Bladder Cancer Flashcards
1
Q
What is the origin of most bladder cancers?
A
transitional (urothelium) cells lining the bladder
2
Q
There are 2 major groups of bladder cancers - what are they?
A
1) high-grade invasive tumours
- invade the bladder wall
- associated with metastasis and worse prognosis)
2) low-grade non-invasive
- can occur after resection
- very few progress to higher-grade tumours
- excellent prognosis
3
Q
What are risk factors for bladder cancer?
A
- may be linked to carcinogens excreted in urine (smoking, breakdown products or aromatic amines in dyes, products in rubber, textiles, paint, chemicals, petroleum)
- chronic bladder infections and stones increase risk
- schistosomiasis (parasite) in bladder
4
Q
What are manifestations of bladder cancer?
A
- microscopic and gross, painless hematuria (can be intermittent)
- frequency, urgency, dysuria
5
Q
How do we screen for bladder cancer?
A
those at high risk recommended:
- periodic urine cytology (microscopic exam of cells in urine, look for abnormal cells)
- flow cytometry
- – fluorochromes or dyes added which interact with DNA
- – cells passed through laser
- – dye and cell components interact and release high-intensity light
- – measure light - malignant cells have more DNA
- – can do on biopsy specimens, bladder washings or cytologic preps
6
Q
How is bladder cancer diagnosed?
A
- cytologic studies (look for malignant cells from bladder washings or biopsies)
- excretory urography (x-ray with contrast medium)
- cystoscopy
- biopsy
- US, CT, MRI to stage the tumour
7
Q
How is bladder cancer treated?
A
depends on grade and degree of invasiveness
- surgical removal of tumour (endoscopic removal of superficial lesions, diathermy, remove part or all of bladder, may remove prostate and seminal vesicles in men, may need urinary diversion)
- radiation
- chemotherapy (may be instilled into bladder to avoid systemic effects)
- immunotherapy (can be instilled) - including bacillus calmette-guerrin vaccine to stimulate cell-mediated immunity)
