Bladder Cancer Flashcards
What is Bladder Cancer?
Malignancy of bladder cells
Describe the histological grading of bladder cancer
Grade 1: differentiated
Grade 2: intermediate
Grade 3: poorly differentiated
Describe the aetiology of bladder cancer
UNKNOWN
80% are confined to bladder mucosa, only ~20% penetrate muscle
Describe the epidemiology of bladder cancer
2% of cancers
2nd most common cancer of the genitourinary tract
M > F
Peak incidence: 50-70 yrs
List 7 risk factors for bladder cancer
FHx
Smoking
Aromatic amines: rubber industry, dye stuffs (naphthylamines + benzidine)
Chronic cystitis
Chemo (cyclophosphamide tx)
Pelvic irradiation
Schistosomiasis: inc risk of squamous cell carcinoma
List 4 symptoms of bladder cancer
Painless macroscopic haematuria
Irritative/ storage symptoms
Recurrent UTIs
Rarely: ureteral obstruction
Describe signs of bladder cancer
Often NO SIGNS
Significant weight loss
Bimanual examination may be performed as part of disease staging
Describe what may be seen in urinalysis in bladder cancer
Haematuria
Possibly sterile pyuria
What other investigations are used in bladder cancer?
Cystoscopy: for visualisation, biopsy or removal
US: visualisation
CT/ MRI for staging
Urinary tumour markers: BTA, NMP22
What is a common complication of bladder cancer? How is this managed?
Hydronephrosis (dilated ureter) is common with cervical, ovarian + bladder cancers
Obstruction will need to be stented
In which patients is a 2WW referral for suspected bladder cancer appropriate?
> 45 with unexplained visible haematuria
Non-visible haematuria (on dip) + >60 + not UTI
List 5 irritative/ storage symptoms seen in bladder cancer
Frequency Urgency Nocturia Voiding irritability Dysuria
What cell types are usually involved in bladder cancer?
Most bladder cancers are transitional cell carcinomas (90%)
Transitional epithelia is a form of stratified epithelia
What cell types may rarely be involved in bladder cancer? What are these associated with?
Squamous cell carcinomas
associated with chronic inflammation (e.g. schistosomiasis)
What investigation is diagnostic of bladder cancer?
Cystoscopy + biopsy