Bladder cancer Flashcards
Bladder cancer is the most common subtype of t_____ cell carcinoma
transitional
True or false: the majority of bladder cancers are superficial at presentation (do not invade the muscle)
True
What is schistosomiasis?
Parasitic infection caused by flatworms, prevalent in tropical regions with limited access to clean water.
Intermediate stage in freshwater snails.
Contact with infested water, penetrate skin, worms grow in blood vessels around bladder (and other organs).
Commonly cause fever, fatigue, abdominal pain, diarrhoea and blood in urine or stool.
If a patient has schistosomiasis, what kind of carcinoma in the bladder is more likely?
Squamous cell carcinoma (rather than transitional)
Other than TCC and SCC what are rarer causes of bladder cancer?
Adenocarcinoma (glandular, malignant)
Sarcoma (begin in bones and soft tissue, malignant)
Small-cell carcinoma (undifferentiated neoplasm, is often malignant)
What are risk factors for bladder cancer?
Smoking
Age
Occupational exposure to dyes / paints/ rubber (eg painter, hairdresser, mechanic)
Chemotherapy
Radiotherapy
Male
Commonly a dye factory worker with painless haematuria has ______ cell carcinoma of the bladder
transitional
Patients with asbestos exposure get…
mesothelioma
Patients with outdoor work and significant sun exposure commonly get…
skin cancer
What is a sign of bladder cancer?
Painless haematuria (can be macroscopic or microscopic)
How do you diagnose bladder cancer?
Flexible cystoscopy and biopsy
NICE guidlines on recognising cancer advises a t__ w___ w___ referral for aged over 45 with unexplained visible haematuria or aged over 60 with microscopic haematuria with dysuria or raised WBCs
two week wait
NICE guidelines recommend considering a non-urgent referral in people over 60 with…
recurrent unexplained UTIs
True or false: anaesthetic cannot be used for cystoscopy
False
Can be performed under local or general anaesthetic
What staging system is used for bladder cancer?
TNM
(tumour, node, metastasis)
Invasive bladder cancer includes what T stages?
T2-T4 and any lymph node or metastatic spread
What treatment options are available for bladder cancer?
Conservative support from specialist nurse
Chemotherapy
Radiotherapy
Surgery - TURBT
Last resort = cystectomy
What is TURBT?
transurethral resection of bladder tumour
Used for non-muscle-invasive bladder cancer
What is intravesical chemotherapy?
Chemotherapy given into the bladder through a catheter.
Often used after TURBT to prevent recurrence.
How does the BCG vaccine play a role in treatment of bladder cancer?
Can be used as form of immunotherapy. The vaccine commonly used for TB can be given into the bladder and is thought to stimulate the immune system to attack the bladder tumours.
How is urine drained after radical cystectomy?
Urostomy with an ileal conduit (most common)
Continent urinary diversion
Neobladder reconstruction (using section of ileum)
Ureterosigmoidostomy
