Bladder cancer

Question 1

parasite that can cause bladder ca? how does it spread

Answer 1

schistosomiasis

through the skin (not up the urinary tract). 50% b ca worldwide

Question 2

commonest b ca in the uk

Answer 2

transitional cell carcinoma. nb it is a urothelial carcinoma and can also affect ureters and renal pelvis)

Question 3

occupational b ca carcinogens

Answer 3

rubber
leather
metal workers
plastics
azo dyes

Question 4

TCC associated with what cancer

Answer 4

hereditary nonpolyposis colon ca

Question 5

sx

Answer 5

painless haematuria
freq, urg, dysuria
obstruction

Question 6

ix suspected b ca

Answer 6

dipstick (? uti)
flexible cystoscopy
CT or MRI staging
TURBT then cytology

Question 7

what ix is diagnostic but also an rx for non-invasive tumours

Answer 7

TURBT

transurethral resection bladder tumour

Question 8

staging used in b ca

Answer 8

TNM

Question 9

what is CIS

Answer 9

carcinoma in situ. v early, high grade (poorly differentiated) ca cells only in innermost bladder lining

Question 10

what can be given at same times as TURBT

Answer 10

iv mitomycin C

Question 11

rx non invasive disease/ CIS

Answer 11

BCG (same as TB vaccine) or radical cystectomy

Question 12

rx invasive tumours

Answer 12

neoadjuvant chemo (cisplatin)
\+ radical cystectomy or radical radiotherapy. in this case i think radical means removal of lymph nodes

Question 13

complications

Answer 13

UTI
retention
hydronephrosis
tumour recurrence
s234 damage during rx -> ED