1: Urological Malignancies - TCC Flashcards
Where do transitional cell carcinomas arise
Urothelial (Transitional cell epithelium)
What % of bladder cancer is TCC
90%
What is the other type of TCC
Squamous cell carcinoma
What is a risk factor for SCC of the bladder
Schistosomiasis
What age-group does TCC occur
> 65 year-olds
What gender does TCC occur
Male (4:1)
What is the biggest risk factor for TCC
Smoking
What are 4 other RF for TCC
HPV16
Cyclophosphamide exposure
FH
Aromatic amines
How does bladder carcinoma present
Painless haematuria
Voiding symptoms: dysuria, frequency, urgency
Who is referred under suspected bladder carcinoma pathway
> 45-years and:
- Macroscopic haematuria
- Haematuria persists beyond UTI treatment
> 60-years and:
- Microscopic haematuria
What is used initially to diagnose and grade TCC
Rigid cystoscopy
Why is a rigid cystoscopy used
Able to take biopsy
Flexible cystoscopy can only visualise cancer
What investigation is used to stage TCC
CT Urogram
What stage do 80% of patients present in
Tis or T1
How is Tis or T1 TCC managed
Trans-urethral resection bladder tumour (TURBT)