Bladder cancer

Question 1

Define bladder cancer

Answer 1

malignancy arising from the bladder

Question 2

Aetiology of bladder cancer

Answer 2

Often environmental, exposure to certain RF

Question 3

RFs of bladder cancer

Answer 3

•	Smoking
o	Accounts for half the cases in men
•	Second hand smoke
•	Occupational exposure to chemical carcinogens
o	Aromatic amines in rubber and dye industries
o	Painters
o	Hairdressers
•	Herbal remedies – aristolocholic acid
•	Pelvic radiation
•	Chronic cystitis
•	Schistosomiasis 
o	Increased SCC risk
•	Chronic indwelling cancers
•	T2DM
•	FH

Question 4

Epidemiology of bladder cancer

Answer 4

9th most common cancer in the world
Men almost 3x increased risk
Over 90% cases in over 55s

Question 5

Presenting symptoms of bladder cancer

Answer 5

•	Haematuria (>80%)
o	Most common is gross, painless haematuria
•	Dysuria
•	Increased urinary frequency
•	Recurrent UTIs
•	Voiding irritability

Question 6

Signs of bladder cancer on examination

Answer 6

No signs

Question 7

Investigations for bladder cancer

Answer 7

•	Urine – 1st line
o	Dipstick
	Positive for blood
o	Urinalysis
	RBC casts and crenated RBCs
o	Urine cytology
•	Renal and bladder US
•	Cystoscopy with biopsy - GS
•	Bloods
o	FBC: normal/mild anaemia
•	CT urogram