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Urinary clinical conditions > Bladder Cancer > Flashcards

Bladder Cancer Flashcards

1
Q

What are the pathological types of bladder cancers?

A

Majority transitional cell carcinoma
In a minority can be squamous cell carcinoma
1% adenocarcinoma (urachal)

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2
Q

What are the risk factors for TCC bladder cancer?

A

Smoking
Aromatic amines
Non-hereditary genetic abnormalities

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3
Q

What are the risk factors for SCC bladder cancer?

A

Schistosomiasis
Chronic cystitis i.e. long term catheterisation, recurrent UTI’s, bladder stone
Cyclophosphamide therapy
Pelvis radiotherapy

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4
Q

What are the presenting features of bladder cancer?

A 
Haematuria (gross or microscopic)
Recurrent UTI
Storage bladder symptoms:
- frequency
- dysuria
- nocturia
- urgency
- urge incontinence 
- bladder pain

Also aymptoms related to invasive or metastatic disease

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5
Q

What is the most common presenting symptom of bladder cancer?

A

Gross haematuria

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6
Q

What investigations should be carried out if you suspected bladder cancer?

A 
Urinalysis
Urine cytology
Cyctoscopy 
Renal and bladder USS
CT- urogram / IV - urogram
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7
Q

What tests would you carry out to investigate the the cause of haematuria?

A 
Urinalysis
Urine culture (UTI ?)
Urine cytology (shows CIS & high grade tumours)
Cytourethroscopy 
CT urogram
USS
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8
Q

What is the risk of malignancy in someone who is > 50 years old and has frank haematuria?

A

25-35%

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9
Q

What is the risk of malignancy in someone who is > 50 yrs old and has microscopic (invisible or dipstix) ?

A

5-10%

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10
Q

What staging is used for bladder cancer?

A

TNM staging

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11
Q

How is bladder cancer graded?

A

Grade of tumour:
G1 = well differentiated (non-invasive)
G2 = moderately differentiated (often non-invasive)
G3 = poorly differentiated (invasive)
Carcinoma in situ - no invasion but very aggressive

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12
Q

What si the treatment for low grade non-invasive bladder cancer?

A

Endoscopic transurethral resection
+ intravesical chemotherapy (within 24hrs post op)
+ delayed intravesical BCG or IV chemotherapy

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13
Q

What is the treatment for muscle invasive bladder cancer?

A

Neoadjuvant chemotherapy
Surgery +/or radical radiotherapy

  • radical cytoprostatectomy in men
  • radical cystectomy with hysterectomy in women
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14
Q

What is the treatment for metastatic bladder cancer?

A

Chemotherapy
Surgery and radiotherapy in selected patients
Immunotherapy

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15
Q

What stages of bladder cancer are superficial?

A

Ta and T1

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16
Q

What is the prognosis of non-invasive, low grade bladder TCC?

A

5yr survival 90%

17
Q

What is the prognosis for invasive, high grade bladder cancer?

A

5 yr survival 50%

Urinary clinical conditions (17 decks)

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