Bladder Cancer Flashcards
What is the commonest type of bladder cancer?
Transitional cell (urothelial) carcinoma (vs squamous cell)
What are risk factors for bladder cancer?
- Smoking
- Aromatic amines - rubber/dye industry
- Chronic cystitis
What might be a typical occupation of a pt with bladder cancer?
Worked in factory - exposure to aromatic amines
What are symptoms of bladder cancer?
- Visible haematuria - painless, macroscopic
- Recurrent UTIs
- Voiding irritability
What are complications of treatment for bladder cancer?
Post-operative urinary incontinence
What is the first line investigation for bladder cancer?
Urinalysis + urine MC&S (urine cytology)
How do you diagnose bladder cancer?
Cystoscopy + biopsy
How do you stage bladder cancer?
- CT urogram (incl. contrast)
- ± bimanual EUA (examination under anaesthesia)
- ± MRI/lymphangiography
How do you curatively treat bladder cancer?
- Surgery (TURBT (transurethral resection of bladder tumour) - CIS/Ta/T1) + chemo/immuno (neo and adjuvant)
- OR Surgery (radical cystectomy - T2+/squamous cell)
How do you palliatively treat bladder cancer?
Chemo/radio (MI/co-morbid)
What imaging would you do in bladder cancer?
Renal and bladder US or CT KUB
What are common complications of bladder cancer?
- Urinary retention
- Hydronephrosis (urine backs up into kidney)
- Other urinary tract cancers
What should you never ignore?
An episode of visible haematuria
Who should you refer for 2 week wait for bladder cancer?
- > 45 + either unexplained visible haematuria OR visible haematuria persisting after treatment of UTI
- > 60 + unexplained non-visible haematuria PLUS dysuria or high WBC
If someone presents with visible haematuria what do you need to exclude?
SIT
Stones
Infection
Tumour
What is first line chemotherapy for bladder cancer?
Mitomycin
