Bladder Cancer

Question 1

Define:

Answer 1

Malignancy of bladder cells (urothelium)

Transitional cell carcinoma = 90% of the cases

Squamous cell carcinoma associated with inflammation (schistomasis) (rare)

Question 2

Why is histology important in bladder cancer?

Answer 2

Determine prognosis.

Grade 1 = well differentiated
Grade 2= intermediate
Grade 3= poorly differeniated

Question 3

Aetiology:

Answer 3

Unknown

Question 4

Risk factors:

Answer 4

Smoking 
Chronic cystitis 
Recurrent kidney stones 
Aromatic amines (used in rubber and dyes)
Pelvic Irradiation 
Schistomasis
Cyclophosphamide treatment

Question 5

Epidemiology:

Answer 5

2% of cancers

2-3x more likely in males

peaks at 50-70 years old

Question 6

Symptoms:

Answer 6

Painless macroscopic haematuria

Frequency

urgency

Nocturia

Voiding irritability

Recurrent UTIs

rare = urethral obstruction

Question 7

Signs:

Answer 7

Usually no signs

Bimanual examination for disease staging

Question 8

Investigations:

Answer 8

Cystoscopy - for biopsy, imaging and removal

urine microscopy/cytology - sterile pyuria

Ultrasound

Intraveneous urogrpahy

CT/MRI for staging