Bladder Cancer Flashcards

1
Q

What are 2 key risk factors for transitional cell carcinoma (TCC)?

A

1) Smoking
2) Aromatic amines

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2
Q

What is the most common clinical presentation of bladder cancer?

A

Painless haematuria

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3
Q

Which medication is a risk factor for TCC?

A

Cyclophosphamide

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4
Q

What are 2 key risk factors for squamous cell carcinoma of the bladder?

A

1) Schistosomiasis
2) Smoking

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5
Q

What infection is a risk factor for squamous cell carcinoma of the bladder?

A

Schistosomiasis

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6
Q

What are the 3 types of bladder cancer?

A

1) TCC (>90%)

2) Squamous cell carcinoma

3) Adenocarcinoma

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7
Q

Where does cancer of the bladder arise from?

A

Endothelial lining (urothelium)

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8
Q

Where were aromatic amines used?

A

In dye and rubber industries

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9
Q

When is a 2 week wait referral for suspected bladder cancer indicated?

A

≥45 y/o with unexplained visible haematuria

≥60 y/o with microscopic haematuria (not visible but positive on a urine dipstick PLUS:
a) dysuria or;
b) raised WCC

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10
Q

Clinical features of bladder cancer?

A

1) Painless haematuria

2) LUTS: dysuria, frequency, urgency

3) Suprapubic pain

4) Systemic e.g. weight loss, fatigue, anaemia

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11
Q

1st line investigation in suspected bladder cancer?

A

Cystoscopy (a camera through the urethra into the bladder).

The cystoscope can be rigid or flexible.

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12
Q

What staging system is used for bladder cancer?

A

TNM staging

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13
Q

What is there a clear distinction between when staging bladder cancer?

A

Non-muscle-invasive bladder cancer (not invading the muscle layer of the bladder)

Muscle-invasive bladder cancer (invading the muscle and beyond)

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14
Q

What does non-muscle-invasive bladder cancer include on the TNM staging system?

A

Tis/carcinoma in situ: cancer cells only affect the urothelium and are flat

Ta: cancer only affecting the urothelium and projecting into the bladder

T1: cancer invading the connective tissue layer beyond the urothelium, but not the muscle layer

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15
Q

What does invasive bladder cancer include on the TNM system?

A

Invasive bladder cancer includes T2 – 4 and any lymph node or metastatic spread.

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16
Q

Possible mx options for bladder cancer?

A

1) Transurethral resection of bladder tumour (TURBT)

2) Intravesical chemotherapy

3) Intravesical Bacillus Calmette-Guérin (BCG)

4) Radical cystectomy

5) Chemotherapy & radiotherapy

17
Q

What does TURBT involve?

A

Removing the bladder tumour during a cystoscopy procedure.

18
Q

What is intravesical chemo?

A

Chemotherapy that is given into the bladder through a catheter.

This is often used after a TURBT procedure to reduce the risk of recurrence.

19
Q

What is intravesical BCG?

A

Intravesical BCG may be used as a form of immunotherapy.

Giving the BCG vaccine (same one as for TB) into the bladder is thought to stimulate the immune system, which in turn attacks the bladder tumours.

20
Q

What is a radical cystectomy?

A

Removal of entire bladder

21
Q
A