5 - Bladder Cancer

Question 1

90% of all bladder cancer are caused by what cells?

Answer 1

urothelial carcinoma (transitional cell)

Question 2

What is the most common malignancy involving the urinary system?

Answer 2

bladder cancer

Question 3

Painless hematuria should have you concerned for this type of cancer.

Answer 3

bladder cancer

Question 4

Irritative voiding symptoms can be an initial presentation of this type of cancer

Answer 4

bladder cancer

Question 5

What is the gold standard for initial diagnosis and staging of bladder cancer?

Answer 5

cystoscopy

Question 6

What is the preferred imaging study for bladder cancer?

Answer 6

CT abdomen/pelvis O+/I+

Question 7

What treatment therapy is indicated in patients with non-invasive bladder cancer (Ta, Tis, T1)?

Answer 7

intravesical therapy (IV BCG)

Question 8

What treatment therapy is indicated in patients with invasive bladder cancer (T3+)?

Answer 8

radical cystectomy

+ bilateral pelvic lymphadenectomy AND urinary diversion

*NEOADJUVANT chemo with CISPLATIN is commonly done

Question 9

What are the 3 types of urinary diversion following a radical cystectomy?

Answer 9

• ileal conduit = use segment of bowel
• Indiana Pouch = patient self catheterizes internally constructed reservoir
• orthotropic neobladder = formed from segment of bowel

Question 10

What is the combined modality approach for bladder preservation? (4 modalities)

Answer 10

• maximal TURBT
• radiation
• concurrent chemo
• surveillance