Bladder cancer Flashcards
name 4 radical tx options for bladder cancer
surgical cystectomy - removal of whole bladder
local resection surgery - tumour removed via urethra - TURBT
EBRT + con-curent CHEMO - 60Gy in 30# and 5-fluorourcil
CHEMO - intravesical = mitomycin-C via catheter or IV= cisplatin and gematabine
role of surgical cystectomy for bladder cancer
only used when tumour invades muscle wall of bladder - whole bladder removed in 1st surgery and then 2nd surgery reconstructs urinary diversion- extremely invasive
role of local resection surgery for bladder cancer
for tumour that haven’t invaded muscle wall of bladder and tumour is removed via urethra - minimally invasive
role of ChemoRAD for bladder cancer
EBRT - delivered to whole bladder (empty) as 60Gy in 30# as VMAT and con-current chemo as 5-fluorourcil as radio-sensitiser
role of chemotherapy for bladder cancer
Intravesical= mitomycin-C via catheter into bladder of weekly dose for 6 weeks followed by maintenance chemo for 2 years
IV chemo = cisplatin and gamatabine to improve local control and survival neoadjuvant to RT or Surgery
4 signs of bladder cancer
haematuria - blood in urine
dysuria - painful urination
cystitis - infection
stricture - narrowing
name 3 investigations for bladder cancer
FBC
urine cytology
u/s
name the 7 TNM stages for bladder cancer
Tis = in situ carcinoma
T1= superficial invasive carcinoma
T2a= invade superficial muscle wall
T2b= invade deep muscle wall
T3 = invades through muscle wall
T4a= invade surrounding organs
T4b = metastatic spread
name 4 aetiological risk factors for bladder cancer
smoking
long term catheters
aromatic amines
polycyclic aromatic hydrocarbons
give examples of spread for bladder cancer
local = rectum, prostate, vagina
lymph= para-aortic + inguinal
blood= lung and bones
name 2 bladder cancer clinical trial
BC2001-whole vs partial
BC2001- irradiation of -ve LNs
what is BC2001- whole vs partial trialling
whether need to irradiate whole bladder
identified no impact of toxicities or loclregional control using partial irradiation - therefore the further is partial
what is BC2001- -ve LN irradiation trial
no data currently supports irradiation of negative LNs till found relapse on 4-6%
what is HYBRID adaptive rt in the concept of bladder cancer
idea of a ‘plan-of-the-day’ to provide multiple plans for daily variation ensuring always recieving optimal tx allowing for greater hypo fractionated txs.
