Bladder cancer

Question 1

What is the peak age of bladder cancer?

Answer 1

over 80years

Question 2

What gender is bladder cancer more prevalent?

Answer 2

men 3:1

Question 3

What are the different types of bladder cancer/

Answer 3

TCC (80-90%) SSC, AC and sarcoma

Question 4

How can bladder cancers be classified into 3?

Answer 4

non muscle invasive bladder cancer (70-80%) and muscle invasive bladder cancer and metastatic

Question 5

What are the 4 layers of the bladder wall?

Answer 5

Inner- transitional epithelium, lamina propria, muscular propria, fatty connective tissue

Question 6

What are the 2 biggest risk factor for bladder cancer?

Answer 6

smoking and increasing age

Question 7

What are the other risk factors for bladder cancer?

Answer 7

aerobatic hydrocarbons, schistosomaisis infection and previous radiation to the pelvis

Question 8

What are the bladder cancer clinical features?

Answer 8

Painless haematuria, recurrent UTIs, LUTS like frequency, urgency or incomplete voiding, pelvic pain, weight loss, lethargy

Question 9

What may be found on examination of bladder cancer?

Answer 9

nothing unless there is ureteric obstruction

Question 10

What are the stages of bladder cancer?

Answer 10

look on teach me surgery hahaha

Question 11

What is a differential diagnosis of bladder cancer?

Answer 11

urinary tract infections, renal calculi or prostate or renal cancer

Question 12

What investigations would you do for bladder cancer?

Answer 12

urgent flexible cystoscopy under local anaesthetic, then a rigid cystoscopy for more definitive assessment

Question 13

If a bladder tumour is found with rigid cystoscopy what is done?

Answer 13

A biopsy and then maybe a transurethral resection of bladder tumour

Question 14

What imaging is needed if muscle-invasive bladder cancer is suspected?

Answer 14

CT staging

Question 15

Why is urine cytology not routinely done but can be done?

Answer 15

identifies cancerous cells in urine but has poor sensitivity and specificity

Question 16

What is the management of non-invasive bladder cancer?

Answer 16

depends on the classification but may be resected via TURBT, may need adjuvant intravesical therapy, radical cystectomy

Question 17

What is the problem with superficial bladder tumours?

Answer 17

high rate of recurrence- 70% in 3 years and they are more likely to be invasive

Question 18

What is TRUBT?

Answer 18

Transurethral resection of bladder tumour- diathermy and rigid cystoscopy

Question 19

How is muscle invasive bladder cancer treated?

Answer 19

radical cystectomy with neoadjuvant chemotherapy with follow up CT regularly

Question 20

How is urinary diversion done?

Answer 20

Ileal conduit with urine draining via the urostomy, bladder reconstruction from a segment of small bowel and urine drains urethral or a catheter

Question 21

Why do you need to take B12 and folate levels after an ileal conduit?

Answer 21

due to resection of part of the ileum

Question 22

How is metastatic bladder cancer treated?

Answer 22

chemotherapy

Question 23

What is the prognosis for bladder cancer?

Answer 23

more likely upper urinary tract tumours and urethral tumours, high survival rate if superficial of 80-90% in 5 years, less if more spread