Bladder Cancer

Question 1

Types of bladder cancer

Answer 1

• 90% transitional cell carcinoma

* 10 % squamous cell carcinomas

Question 2

Where do they arise from?

Answer 2

•They arise from the endothelial lining (urothelium)

Question 3

How do they present

Answer 3

painless haematuria

Question 4

How are they diagnosed?

Answer 4

•Diagnosed by cystoscopy and biopsy

Question 5

RF for bladder cancer

Answer 5

Smoking
•There are key workplace carcinomas that are risk factors

◦Carcinogens include aromatic amines, polycyclic aromatic hydrocarbons, arsenic and tetrachloroethylene
◦These are found in hair dyes, industrial paint, rubber, motor, leather, and rubber workers, blacksmiths etc.

• Schistosomiasis causes squamous cell carcinoma in countries with a high prevalence
• Drinking sufficient water is thought to be protective

Question 6

TReatments for cancer not invading the muscle

Answer 6

◦Transurethral Resection of a Bladder Tumour (TURBT)
◦Chemo into bladder after surgery (use barrier contraception afterwards)
◦Weekly treatments for 6 weeks with BCG vaccine squirted into the bladder via catheter, then every six months for 3 years.

Question 7

Treatments for cancer invading the muscle

Answer 7

◦Radical cystectomy with ileal conduit
◦Radiotherapy (as neoadjuvant, primary treatment or palliative)
◦IV chemotherapy as neoadjuvant or palliative