Bladder and Renal Cancer

Question 1

What are some primary symptoms of bladder cancer?

Answer 1

a. Hematuria, either gross or microscopic is number one presenting symptom.
b. Irritative voiding symptoms can occur
c. Most patients do not experience symptoms
d. Liver and spleen may be enlarged if it has spread

Question 2

What are some risk factors for developing bladder cancer?

Answer 2

Bladder cancer is the 2nd most common urologic cancer. It occurs more frequently in men. Mean age of diagnosis is 73. Cigarette smoking and exposure to industrial dyes or solvents are risk factors for the disease and account for many new cases. 98% are EPITHELIAL MALIGNANCIES

Question 3

if you suspect bladder cancer, what imaging is indicated?

Answer 3

Bladder cancers may be ID’d using US, CT, or MRI as masses within the bladder. However, the presence of cancer is confirmed by cystoscopy and biopsy

Question 4

describe the grading and staging for bladder cancers:

Answer 4

• grading is based on cellular features

- staging is based on extent of bladder wall penetration and distance of spread

Question 5

Describe treatment options for bladder cancer

Answer 5

• Patients with superficial cancer are treated with transurethral resection and selective chemo.
• Patients with invasive but still localized cancers are at risk for nordal metastases and require cystectomy, irradiation, or the combo of chemo and selective surgery.
• For patients with muscle invasion: chemo PRIOR to cystecomty is indicated.

Question 6

What are the details of treatments for bladder cancer?

Answer 6

o	Intravesical Chemo:
•	Give chemo thru catheter into bladder
•	6-12 weeks of treatment
•	SE: irritative symptoms
o	Surgical Treatment:
•	Transurethral resection is initial form 
•	Partial cystectomy if indicated
•	Radial cystectomy removes the bladder, prostate, seminal vesicles, and surrounding fat in men, and the uterus, cervix, urethra, vaginal vault, and ovaries in women. Pelvic lymph removal is performed. 
o	Radiotherapy
•	Given over 6-8 weeks
•	Some bowel complications
•	Usually combined with chemo
o	Chemo
•	Combo therapy is usually indicated.
•	Given before surgery in those with large cancers.

Question 7

T/F : If you see bladder cancer, you should also look at the upper tract for cancer as well:

Answer 7

true

Question 8

What are the signs of renal carcinoma

Answer 8

1. Gross or microscopic hematuria
2. Flank pain or mass in some patients
3. Systemic symptoms such as fever, weight loss, may be prominent.

Question 9

What is the main risk factor for renal cell carcinoma:

Answer 9

Cigarette smoking is the only significant environmental risk factor that has been identified. Familial causes of renal cell carcinoma have been identified, and there is an association with dialysis-realted acquire cystic disease and specific genetic aberrations, but sporadic tumors are far more common.

Question 10

where does renal cell carcinoma originate from?

Answer 10

• Renal Cell Carcinoma originates from the proximal tubule cells.

Question 11

What imaging is indicated for renal cell carcinoma?

Answer 11

Solid renal masses are often first identified by abdominal US or CT. CT and MRI are most reliable for renal cell carcinoma

Question 12

Solid lesions in the kidney are considered _____ until proven otherwise

Answer 12

renal cell carcinoma

Question 13

What is the primary treatment for renal cell carcinoma?

Answer 13

• Surgical removal is the primary treatment for localized.

- NO effective chemotherapy is available for metastatic renal cell carcinoma.

Question 14

What is the prognosis for renal cell carcinoma?

Answer 14

• Tumors extending beyond the renal capsule (T3 and T4) have lower survival rates, while those inside the capsule have very high survival rates