Bladder

Question 1

What is the histology of bladder Ca?

Answer 1

Transitional cell carcinoma (TCC)

Question 2

List the risk factors for bladder Ca

Answer 2

Smoking

Cyclophosphamide

TZD - thiazolidinediones

Dye

Schistosomiasis (SCC)

Question 3

Outline the 2WW referral criteria for suspected bladder/renal Ca

Answer 3

> 45 yrs with visible haematuria

Question 4

How should bladder/renal Ca be investigated?

Answer 4

Urine microscopy

Flexible cystoscopy

Staging CT TAP

Question 5

Outline the management for bladder/renal Ca

Answer 5

Low risk non-muscle invasive TCC =
- check cystoscopies

I/high risk non-muscle invasive TCC =

• intravesical chemo
• intravesical IT (BCG)

Muscle invasive TCC =

• radical cystectomy (ileal conduit) or RT
• neoadjuvant chemo

Metastatic TCC =

• palliative cisplatin based chemo
• palliative immunotherapy (atezolizumab)

Question 6

How is bladder cancer staged?

Answer 6

Tis = carcinoma in situ
Ta = confined to ep
T1 = in lamina propria 
T2 = superficial muscle involved 
T3 = deep muscle involved
T4 = invasion beyond bladder