bladder cancer

Question 1

arises from..

Answer 1

endothelial lining - urothelium

Question 2

risk factors

Answer 2

inc age
smoking
aromatic amines - dye and rubber
shistosomiasis - squamous cell carcinoma

Question 3

types

Answer 3

transitional cell carcinoma (90%)
squamous cell carcinoma (5%)
adenocaricnoma (2%)
sarcoma 
small cell carcinoma

Question 4

main presenting symptom

Answer 4

painless haematuria

Question 5

2 wk wait referral - when for >45yrs

Answer 5

unexplained visible haematuria

either w/o UTI or persisting after UTI Rx

Question 6

2 wk wait referral - when for >60yrs

Answer 6

microscopic haematuris

plus either of

• dysuria
• raised WCC on FBC

Question 7

diagnostic Ix

Answer 7

cystoscopy

can be rigid or flexible
local or general anaesthetic

Question 8

non-invasive bladder cancer

Answer 8

not invading muscle layer of bladder

Question 9

muscle invading bladder cacer

Answer 9

invades muscle and beyond

Question 10

Tis/carcinoma in situ

Answer 10

cancer cells only affect urothelium + are flat

Question 11

Ta

Answer 11

cancer only affects urothelium and projecting into bladder

Question 12

T1

Answer 12

cancer invading connective tissue layer beyong urothelium

but not muscle layer

Question 13

invasive bladder cancer- staging

Answer 13

included T2-4 and any lymph node or metastatic spread

Question 14

Mx options

Answer 14

TURBT
intravesical chemotherapy
Intravesicle BCG
radial cystectomy

Question 15

TURBT

Answer 15

transurethral resection of bladder tumour

can be used for non-invasive bladder cancer

Question 16

after cystectomy - options for draining urine

Answer 16

urostomy with ileal conduit (most commone)
continent urinary diversion
neobladder recontruction
uterosigmoidostomy