8.1: Overview of Bladder Cancer

1. What are the risk factors associated with bladder cancer?

Genetic Factors: Family History, Genetic Polymorphisms, Genetic Mutations

Environmental Factors: Exposure to Chemicals, Smoking, Infection and Inflammation, Previous Cancer Therapy

2. What are the three types of bladder cancer?

1. Urothelial Carcinoma
2. Squamous Cell Carcinoma
3. Adenocarcinoma

3. What are the five signs and symptoms of bladder cancer?

1. Hematuria
2. Pain when urinating
3. Frequent and Urgent Urination
4. Pain in Pelvis or Abdominal Area
5. Pain in Back

4. What are the four techniques used in the diagnosis of bladder cancer?

1. Urine Cytology
2. Cystoscopy
3. CT Urography
4. Biopsy

8.2: Current Treatment Methods

1. What are the three types of radical cystectomy?

1. Single Incision
2. Multiple Incisions
3. Robotic Surgery

2. What are the advantages and disadvantages of radical cystectomy?

Advantage: Quick way to treat bladder cancer.

Disadvantage: Affect reproductive function of patients.

3. What are the three types of urinary diversions?

1. Neobladder
2. Continent Diversion
3. Ileal Conduit

4. What are the three advantages and disadvantages of urinary diversions?

Advantage: Restores urinary function.

Disadvantage: High risk of infection.

8.3: Novel Treatment Methods Following a Radical Cystectomy

Recall Question

Answer: Adipose-derived stem cells

1. What are the advantages and disadvantages of adipose-derived stem cells?

Advantage: Easily, inexpensively, and non-invasively obtained.

Disadvantage: Limited understanding of its efficacy.

2. What are the three basic considerations for tissue-engineering?

1. Migration and attachment of stem cell progenitors to scaffold.
2. Biomaterials needed for scaffold creation and facilitation of growth-factor delivery.
3. Regulation of cell differentiation and tissue formation.

3. What are the three main growth factors involved in tumour proliferation for bladder cancer?

1. Epidermal Growth Factor
2. Fibroblast Growth Factor
3. Platelet Derived Growth Factor Beta

4. What are the main disadvantages of tissue-engineering?

There is a strong potential to progress cancer growth, increase metastasis, and trigger recurrence.

8.4: Future Directions

1. What is the problem that both current and novel treatment options have in common?

For both current and novel treatment options there is a very high risk of recurrence.

2. What is a solution to reduce recurrence in patients that undergo radical cystectomy and urinary diversions?

Work towards a protocol that allows for early diagnosis of bladder cancer, thus taking into account important risk factors that can be accounted for at this point.

3. What needs to be known for tissue-engineering to be a viable treatment option?

More information needs to be obtained regarding the details behind the tumour-proliferating pathways that are initiated by adipose-derived stem cells.

4. In addition to tumour proliferation, what is another factor that needs to be considered for tissue-engineering?

Adipose-derived stem cells are very sensitive to urine, so the cytotoxicity of urine needs to be account for when designed urinary implants for bladder cancer patients.