Bladder Cancer

Question 1

What is bladder cancer?

Answer 1

malignancy of bladder cells

Question 2

What are two types of bladder cancer/

Answer 2

1. 90% urothelial carcinoma

2. RARE: Squamous cell carcinoma associated with chronic inflammation

Question 3

What are RF for Squamous cell carcinoma?

Answer 3

1. Chronic UTI

2. Schistosoma (parasitic worm) Haematobium

Question 4

What are RF for urothelial carcinoma?

Answer 4

1. Smoking
2. Carcinogen exposure
3. Aromatic amines
4. Polycyclic aromatic hydrocarbons
5. Arsenic
6. Painters and hairdressers

Question 5

What occupation do you check in history?

Answer 5

painter, hairdresser

Question 6

What are symptoms of bladder cancer?

Answer 6

1. Painless macroscopic haematuria
2. Irritative/storage symptoms: FUND HIPS
3. FLAWs

Question 7

What are FUND HIPS symptoms?

Answer 7

1. Frequency
2. Urgency
3. Nocturia
4. Hesitancy
5. Incomplete voiding
6. Poor stream

Question 8

How is painless macroscopic haematuria treated?

Answer 8

bladder cancer until proven otherwise

Question 9

What bedside test is done for bladder cancer?

Answer 9

1st line: urinalysis: confirms haematuria

Question 10

What bloods are done in bladder cancer?

Answer 10

1. ALP

2. U + Es

Question 11

What is the gold standard investigation for bladder cancer?

Answer 11

Cystocscopy + biopsy

Question 12

What other imaging is done in bladder cancer and why?

Answer 12

1. CTAP, MRI AP: exclude kidney stones, visualise balder cancer
2. Isotope bone scan: bony mets
3. CXR: lung mets

Question 13

What are common types of bladder cancer?

Answer 13

Mostly TCC but SCC in area where schistosomiasis is endemic

Question 14

How do you manage T1 and superficial bladder cancer?

Answer 14

1. TURBT
2. Flexible cystoscopy surveillance
3. Intravesical chemotherapy/immunotherapy (BCG)

Question 15

How do you manage bladder cancer that reaches muscle?

Answer 15

1. Radical cystectomy

2. Radiotherapy