Urologist

Question 1

what is the most common bladder cancer?

Answer 1

transitional cell carcinoma (>90%)

Question 2

how does TCC of bladder present?

Answer 2

mainly painless haematuria
recurrent UTIs
voiding irritability

Question 3

how is bladder cancer diagnosed?

Answer 3

cytoscopy with biopsy
CT urogram is also diagnostic and provides staging
bimanual eua helps assess spread

Question 4

how is Tis, Ta, T1 TCC treated?

Answer 4

= (80% cases) - diathermy via transurethral cytoscopy / transurethral resection (TURBT)

• consider a regime of intravesicle BCG for multiple small tumours/high grade
• alternative chemo meds = mitomycin, epirubicin. gematabine

Question 5

how is T2-T3 TCC treated?

Answer 5

gold standard = radical cystectomy
radiotherapy preserves bladder but worse prognosis
post op chemo = e.g. MVAC = methotrexate, vinblastine, doxorubicin, cisplatin or GC gematabine and cisplatin

Question 6

how is T4 TCC treated?

Answer 6

palliative chemo/radiotherapy

Question 7

how are simple lower UTIs treated?

Answer 7

3 day antibiotic course
trimethoprim
nitrofurantoin
cephalexin