Bladder Cancer Flashcards
What are the risk factors for bladder cancer?
What might be a classical exam presentation?
Smoking
Increased age
Aromatic amines (carcinogen) -found in dye and rubber and cigarette smoke
Retired dye factory worker with painless haematuria
What are the different types of bladder cancer?
Where in the bladder does bladder cancer arise from?
Transitional cell carcinoma
Squamous cell carcinoma
Adenocarcinoma (2%)
Small cell carcinoma
Arise from urothelium of bladder
How might someone with bladder cancer present?
What presentations would lead to a 2 week wait referal?
Painless haematuria
2 week wait for:
- > 45 w/ unexplained macroscopic haematuria
- > 60 w/ microscopic haematuria w/ dysuria +/- raised WCC
How is bladder cancer diagnosed?
Cytoscopy (rigid or flexible)
-can be used to visualise the inside of bladder and take a biopsy
Urinalysis
Urine cytology
FBC
CT/MRI
What types of bladder cancer are clearly distinguished between with staging?
Non-muscle invasice bladder cancer
Muscle invasive bladder cancer
What are the different types of non-muscle invasive bladder cancer?
Carcinoma in-situ:
-only affect the urothelium and are flat
Ta:
-cancer only affecting urothelium and projecting into bladder
T1:
-invading CT beyond urothelium but not into bladder
What are the treatment options for non-invasive bladder cancer?
Transurethral resection of bladder tumour (TURBT)
Adjuvant chemo therapy =Single dose of intravesical mitomycin C
-used to reduce the risk of recurrence
What are the treatment options for invasive bladder cancer?
What is the treatment for mets?
Radical cystectomy
Radiotherapy/chemo
What are the options for draining urine following a radical cystectomy?
Urostomy with ileal conduit (most popular)
- drains urine from kidneys directly
- part of ileum resected and ends of ureters anastomosed to seperate part of ileum
- other end of ileum brough to surface to drain into urostomy bag
Neobladder reconstruction
Ureterosigmoidostomy
