Bladder Cancer Flashcards

1
Q

What is Bladder Cancer?

A

Malignancy of bladder cells

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2
Q

Describe the histological grading of bladder cancer

A

Grade 1: differentiated
Grade 2: intermediate
Grade 3: poorly differentiated

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3
Q

Describe the aetiology of bladder cancer

A

UNKNOWN

80% are confined to bladder mucosa, only ~20% penetrate muscle

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4
Q

Describe the epidemiology of bladder cancer

A

2% of cancers
2nd most common cancer of the genitourinary tract
M > F
Peak incidence: 50-70 yrs

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5
Q

List 7 risk factors for bladder cancer

A

FHx
Smoking
Aromatic amines: rubber industry, dye stuffs (naphthylamines + benzidine)
Chronic cystitis
Chemo (cyclophosphamide tx)
Pelvic irradiation
Schistosomiasis: inc risk of squamous cell carcinoma

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6
Q

List 4 symptoms of bladder cancer

A

Painless macroscopic haematuria
Irritative/ storage symptoms
Recurrent UTIs
Rarely: ureteral obstruction

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7
Q

Describe signs of bladder cancer

A

Often NO SIGNS
Significant weight loss
Bimanual examination may be performed as part of disease staging

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8
Q

Describe what may be seen in urinalysis in bladder cancer

A

Haematuria

Possibly sterile pyuria

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9
Q

What other investigations are used in bladder cancer?

A

Cystoscopy: for visualisation, biopsy or removal
US: visualisation
CT/ MRI for staging
Urinary tumour markers: BTA, NMP22

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10
Q

What is a common complication of bladder cancer? How is this managed?

A

Hydronephrosis (dilated ureter) is common with cervical, ovarian + bladder cancers
Obstruction will need to be stented

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11
Q

In which patients is a 2WW referral for suspected bladder cancer appropriate?

A

> 45 with unexplained visible haematuria

Non-visible haematuria (on dip) + >60 + not UTI

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12
Q

List 5 irritative/ storage symptoms seen in bladder cancer

A
Frequency 
Urgency 
Nocturia 
Voiding irritability  
Dysuria
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13
Q

What cell types are usually involved in bladder cancer?

A

Most bladder cancers are transitional cell carcinomas (90%)

Transitional epithelia is a form of stratified epithelia

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14
Q

What cell types may rarely be involved in bladder cancer? What are these associated with?

A

Squamous cell carcinomas

associated with chronic inflammation (e.g. schistosomiasis)

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15
Q

What investigation is diagnostic of bladder cancer?

A

Cystoscopy + biopsy

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