Epidemiology
Bladder cancer is quite common. The ratio of men to women is three to one.
Predisposing Factors
- Smoking (the most important)
- Occupational agents: exposure to aniline dyes and aromatic compounds
- Drugs: phenacetin, cyclophosphamide
- Schistosomiasis (parasitism)
- Chronic irritation and inflammation of the bladder urinary tract infections, stones, the use of a permanent catheter
- Pelvic radiation
Symptoms and Signs
- Hematuria (usually painless)
- Frequency, pain when urinating, urgency to urinate
- Pain in the waist or lower abdomen
- Renal insufficiency – anuria
Diagnosis- prevention
The available diagnostic means are the following:
- Kidney-cyst ultrasound
- Intravenous pyelography
- Urine cytology
- Cystoscopy
- Computed Tomography
Field carcinogenesis
Patients with precancerous or cancerous lesions in the bladder are at risk of developing other such lesions anywhere in their urinary system and should be closely monitored by a urologist. This is because the entire urinary tract exposed to the carcinogen is at risk of developing cancer (a phenomenon called field carcinogenesis).
Treatment
- Transurethral resection. Precancerous lesions are often found that can be removed by cystoscopy. The bladder is mapped to make sure the urologist has no other lesions. Sometimes depending on the findings of the cystoscopy and biopsy, treatment with a drug injection may be needed. Usually the preferred drug is BCG which acts by stimulating the immune system
- Radical cystectomy (surgery)
- Radiotherapy
- Chemotherapy
- Immunotherapy
