Bladder cancer Flashcards
What is the peak age of bladder cancer?
over 80years
What gender is bladder cancer more prevalent?
men 3:1
What are the different types of bladder cancer/
TCC (80-90%) SSC, AC and sarcoma
How can bladder cancers be classified into 3?
non muscle invasive bladder cancer (70-80%) and muscle invasive bladder cancer and metastatic
What are the 4 layers of the bladder wall?
Inner- transitional epithelium, lamina propria, muscular propria, fatty connective tissue
What are the 2 biggest risk factor for bladder cancer?
smoking and increasing age
What are the other risk factors for bladder cancer?
aerobatic hydrocarbons, schistosomaisis infection and previous radiation to the pelvis
What are the bladder cancer clinical features?
Painless haematuria, recurrent UTIs, LUTS like frequency, urgency or incomplete voiding, pelvic pain, weight loss, lethargy
What may be found on examination of bladder cancer?
nothing unless there is ureteric obstruction
What are the stages of bladder cancer?
look on teach me surgery hahaha
What is a differential diagnosis of bladder cancer?
urinary tract infections, renal calculi or prostate or renal cancer
What investigations would you do for bladder cancer?
urgent flexible cystoscopy under local anaesthetic, then a rigid cystoscopy for more definitive assessment
If a bladder tumour is found with rigid cystoscopy what is done?
A biopsy and then maybe a transurethral resection of bladder tumour
What imaging is needed if muscle-invasive bladder cancer is suspected?
CT staging
Why is urine cytology not routinely done but can be done?
identifies cancerous cells in urine but has poor sensitivity and specificity
What is the management of non-invasive bladder cancer?
depends on the classification but may be resected via TURBT, may need adjuvant intravesical therapy, radical cystectomy
What is the problem with superficial bladder tumours?
high rate of recurrence- 70% in 3 years and they are more likely to be invasive
What is TRUBT?
Transurethral resection of bladder tumour- diathermy and rigid cystoscopy
How is muscle invasive bladder cancer treated?
radical cystectomy with neoadjuvant chemotherapy with follow up CT regularly
How is urinary diversion done?
Ileal conduit with urine draining via the urostomy, bladder reconstruction from a segment of small bowel and urine drains urethral or a catheter
Why do you need to take B12 and folate levels after an ileal conduit?
due to resection of part of the ileum
How is metastatic bladder cancer treated?
chemotherapy
What is the prognosis for bladder cancer?
more likely upper urinary tract tumours and urethral tumours, high survival rate if superficial of 80-90% in 5 years, less if more spread
