originate in germinal elements.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 851

20. What is the most common form of penile cancer?
squamous cell carcinoma
germ cell tumors
Adenocarcinomas
stromal tumors

21. ANS: A
Most malignant penile tumors are well-differentiated squamous cell carcinomas.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 841

22. What region might receive prophylactic radiation therapy for advanced right sided testicular cancer?
right SCV nodes
left SCV nodes
para-aortic nodes
left inguinal nodes

23. 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.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 853

24. What is the primary treatment option for kidney cancer?
surgery
Chemotherapy
radiation therapy
immunotherapy

25. ANS: A
Radiation and chemotherapy have limited roles in the management of kidney cancers.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, pp

26. What is the most common symptom of testicular cancer?
night sweats
Fever
dysuria
Painless mass

27. 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.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 850

28. What is the first treatment a male will receive for testicular cancers?
surgery
Chemotherapy
radiation therapy
immunotherapy

29. 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.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 851

30. Who has the most significant risk of developing prostate cancer?
45-year-old black male
50-year-old white male
70-year-old black male
81-year-old black female

31. 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.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 823

32. Which of the following cancers is most likely to occur in a 27-year-old male?
penis
Testicle
Prostate
Bladder

33. ANS: B
Although testicular tumors are relatively rare, they are the most common malignancy in men between 20 and 34 years of age.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 850

34. Which of the following is least likely to be used in the management of a patient with prostate cancer?
watchful waiting
Hormone therapy
Radiation therapy
Chemotherapy

35. 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.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, pp

36. 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
I and II
I and III
II and III
I, II, and III

37. 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.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, p. 851

38. Which of the following treatment techniques can be used to treat the prostate?
4-field box
IMRT
brachytherapy
All of the above

39. ANS: D All are viable treatment options for prostate cancer.
REF: Chapter 37, Male Reproductive and Genitourinary Tumors, pp

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