bladder cancer

Question 1

epidemiology

Answer 1

11th most common cancer in the UK.

In developed countries, 90% of bladder cancers are transitional cell carcinomas.

The remainder are mostly squamous cell carcinomas.

Question 2

RFs for transitional

Answer 2

Smoking
Aromatic amines (rubber, dyes and chemical industry)
Cyclophosphamide
genetics

Question 3

RFs for squamous cell

Answer 3

Schistosomiasis infection
Long term catheterisation (10+ years)

Question 4

clinical features

Answer 4

Visible haematuria
Painless haematuria
UTIs
Hydronephrosis
Weight loss
Night sweats

Question 5

sites of metastases

Answer 5

lungs, liver, bone

Question 6

investigations

Answer 6

urine dipstick- look for haematuria
CT urogram
flexible cystoscopy
imaging to help stage

Question 7

grading and staging systems

Answer 7

G1-3
TNM

Question 8

treatment

Answer 8

endoscopic or radical resection
cystoscopy- grade 1 TURBT resection GOLD STANDARD
chemotherapy and radiotherpay in addition or in recurrences

aggressive- intravesical BCG therapy.
muscle invasion T2 and above- cystectomy with urinary division