Bladder cancer

Question 1

What is the most common type of bladder cancer?

Answer 1

Transitional cell carcinoma

Question 2

What are the less common types of bladder cancer?

Answer 2

Squamous cell carcinoma
Adenocarcinoma

Question 3

What is squamous cell carcinoma of the bladder associated with?

Answer 3

Schistosomiasis

Question 4

What are the risk factors for bladder cancer?

Answer 4

Smoking
Increased age
Exposure to aniline dyes
Rubber manufacture
Schistosomiasis
Cyclophosphamide

Question 5

What is the 2 week wait criteria for bladder cancer?

Answer 5

Over 45 with unexplained visible haematuria (without a UTI or persisting after a UTI)

Over 60 with microscopic haematuria, plus dysuria or raised white cells on full blood count

Question 6

What is the presentation of bladder cancer?

Answer 6

Painless haematuria
Can cause dysuria
Frequency
Weight loss
Palpable suprapubic mass (advanced cases)
Anaemia

Question 7

What investigation is diagnostic of bladder cancer?

Answer 7

Flexible cystoscopy

Question 8

What investigations are useful in the diagnosis of bladder cancer?

Answer 8

Urinalysis
FBC
U&Es
Bone profile (bone metastasis)
CTAP - assess spread
CT urogram
Pelvic MRI - for staging

Question 9

What is the management of superficial/ non-muscle invasive bladder cancer?

Answer 9

Trans-urethral resection of bladder tumour
- Involves removing the tumour through a cystoscopy procedure

Intravesical chemotherapy is given alongside TURBT

Question 10

What is the management of muscle invasive bladder cancer?

Answer 10

Radical cystectomy with neoadjuvant chemotherapy

Radical radiotherapy with neoadjuvant chemotherapy