Bladder cancer: superficial
Bladder cancer is the second most common genitourinary malignancy.
Approximately 70% of bladder tumors are superficial.
Only 10–20% of superficial bladder tumors will progress to muscle-invasive disease.
Environmental exposures (i.e. tobacco smoke, aniline dyes) are strongly associated with development of bladder cancer.
Gross, painless hematuria is the most common presenting symptom.
Evaluation includes history and physical exam, urinalysis, urine culture and cytology, serum electrolytes and liver function tests, upper urinary tract imaging, and cystoscopy.
Mainstay of treatment for superficial disease is transurethral resection of bladder tumor (TURBT) with or without adjuvant intravesical chemotherapy.
Following initial transurethral resection, surveillance cystoscopy should be performed every 3 months during the first 2 years, every 6 months during the next 2 years, and once a year thereafter.
Urinary tumor markers may be used as an adjunct to cystoscopy and urine cytology for diagnosis and/or surveillance.