Bladder Cancer

Question 1

What are the risk factors for bladder cancer?

Answer 1

• Tobacco exposure
• Other carcinogens (aromatic amines/hydrocarbons)
• Pelvic radiation/chemotherapy
• Schistosoma inflammation (SCC)
• Chronic bladder inflammation (UTIs, stones)

Question 2

What are the likely history/exam findings in a person with bladder cancer?

Answer 2

• Haematuria (normally painless)
• Dysuria
• Frequency

Question 3

How is a case of bladder cancer worked up investigation-wise?

Answer 3

• Urinalysis and urine cytology
• Cystoscopy/biopsy (definitive)
• CT urogram (staging)

Question 4

What are the management principles for a patient with bladder cancer?

Answer 4

• Low grade tumours
  
  • Transurethral resection
  • Intravesical chemotherapy
• Locally invasive tumours
  
  • Radical or partial cystectomy with lymph node cystectomy
  • Neoadjuvant and adjuvant chemo/radiotherapy