Hematuria Bladder Cancer Flashcards
What are thr risk facotrs for urologic diseae?
Age >40 yo Male Cigrette Smoking Chemical exposure Pelvicradiation Irrittive voiding symptoms Urologic disease
What are the step of Eval for hematuria?
UA with MICRO ANALYSIS Urine culture Cytology/markers Upper UT imaging CT UROGRAM Cystoscopy
What is the most common urologic CA?
Urothelial/Trnsitional Cell CA
What chemicals can increase risk of Bladder cancer?
Aromatic amines
Aniline Dyes
Analgesic abuse
What is the presentatin of Bladder Cancer?
Painless gross hematuria is bladder cancer unless proven otherwise
WHat are the bladder cancer tumor markers?
Bladdertumor antigen (BTA)
Nuclear matrix protein (NMP-22)
FISH(florescence in situ hybridization)
How is Bladder cancer diagnosed?
Transurethral Resection of bladder tumor (Biopsy)
Bimanual exam
What is charicteristic of Early Stage cancer? (Ta, T1,CIS)
70-80 % of bladdercancers
70-80% Recurr
How is Clinical staking if bladdercancer done?
CT scanning of Abdomen and pelvis
Chest radiography
Serum Chemistries
How are patients monitored after noninvasive disease?
Cystoscopy and urine cytology/FISH ev 3mon for 1-2 years ev 6 mon for next 1-2 years annually for life Restart protocol in recurrence
What is Adjuvant thaerapy for noninvasive disease?
Intravesical therapy
- BCG
- Mitomycin C
- Interferon alpha
- Doxorubicin, Valrubicin, epirubicin
What can be introduced into the bladder to prevent invasion of bladder tumors?
Attenuated Strain of Mycobacterium Bovis
When is BCG indicated for bladder cancer?
Tumor prophylaxis for T1 and high grade recurrent Ta lesions
Dec recurrence
CIS
Residual tumor/mult tumors/ persistent pos cytology
What is used for intravesical Chemotherapy?
Mitomycin C
Intrferon Alpha
Doxorubicin, valrubicin, epirubicin
What is included in a radical cystectomy?
Remove Bladder, prostate, pelvic LN and urethra in MEN
Remove Bladder, uterus, cervix, ovaries, anterior vaginal wall, pelvic LN, urethra in WOMEN
