Bladder CA Flashcards
1
Q
epi of bladder
A
common
- M>F
- 90% are urothelial carcinoma
2
Q
risk for bladder
A
- smoking !!1
- occupational exposures
- chinese herbs
3
Q
presentation of bladder CA
A
- hematuria - most common
- gross or microscopic - pain
- LUTS
- constitutional Sx
4
Q
4 types of tests for Dx
A
- urine tests
- routine microscopy
- C+S
- cytology - imaging
- cystoscopy
- biopsy
5
Q
what is imaging of choice
A
CT uroscpoy
- comprehensive evaluation of bladder and upper urinary tract
- multiphase aquisition
6
Q
3 parts of multiphase aquisition
A
- pre-contrast - look normal
- 120secs - look for renal
- 20mins - look at bladder etc
7
Q
what is role of MRI
A
limited
- onlt for those that can’t CT
8
Q
what is urine cytology
A
- look for cells sloughing off
- pathologist skill dependent
- low sens, high spec
9
Q
what is stage based on
A
T - based on TURBT
NM - imaging
10
Q
most important part of T
A
past the muscularis
11
Q
2 main types
A
- non-invasive - 70%
- low risk of mets, high risk of recurrence - muscle invasive
- high risk of death, mets
12
Q
mgmt of non-invasive
A
- TURBT
- single dose of intravesicle chemo
- surveillance cysto
- immunotherap - BCG
- chemo
13
Q
mgmt of muscle invasive
A
take out bladder and everything around it + LN
- ileal conduit
- neobladder
