Bladder carcinoma (brief)

Question 1

How common is it?

Answer 1

5th commonest cause of cancer deaths

Question 2

Who does it affect?

Answer 2

M:F 3:1.

Question 3

What risk factors are there?

Answer 3

Exposure to aromatic hydrocarbons e.g. workers in the petrochemical, industrial dye, rubber industries, chimney sweeps. Also, smoking (esp. women). Risk is probably due to excretion of carcinogenic products excreted and concentrated in the urine, and tumours are likely to arise in locations exposed to urine the longest.

Question 4

How does it present?

Answer 4

Majority with painless haematuria. Other features are painless micturition, renal colic due to blood clot, disturbance of urinary stream, retention of urine.

Question 5

Investigations

Answer 5

Urine cytology, may reveal malignant cells. Cystoscopy is also possible.

Question 6

Treatment

Answer 6

Transurethral resection.

TCT can be completed by endoscopic resection, intravesical chemo reduces the high risk of recurrence.

Other types of bladder cancer require more thorough therapy, such as radical cystectomy.