Bladder Cancer

Question 1

Definition

Answer 1

· Malignancy of bladder cells

o Most bladder cancers are transitional cell carcinomas
o RARELY, bladder cancers may be squamous cell carcinomas associated with chronic inflammation (e.g. schistosomiasis)

Question 2

Aetiology

Answer 2

Unknown

Question 3

Risk factors

Answer 3

o Smoking
o Dye stuffs (naphthylamines and benzidine)
o Cyclophosphamide treatment
o Pelvic irradiation
o Chronic UTIs
o Schistosomiasis

Question 4

Epidemiology

Answer 4

· 2% of cancers
· 2nd most common cancer of the genitourinary tract
· 2-3 x more common in MALES
· Peak incidence: 50-70 yrs

Question 5

Presenting symptoms

Answer 5

· Painless macroscopic haematuria

· Irritative/storage symptoms
o Frequency
o Urgency
o Nocturia

· Recurrent UTIs

· Rarely: ureteral obstruction

Question 6

Signs on physical examination

Answer 6

· Often NO SIGNS

· Bimanual examination may be performed as part of disease staging

Question 7

Investigations

Answer 7

· Cystoscopy - allows visualisation, biopsy or removal
· Ultrasound
· Intravenous urography
· CT/MRI for staging