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Bladder Cancer



Bladder Cancer

Epidemiology

Bladder cancer is fairly common. It usually affects men to women in a 3:1 ratio.

Predisposing Factors

  • Smoking (increase risk by a 4x)
  • Professional exposure (exposition to aniline).
  • Drugs (phenaketin)
  • Schistosomiasis
  • Chronic infections and bladder inflammation (urinary infections, bladder stones, use of permanent urine catheter)
  • Pelvic irradiation

Symptoms and clinical signs

  • Haematuria (usually painless, or presents with intervals)
  • Increased urinary frequency, pain during urination, or urge for urination)
  • Back or lower abdominal pain
  • Renal impairement

Diagnosis- prevention

Bladder cancer can be cured if its diagnosed in early stages. Usually, the only symptom could be haematuria. For that reason when it happens it should be checked out thoroughly.

The available diagnostic means are the following:

  • Kidney – bladder- prostate ultrasound
  • Intravenous pyelography
  • Urine cytology
  • Cystoscopy
  • CT

Patients with precancerous lesions in the bladder (papillomas) are more likely to develop them anywhere across the urothelial system, for that reason in that case it is named carcinogenic field, i.e. the endothelium that has been exposed to a carcinogenic substance which would be more likely to cause cancer. Thus an urologist is necessary to follow those patients closely as they usually present with precancerous lesions before they develop cancer.

Treatment

Transurethral Excision: Precancerous lesions may be excised with cystoscopy. The next step is the urologist to perform a bladder mapping in order to ensure there are no other lesions. Sometimes treatment with drugs injected inside the bladder is necessary. Usually BCG is preferred in order to stimulate the immune system.

  • Radical cystectomy (surgical approach)
  • Radiotherapy
  • Systemic chemotherapy

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Filed In: Bladder Cancer