Bladder Cancer
Reference: Sur Talk 264, OHCM 502, Lec
Not
Onc 110
Epidemiology
>40y, ♂>♀
Pathology
Transitional cell carcinoma.
Site:
Bladder (50%) > ureter > renal pelvis.
Risk Factors.
Smoking, drugs (cyclophosphamide), industrial carcinogens (azo dyes),
schistosomiasis
Clinical
Painless haematuria, frequency, urgency, dysuria, urinary tract
obstruction.
Spread
-
Local (bladder wall, prostate, urethra, colon)
-
Lymph (iliac/para-aortic)
-
Blood (liver, lungs, bones)
Investigations
-
Bedside: Haematuria, urine cytology
-
Diagnostic: cystoscopy+biopsy
-
Staging: IVU, CT/MRI
Management
Early:
Diathermy via cystoscope
Early-ish:
Radical cystectomy + chemotherapy. Radiotherapy gives worse results but
preserves bladder. Neobladder formation if -ectomy.
Palliative
:
chemotherapy/radiotherapy
