Week 3 - K(2) - Bladder Cancer Flashcards
What is the muscle of the bladder and what epithelium lines this?
This is the detrusor muscle which is lined by transitional cell epithelium
What is the most common type of lower urinary tract carcinoma and where does it arise?
The most common type is transitional cell carcinoma and this arises usually in the bladder
What is the major risk factor for transitional cell carcinomas?
Smoking is the major risk factor
Transitional cell carcinomas (urothelial carcinomas) These constitute 90% of urothelial tract cancers. What is the main other cancer of the urothelial tract?
This is squamous cell carcinoma
What is the typical presentation of a transitional cell carcinoma and what are the two different types?
Typical presentation is painless haematuria Two types Papillary Non-papillary
Which type of transitional cell carcinoma is more common?
Papillary is more common - accounts for 80% of TCC Non-papillary accounts for the other 20% of TCC
What are other risk factors for TCC apart from smoking?
Aniline dyes -rubber and dye industry Long term use of cyclophosphamide Pic shows non-papillary
What is the main imaging carried out in bladder cancers?
CT urography + cystoscopy if suspected bladder cancer
TCC TENDENCY TO BE MULTICENTRIC AND BILATERAL What percentage of patinets will have a bilateral TCC?
Up to 10% of patinets have a bilateral TCC
Is urinary bladder cancer more common in males or females?
More common in males usually occurring after the age of 50
o Malignant proliferation of squamous cells, usually involving the bladder How does schistosomiasis cause squamous cell carcinomas?
Is known to cause the metaplasia of Transitional cell epithelium to squamous cell by the deposition of their eggs and this can cause bladder cancer
What are other risk factors for squamous cell carcinomas of the bladder?
o Risk factors include – chronic cystitis (older women), schistosomiasis infection (Egyptian male) and long standing nephrolithiasis/calculi
How do adenocarcinomas of the bladder arise?
o Arises from a urachal remnant (tumour develops at the dome of the bladder), cystitis cystica (glandularis), or Extroversion (glandular metaplasia),
Cystitis cystica occurs due to chronic irritation of the bladder What is seen on cystoscopy?
Subepithelial vesicles
What is the treatment of bladder cancer if Superficial lesion Higher grade tumours on histology?
Superficial lesion - transurethral resection of bladder tumour (TURBT) (or intravesical BCG for multiple small tumours) Higher grade on histology - radical cystectomy +/- post-op chemotherapy
