Bladder cancer

Question 1

Risk factors

Answer 1

Old, male, family history, smoker, occupational exposure in the rubber and dye industry.

Question 2

Types

Answer 2

90% transitional cell malignancies
Others: SSC, adenocarcinoma.
SCC is seen in Schistosoma haematobium infection common in Egyptian backgrounds.
Biopsy- show either papillary or flat tumours. 70% papillary: grow outwards, less invasive and better prognosis.
Flat tumours: more invasive, higher grade, worse prognosis.

Question 3

Symptoms

Answer 3

Painless macroscopic haematuria

Question 4

Investigations

Answer 4

USC referral to urology clinic -> bloods, urinalysis, flexible cystoscopy for diagnosis and biopsy.
Staging: CT, pelvic MRI, bone scan.

Question 5

Treatment

Answer 5

Superficial lesions- TURBT. Transurethral resection of bladder tumour. Post op mitomycin C directly into the bladder.
Invades muscle- radical cystectomy + RT