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Principles and Procedures > Bladder Cancer > Flashcards

Bladder Cancer Flashcards

1
Q

Bladder cancer is the __ most common cancer in the US?

A

6th

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2
Q

Bladder cancer is the __ most prevalent malignancy in the men?

A

4th

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3
Q

What percentage of bladder cancer occurs in men?

A

75%

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4
Q

What demographic group is more susceptible to bladder cancer?

A

White 2x more than blacks, however black have higher incidence of advanced disease

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5
Q

What are the two important prognostic factors?

A

Tumor extent and depth of muscle invasion

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6
Q

What does the histological prognostic factor entail?

A

Whether the cells are poorly or well differentiated

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7
Q

What does the morphological prognostic factor entail?

A

the different between papillary tumors being low grade and superficial, while invasive lesions are high grade and have high chance of invasion into lymphatics, BV, and tissue

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8
Q

What was the survival rate from 2006-2012 for bladder cancer?

A

77.5%

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9
Q

What percentage of bladder cancers are in situ?

A

50%

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10
Q

What can the bladder be described as?

A

Flexible, muscular, tetrahedral bag

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11
Q

What is the function of the bladder?

A

To collect urine from the kidneys via the ureters

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12
Q

What is the average volume the bladder can hold?

A

2 cups

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13
Q

What structure aids in the elimination of urine from the bladder?

A

urethera

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14
Q

What is the difference between the male and female urethera?

A

Female urethra is shorter

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15
Q

What is the most superior and anterior portion of the bladder called?

A

Apex

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16
Q

Do ureters pierce the base of the bladder laterally, posteriorly or neither?

A

Neither, Obliquely

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17
Q

What is the trigone of the bladder and what structures define it?

A

The trigone is a triangular portion of the lower bladder and it is defined by bother of the ureter orifices and urethra orifice

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18
Q

What type of cell lines the bladder?

A

Transitional Epithelium

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19
Q

What are the risk associated with bladder cancer? (7 answers)

A

Smoking, Age, Chronic Bladder Inflammation, High saturated fat diet, EBRT, workers in rubber or dye industries, Well water in New England

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20
Q

How much more likely are smokers to get bladder cancer then non-smokers?

A

3 times more likely

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21
Q

What does bladder cancer symptoms present as? (4 answers)

A

Hematuria, urine retention, clotting, Vesical irritability

22
Q

What percentage of patients will present with hematuria?

A

75-80%

23
Q

What percentage of patients will present with vesical irritability?

A

25%

24
Q

What symptoms are more likely for bladder carcinoma in situ? (4 answers)

A

frequency, urgency, dysuria and hematuria

25
Q

What are some methods used to detect bladder cancer? (5 answers)

A

Rectal/Pelvis exam, Urinalysis, Cystoscopy, Biopsy, Bone scans for mets,

26
Q

What percentage of bladder cells are epithelial cells?

A

98%

27
Q

What are the different percentages of bladder cancer based on cellular makeup? (3 answers)

A

92% Transitional Carcinoma, 6-7% are Squamous Cell Carcinoma, 1-2% Adenocarcinomas

28
Q

What is the route of spread for bladder cancer?

A

Direct extension into or through the bladder wall

29
Q

What is likely after the spread of bladder cancer extends through the mucosal surface? (2 answers)

A

Lymphatic and Bloodstream invasion

30
Q

What is the primary lymphatic drainage of the bladder? (4 answers)

A

Internal/External iliacs, presacral and Para-aortics

31
Q

What are the most common sites of metastasis for bladder cancer? (3 answers)

A

Lung, bone and Liver

32
Q

What percentage of all bladder cancers are superficial bladder cancer?

A

75-85%

33
Q

What is the standard of care for superficial bladder cancer?

A

TURBT (Transurethral resection of Bladder tumor)

34
Q

What is often given after TURBT?

A

Intravesical Therapy

35
Q

What is the a requirement for Electrofulguration of bladder cancer?

A

Muscle must be seen in specimen

36
Q

What percentage of bladder cancer reoccur?

A

30%

37
Q

What are the factors of reoccurring bladder cancer? (4 answers)

A

Grade, Depth, Multifocality, and in-situ

38
Q

What is the standard of care for muscle-invasive bladder cancer?

A

Radical Cystectomy

39
Q

What is removed for radical cystectomy for males? (8 answers)

A

Bladder, Adipose tisssue, Lower ureters, prostate, SV, Vas deferens, Proximal urethera, and pelvis LNs

40
Q

What is removed for radical cystectomy for females? (7 answers)

A

Bladder, urethra, uterus, fallopian tubes, ovaries, anterior vaginal wall, pelvis LNs

41
Q

What is restructured as the bladder for the patient following cystectomy?

A

Ileal conduit, which is a portion of small bowel reconstructed to be utilized as for connection to the ureters and stoma

42
Q

What is an orthotopic neobladder?

A

a newly reconstructed bladder from intestine which is connected to the ureters and the urethra to function as a bladder

43
Q

When is radiation therapy used for bladder cancer?

A

For extensive disease or inoperable patients

44
Q

TURBT is often utilized before XRT or chemotherapy. True or False?

A

True

45
Q

When utilized is radiotherapy utilized alone or with chemotherapy for bladder cancer?

A

Concurrent chemoradiation

46
Q

What are the simulation steps for bladder patients? (5 answers)

A

Supine, contrast (via catheter) and air within the bladder, barium within the rectum and legs straight

47
Q

Why is it essential that the legs are not bent during radiotherapy for bladder cancer?

A

To not shift the bladder superiorly and exposing more of the genitals

48
Q

What structures are often included in the treatment portals for bladder cancer? (5 answers)

A

Total bladder, Tumor volume, Prostate, Prostatic Urethra, and Pelvic LNs

49
Q

What are the radiation treatment fields used for bladder cancer? (2 answers)

A

4 field box with 12x12 field size

50
Q

What is th NCCN dosage for bladder cancer including the boost? (2 answers)

A

40-45 Gy w/ or w/o Pelvic LN, Boost to 66 Gy

Principles and Procedures (27 decks)

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