Bladder cancer

Question 1

Define bladder cancer

Answer 1

Malignancy of bladder cells

Question 2

What are the types of 2 main types of bladder cancer and which one is more common?

Answer 2

1. Urothelial (transitional cell) carcinoma - 90%

2. Non-urothelial carcinoma = Squamous cell and adenocarcinoma - 10%

Question 3

What proportion of bladder cancers penetrate the muscle layer?

Answer 3

20%, most do not

Question 4

What are risk factors for bladder cancer?

Answer 4

1. Smoking
2. Aromatic amines – rubber industry, dye stuffs (naphthylamines and benzidine)
3. Chronic cystitis
4. Cyclophosphamide treatment (chemotherapy)
5. Pelvic irradiation
6. Schistosomiasis – inc risk of squamous cell carcinoma
7. Arsenic in drinking water
8. White ethnicity

Question 5

What is the epidemiology of bladder cancer?

Answer 5

1. More common in males
2. Peak incidence = 50-70yrs
3. 2nd most common cancer of the genitourinary tract

Question 6

What are the presenting symptoms of bladder cancer?

Answer 6

1. Macroscopic haematuria
2. Painless
3. Frequency
4. Urgency
5. Nocturia
6. Voiding irritability
7. Recurrent UTI’s
8. Mucus in urine (Adenocarcinoma)

Question 7

What are the signs of bladder cancer of physical examination?

Answer 7

Often no signs

Question 8

What are the appropriate investigations for bladder cancer?

Answer 8

1. Cystoscopy
2. Urine MCS
3. CT

Question 9

What are transitional cells?

Answer 9

Transitional cells are able to change shape and stretch. They make up the lining of the renal pelvis, ureters, bladder and urethra.