Bladder Cancer Flashcards
Definition of bladder cancer
Malignancy of the bladder cells
• Most common is transitional cell carcinomas (TCCs) (urothelial)
Aetiology of bladder cancer
• Unknown cause
• Most common form is transitional cell carcinoma
• Second most common urological cancer
Risk factors for bladder cancer
• smoking (most important risk factor) 2,3x more risk
• Radiation
• Chronic catheters
• Chronic UTIs
• Carcinogenic chemicals in dye and rubber industries
• Men
• Age >65
History and examination of bladder cancer
• Painless, macroscopic haematuria:
◦ MAIN presenting complaint.
◦ Episodes of haematuria are typically intermittent
◦ Can be microscopic
• Dysuria: voiding irritability
• Urinary frequency: may get frequent urination
• Recurrent UTIs
Investigations for bladder cancer
• Urinalysis: haematuria is typical, but may be absent in some patients
• Flexible CYSTOSCOPY: key to making diagnosis. Would be able to visualise the tumours, can also take a BIOPSY. Can be used to stage the tumour
• CT Urogram
• US KUB
Treatment for bladder cancer
Non-muscle invasive:
1) Transurethral Resection of The Bladder (TURBT): uses a rigid cystoscope, can take biopsy and be curative as well
+ immediate post-op chemotherapy
+ Delayed intravesical bacilli Calmette-Gurinder (BCG) immunotherapy
Locally invasive cancer:
1) Radical cystectomy: prostate removed as well
+ post-op chemo-radiotherapy
+ adjuvant chemotherapy?
Metastatic disease:
1) Chemotherapy
+ Palliative treatment
Prevention and prognosis of bladder cancer
• Avoid smoking
• Prompt treatment and prevention of UTIs, urinary stones and avoid use of indwelling catheters
• SMOKING CESSATION as secondary prevention
Most present with low grade non-muscle invasive cancer. There is high risk of tumour recurrence, but low risk of death with these
Age at surgery can determine survival rate
Complications of bladder cancer
• Prostatic urothelial carcinoma
• Cystectomy complications: can result in sexual and urinary malfunction
