Items in AFP with MESH term: Carcinoma, Transitional Cell
ABSTRACT: Bladder cancer is the sixth most prevalent malignancy in the United States. The most common type of bladder cancer is urothelial (transitional cell) carcinoma, and cystoscopy remains the mainstay of diagnosis and surveillance. Fluorescence cystoscopy offers improvement in the detection of flat neoplastic lesions, such as carcinoma in situ. Non-muscle-invasive bladder cancer is typically managed with transurethral resection and perioperative intravesical chemotherapy. Intravesical bacille Calmette-GuÃ©rin therapy is preferred over mitomycin for those at high risk of disease progression. For muscle-invasive disease, standard management is radical cystectomy. In these patients, neoadjuvant chemotherapy or postoperative adjuvant chemotherapy should be considered based on pathologic risks, such as positive lymph nodes or pathologic T stage. Multidrug systemic chemotherapy involving cisplatin is commonly used. No major organization recommends screening for bladder cancer.
ABSTRACT: In patients without significant urologic symptoms, microscopic hematuria is occasionally detected on routine urinalysis. At present, routine screening of all adults for microscopic hematuria with dipstick testing is not recommended because of the intermittent occurrence of this finding and the low incidence of significant associated urologic disease. However, once asymptomatic microscopic hematuria is discovered, its cause should be investigated with a thorough medical history (including a review of current medications) and a focused physical examination. Laboratory and imaging studies, such as intravenous pyelography, renal ultrasonography or retrograde pyelography, may be required to determine the degree and location of the associated disease process. Cystourethroscopy is performed to complete the evaluation of the lower urinary tract. Microscopic hematuria associated with anticoagulation therapy is frequently precipitated by significant urologic pathology and therefore requires prompt evaluation.