Risky Business
This lifestyle habit is the most significant preventable risk factor for bladder cancer
What is cigarette smoking?
RATIONALE: tobacco carcinogens enter the bloodstream, are filtered by the kidneys, and accumulate in urine, exposing bladder cells to harmful chemicals.
This common finding, which may be painless, is often the first warning sign of bladder cancer.
What is hematuria?
RATIONALE: Bleeding from a bladder tumor may cause visible or microscopic blood in the urine.
This common urine test can detect red blood cells that may indicate bladder or kidney cancer.
What is urinalysis?
RATIONALE: urinalysis identifies microscopic hematuria, but the blood in the urine has many possible causes.
This surgical procedure removes all or part of a kidney affected by cancer.
What is a nephrectomy?
RATIONALE: partial or radical nephrectomy is a common treatment for localized renal cell carcinoma.
Four hours after nephrectomy, a patient develops BP 82/48, HR 128, cool clammy skin, and declining urine output. What complication requires immediate action?
What is postoperative hemorrhage with hypovolemic shock?
RATIONALE: hypotension, tachycardia, poor perfusion, and oliguria suggest shock. Activate rapid response, assess the bleeding, and initial
The cardiovascular condition is a recognized risk factor for kidney disease?
What is hypertension? (high blood pressure)
RATIONALE: hypertension is associated with increased risk of renal cell carcinoma.
A patient with kidney cancer reports persistent pain on one side of the back, below the ribs. This is known as what?
What is a flank pain?
RATIONALE: a renal tumor may cause discomfort in the flank as it grows or affects nearby tissue.
This procedure uses a small camera inserted through the urethra to directly inspect the bladder.
What is cytoscopy?
RATIONALE: cytoscopy allows direct visualization of suspicious bladder lesions and helps guide biopsy.
This surgery removes the bladder in selected patients with muscle invasive bladder cancer.
What is radical cystectomy?
RATIONALE: radical cystectomy removes the bladder and usually involves creation of a urinary diversion.
Long term occupational exposure to chemicals used in these two industries increases bladder cancer risk.
What are the rubber and dye industries?
RATIONALE: certain aromatic amines and industrial chemicals can damage bladder cells.
Along with hematuria, these two urinary symptoms can occur with bladder cancer due to irritation.
What is urinary frequency and dysuria?
RATIONALE: Bladder tumor can produce irritative voiding symptoms that resemble a urinary tract infection.
This imaging method uses sound waves and can identify a suspicious mass in the kidney.
What is an ultrasonography? (Ultrasound)
RATIONALE: ultrasound can visualize renal masses and distinguish some cystic from solid abnormalities.
This medication, abbreviated BCG, is placed directly to treat certain non-muscle invasive cancers.
What is Bacillus-Calmette-Guerin?
RATIONALE: intravesical BCG stimulates a local immune response against bladder cancer cells.
Having this condition, characterized by excess body fat, increases the risk of developing both bladder and kidney cancer.
What is obesity?
RATIONALE: obesity is associated with an increased risk of kidney cancer and also may increase bladder cancer risk. Excess body fat can contribute to chronic inflammation, hormonal changes, and insulin resistance, which may promote cancer development.
Kidney cancer may produce this hematologic abnormality, causing weakness, pallor, and fatigue.
What is anemia?
RATIONALE: chronic blood loss, inflammation, or impaired erythropoietin production can contribute to anemia.
This test examines urine for abnormal or malignant cells and may support a bladder cancer diagnosis.
what is urine cytology?
RATIONALE: urine cytology is useful especially for high grade urothelial cancers but cannot exclude cancer when negative.
This kidney-sparing procedure removes the renal tumor while preserving healthy kidney tissue.
What is partial nephrectomy?
RATIONALE: preserving functioning renal tissue can help maintain kidney function while treating an appropriate localized tumor.
A patient previously received this chemotherapy drug, which is associated with an increased risk of bladder cancer.
What is cyclophosphamide?
RATIONALE: Cyclophosphamide can produce the bladder-toxic metabolite acrolein, which may cause hemorrhagic cystitis and contribute to long term malignancy risk.
A patient with renal cell carcinoma develops confusion, constipation, and muscle weakness. These findings may indicate this elevated serum electrolyte.
What is calcium?
RATIONALE: renal cell carcinoma can cause paraneoplastic hypercalcemia, which can produce neurologic and gastrointestinal symptoms.
This procedure confirms bladder cancer through microscopic examination of suspicious tissue.
What is biopsy, often obtained during transurethral resection of a bladder tumor. (TURBT)
RATIONALE: histopathology establishes the cancer diagnosis and determines tumor grade and depth of invasion.
This type of cancer therapy blocks molecular pathways involved in tumor growth, such as VEGF signaling, and is used for some advanced kidney cancers.
What is targeting therapy?
RATIONALE: targeted drugs such as VEGF-receptor tyrosine kinase inhibitors can slow tumor growth and blood-vessel formation.