Bladder Cancer

Question 1

90% of bladder cancers are what?

Answer 1

90% are transitional cell carcinomas, although can be adenocarcinoma or squamous cell carcinoma (schistosomiasis)

Question 2

RF’s

Answer 2

↑ Age,
smoking,
rubber/dye industry, chronic inflammation (catheters/cystitis/stones),

Question 3

Presentation

Answer 3

Painless haematuria, 
recurrent UTI’s 
frequency,
 nocturia, 
 ↓ weight/appetite

Question 4

Ix?

which Ix is for diagnosis?

which Ix for staging?

Answer 4

Urine cytology and microscopy

Cystoscopy + biopsy (TURBT) for diagnosis

CT urogram – Staging (TNM)

Question 5

Mx

T1 - doesnt’ involve bladder wall?

T2-3 - spread to bladder wall?

T4 - metastasised outside of bladder?

Answer 5

Tis/Ta/T1 – Diathermy via TURBT ( Trans urethral resection of bladder tumour) + chemo
T2-3 – Radical cystectomy
T4 – Palliative chemo/radiotherapy