Bladder Cancer

Question 1

what are the 2 common types of bladder cancer

Answer 1

transitional cell (90%)
squamous cell carcinoma (5%)

Question 2

what are the risk factors for bladder cancer

Answer 2

Aromatic amines are carcinogenic so people who work in factories with dye or rubber

Schistosomiasis (disease caused by parasitic worms) can cause SCC

being male

Question 3

how does a bladder carcinoma present

Answer 3

• painless haematuria
• recurrent UTIs
• hydronephrosis (kidney fluid build up caused by tumour)
• weight loss
• night sweats

Question 4

how do you investigate a bladder carcinoma

Answer 4

CT Urogram is diagnostic and provides staging

Flexible cytoscopy helps to see defects in the bladder and to take biopsies

Question 5

how do you manage a bladder cancer

Answer 5

radiotherapy- curative or palliative

chemotherapy (e.g. methotrexate, vinblastine, doxorubicin)- curative if alongside surgery or palliative

surgical:

• if muscle invasive (stage T2 and above)
• cystectomy with urinary diversion is gold standard

Question 6

where does bladder cancer likely metastasise to

Answer 6

lungs (haematgenous)
liver (haematgenous)
bone
pelvic structures (lymphatics)

Question 7

what is an ileal conduit

Answer 7

removal of the small bowel and the 2 free ends are anastomosed

the cut out part of the ileum is used as a stoma for urine