bladder cancer

Question 1

what is the etiology and risk factors of bladder carcinoma ?

Answer 1

smoking 
chronic cystitis 
cyclophosphamide
pelvic irradiation 
aromatic amines 
genetic factors

Question 2

what are the signs and symptoms of bladder cancer ?

Answer 2

1. hematuria
2. irritative LUTS ( dysuria, urgency, bladder pain)
3. symptoms of advanced metastatic disease

Question 3

what type pf lab studies are performed inn a case of suspected bladder cancer ?

Answer 3

urine analysis
urine cytology
KFTs, CBC

Question 4

what urinary markers can be detected ?

Answer 4

NMP 22

AuraTack FDP

Question 5

what are the two types of bladder cancer according to histopathology ?

Answer 5

squamous cell carcinoma

transitional cell carcinoma

Question 6

in cases of microscopic hematuria what type of imaging can be used ?

Answer 6

plain KUB X-ray

Ultrasound of the renal tract

Question 7

in cases of macroscopic hematuria what type of imaging can be used ?

Answer 7

CT urogram

Question 8

how can we make a definitive diagnosis of bladder cancer ?

Answer 8

cystoscopy
TUR-BT ( trans-urethral resection of the bladder)
biopsy

Question 9

what is the staging for bladder cancer ?

Answer 9

T0 - no carcinoma 
Tis - carcinoma in situ 
Ta - tumor confined to the mucosa 
T1- tumor confined to the submucosa 
T2- superficial muscle invasion 
T3a - deep muscle invasion
T3b - perivascular fat invasion
T4a - invasion of nearby organ
T4b- fixed to pelvis or abdominal wall

Question 10

what is the management for non-invasive bladder cancer?

Answer 10

TUR-BT
Adjuvant Therapy ( intravesical chemotherapy and immunotherapy BCG)
Radical cystectomy

Question 11

what is the required surveillance for a non invasive bladder cancer for low grade Ta vs high grade Ta, T1 or CIS ?

Answer 11

for low grade Ta - cystoscopy every 3 months for 1 year and then annually

for high grade Ta,T1 orr Cis - cystoscopy and cytology every 3 months for 2 years then every 6 months
annual IVP/CT for 2 years

Question 12

what is the most effective management for muscle invasive bladder cancer ?

Answer 12

radical cystectomy with urinary diversion

followed by urinary diversion

Question 13

what are the types of urinary diversion ?

Answer 13

intestinal conduit urinary diversion
continent cutaneous diversion
continent orthotopic diversion (neobladder )

Question 14

how is metastatic bladder carcinoma managed ?

Answer 14

using the MVAC regimen ( combination chemotherapy)
GC regimen can also be used
along with palliative therapy

Question 15

what is the management for non muscle invasive bladder cancer ?

Answer 15

1- intravesical chemotherapy -
mitomycin C
Thiotepa
2- Doxorubicin
3- immunotherapy - BCG

Question 16

what are the stages associated with non muscle invasive bladder cancer ?

Answer 16

Tis
Ta
T1

Question 17

chronic schistosoma is associated with which type of bladder cancer ?

Answer 17

squamous cell carcinoma