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Bladder Cancer

Bladder cancer is the second most common cancer in Egypt and the seventh leading cause of death in men in the USA, with a higher prevalence in males. Risk factors include occupational exposures, smoking, and certain infections, with the majority of cases being transitional cell carcinoma (TCC). Diagnosis involves endoscopy and imaging, while treatment options vary from resection and immunotherapy for superficial cases to cystoprostatectomy and adjuvant therapy for infiltrating tumors.

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13 views10 pages

Bladder Cancer

Bladder cancer is the second most common cancer in Egypt and the seventh leading cause of death in men in the USA, with a higher prevalence in males. Risk factors include occupational exposures, smoking, and certain infections, with the majority of cases being transitional cell carcinoma (TCC). Diagnosis involves endoscopy and imaging, while treatment options vary from resection and immunotherapy for superficial cases to cystoprostatectomy and adjuvant therapy for infiltrating tumors.

Uploaded by

ahmedhamada4444444
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

UROLOGICAL TUMORS

Bladder cancer
Bladder cancer

Epidemiology
 In Egypt is the second most common cancer after breast
cancer in the cancer institute.
 In USA it is the 7th most common cause of death in men
 Sex:
– In Egypt M: F 7 : 1
– In the States M :F 2.5 : 1
 Age:
– disease of middle age 45 – 65y in Egypt.
– Older age group in USA at a later age group and increasing with
age
Bladder cancer

Risk factors:
 Occupational: aniline dye, Industrial chemical
drugs and textile
 Metabolites of tryptophan metabolism
 Cigarette smoking
 Analgesic abuse
 Biharziasis
Bladder cancer

Pathology

 Abroad: > 90% TCC


 Egypt: 60`% TCC- 30% sq. cell.
 Rest is adenocarcinoma 5.8%
 Undifferentiated and mixed 2-5%
Bladder cancer

Urothelial carcinoma
 CIS
 TCC:

– Grading:
 Only mucosa  TCC of low malignant potential
 Low grade TCC
 High grade TCC
Bladder cancer
 TCC is multicenteric tumor

Spread:
– direct (by implantation ?)
– Lymphatic
– Hematogenous (Invasive TCC in 20% (liver ,
bone, adrenal)
Bladder cancer

Clinical picture
– hematuria (esp. in TCC)
– Bladder irritative symptoms ( CIS, SCC & invasive TCC)
– Loin pain
– Pelvic mass

Diagnosis
– Endoscopy + biopsy (TURBT)
– Examination under anesthesia (before & after resection)
– Cytology
– Flow cytometry
Bladder cancer

Imaging:

– U/S
– Urography
– C.T.
– MRI
– CXR – bone scan
Bladder cancer

Staging
– Superficial or infiltrating ?
– Localized or metastatic ?
TNM staging system:
– Tis flat mucosa (high grade)
– Ta papillary mucosal (TCC.)
– T1 infiltrating lamina propia
– T2 reaching muscularis
– T3a reaching perivesical fat but not beyond

3b reaching all thickness of perivesical fat

– T4 invading contiguous organs


Bladder cancer
Treatment
 Superficial:
– Resection
– Intravesical instillation (immunotherapy e.g BCG, chemotherapy e.g.
Mitomycin c)
– Follow up (endoscopy-cytology-markers)

 Infiltrating:
– Gold standard is Cystoprostatectomy
+ bilateral Iliac L.N. dissection
+ orthotopic urinary diversion vs. ileal
conduit diversion

– Adjuvant (post surgery) chemo or radiotherapy or both in


some cases (only TCC).

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