Bladder cancer 

• HOPC:
  • Haematuria (usually painless)
  • Pain
  • Frequency, urgency, bladder neck uobstructive symptoms
  • Constitutional symptoms

• Risk factors:
  • SMOKING
    Occupations that have been linked to an increased risk of bladder cancer include metal workers, painters, rubber industry workers, leather workers, textile and electrical workers, miners, cement workers, transport operators, excavating-machine operators, and jobs that involve manufacture of carpets, paints, plastics, and industrial chemicals (though to be polycylcic aromatic hydrocarbons)
  • Family history
  • Chronic cystitis
  • Radiation
  • Drugs : cyclophosphamide, Thiazolidinediones 

• Investigations:
  • Cystoscopy !!
  • Urine cytology / microscopy(look for other causes of haematuria as well)
  • Staging – CT/MRI/PET 

• Treatment:
• Non Muscle invasive disease:
  • TURBT, intravesical therapy post TURBT

• Muscle invasive Disease:
  • Standard treatment is radical cystectomy (+/- neoadjuvant chemo)
  • Bladder sparing (TURBT, chemo, radio)
  • Metastatic
    • Cislatin based regimen with other cytotoxic agents (methotrexate, vinblastine etc)

Follow up:

Guided by urology but apparently those with non muscle invasive disease should have 3 monthly cystoscopy and urine cytology for 2 years and annually thereafter (? For how long)