Bladder carcinoma Flashcards
Origin of bladder carcinoma
Urothelium (endothelial lining)
Carcinogen aromatic amines can be found in
- dye
- rubber
Schistosomiasis is a RF to which cancer
SCC
Most common type of bladder carcinoma
Transitional cell carcinoma (90%)
Less common type of bladder carcinoma
SCC (5%)
Dye factory workers are at risk of
Transitional cell carcinoma
Asbestos exposure is associated with
Mesothelioma
Outdoor workers/sun is associated with
Skin cancer
Classic exam presentation
Retired dye factory worker with painless haematuria
Classic presentation of bladder cancer
Painless haematuria
A two-week referral is made for >45 if they experience
- unexplained visible haematuria AND
- without UTI/ Tx after UTI
A two-week referral is made for >60 if they experience
- microscopic haematuria AND
- dysuria/raised WCC
Non-urgent referral is made for >60 if they experience
Recent unexplained UTIs
Dx method that uses a tube and can use GA/LA
Cystoscopy
Non-muscle-invasive bladder TNM
- Tis/carcinoma in situ
- Ta
- T1
Describe the affected tissue and tumour shape in Tis/carcinoma in situ
- urothelium
- flat
Describe the affected tissue and projection of Ta
- urothelium
- bladder
Tissue affected in T1
- urothelium & connective tissue
- NOT muscle
Affected tissue in T2-4 muscle-invasive bladder cancer
- muscle
- lymph nodes
- metastatic spread
1st line Tx bladder cancer
Transurethral resection of bladder (TURBT)
Indication for TURBT
Non-muscle invasion bladder
2nd line Tx bladder cancer to try after TURBT
Intravesical chemotherapy
Intravesical chemotherapy has an advantage of
— recurrence risk
Rationale behind intravesical BCG vaccine
- stimulate immune repsonse
Possible solutions to deal with urine following radical cystectomy
- urostotomy
- continent urinary diversion
- neobladder reconstruction
- ureterosigmoidostomy
