·
Incidence
o
In the US,
bladder
cancer is
the 4th
most
common
cancer in
men
§
Prostate
§
Lung
§
Colorectal
cancer
§
Bladder
cancer
o
It is the
10th
most
common
cancer in
women
o
More
common in
whites
than in
blacks
§
3:1 male
to female
predominance
·
Classic
clinical
presentation
is
painless,
gross
hematuria
·
Risk
factors
o
Smoking
o
Pelvic
irradiation
o
Exposure
to
aniline
dyes
o
Chemotherapy
with
cyclophosphamide
·
Most
common is
urothelial
carcinoma,
formerly
known as
transitional
cell
carcinoma
(90%)
o
Multicentric
§
May
involve
the
urothelium
in the
entire GU
tract from
kidney to
ureter to
bladder
o
Tumors may
be
classified
by growth
patterns
§
Papillary
(70%)
§
Sessile or
mixed
(20%)
§
Nodular
(10%)
CT
urogram.
CT of the
abdomen with
contrast
reformatted in
the coronal
projection
shows a
filling defect
in the left
lateral wall
of the urinary
bladder (red
arrow)
representing a
papillary
urothelial
tumor of the
bladder.
Click here for
this photo
without
annotations
·
Squamous
cell
carcinoma
(4%)
o
Worst
prognosis
§
Associated
with
chronic
infection
and
irritation
o
Worldwide
(not in
the USA),
squamous
cell
carcinoma
of the
bladder is
the most
common
cell type
§
In
underdeveloped
nations,
associated
with
bladder
infection
by
Schistosoma
haematobium
·
Adenocarcinoma
(1%)
o
Most
common in
bladder
exstrophy
o
Respond
poorly to
radiation
therapy
·
Stage of
disease
o
More than
70% of all
newly
diagnosed
bladder
cancers
are
superficial
o
About 5%
present
with
metastatic
disease
§
Most often
lymph
nodes
§
Lung
§
Liver
§
Bone
§
Central
nervous
system
·
Prognosis
o
Superficial
bladder
cancer has
good
prognosis
with
5-year
survival
rates of
82-100%
o
Prognosis
for
metastatic
transitional
cell
cancer is
much
poorer
with only
5% of
patients
living 2
years
after
diagnosis
