Coronary Intervention in a Patient with Invasive Bladder Carcinoma: Role of Multidisciplinary Approach for High Risk Patients

Abstract

Bladder cancer is the second most common malignancy of the genitourinary system. Several types of carcinoma arise on the urothelial surface, the most common type being transitional cell carcinoma (TCC). The incidence of TCC in the bladder in the UK is 45 cases per 100,000 population. Painless haematuria is the most common presenting symptom in 85-90% of patients with bladder cancer, although recurrent urinary tract infection & obstructive symptoms may occur. Physical examination is usually unremarkable except in very advanced disease. Investigation of haematuria as well as cytological examination of urine for malignant cell and renal imaging study usually identifies the tumour. Treatment of TCC of bladder primarily involves surgery, chemotherapy or radiotherapy as needed. Radical cystectomy for TCC in elderly carries adverse prognosis because of associated co-morbid conditions like hypertension, diabetes, chronic obstructive pulmonary disease (COPD) & ischaemic heart disease (IHD). However, close co-operation between different disciplines can make radical curative surgery a viable alternative even in these high-risk groups. Â doi:10.3329/jom.v10i3.2017 J Medicine 2009; 10 (Supplement 1): 40-42