Bladder cancer: symptoms and treatment
Bladder cancer is the occurrence of malignant neoplasms in the wall or in the mucosa. Bladder cancer is diagnosed in 3% of cases of all malignancies. Men have this disease more often women. The risk significantly increases after age 50.
Factors leading to bladder cancer
The factors significantly increasing the likelihood of cancer of the bladder include:
- the work in the production of aniline dyes, permanent contact with them;
- work on paint or rubber industry;
- the use of certain drugs used in chemotherapy, and the use of sweeteners (saccharin and cyclamate);
- chronic inflammatory processes in the bladder;
- the age of 50 years.
Smokers are prone to cancer of the bladder 6 times more than those who do not smoke. The work of a cosmetologist, hairdresser, dentist, cleaner and a car wash is also associated with carcinogens leading to bladder cancer. Also this malignant disease may develop in a person who has for a long time a urinary catheter.
Heredity on the incidence of bladder cancer does not have much impact.
Forms and stages of bladder cancer
Bladder cancer can occur in the following forms:
- transitional cell cancer;
- squamous cell carcinoma;
- adenocarcinoma, lymphoma.
Transitional cell cancer originates in the transitional epithelium of the urinary tract, occurs in 90% of cases of bladder cancer. Squamous cell carcinoma can appear in people with chronic inflammatory disease, such as cystitis.
Classification of bladder cancer:
1) stage 0 – discovery of malignant cells in the bladder. At stage 0A malignancy appears without sprouting to the walls of the bladder in the lumen. Stage 0is says is characterized by the fact that the tumor grows outside the wall of the bladder and grows into the lumen.
2) When 1st stage, the tumor invades the bladder wall, but does not reach the muscle layer.
3) When the 2nd stage of bladder cancer begins to grow in the muscle layer.
4) At the third stage, the tumor reaches the adipose tissue that surrounds the bladder and may spread to seminal vesicles and prostate in men and the vagina and uterus in women.
5) In the fourth stage the malignancy spreads to the lymph nodes, can cause metastases to liver, lungs, etc.
Symptoms of bladder cancer include:
- blood in the urine;
- the appearance of pain when urinating;
- urinary retention;
- false urge to urinate;
- pain in the pelvis or in the posterior abdomen.
In the early stages of tumor formation any symptoms are often absent. The first sign of bladder cancer, which detects up to 90% of patients is the appearance of blood in the urine. In addition for bladder cancer about a quarter of patients may experience symptoms of urethritis or cystitis. Hematuria and other symptoms are not specific (not a sign of bladder cancer), they can be caused by many diseases: urinary infections, urolithiasis, hemorrhagic cystitis, kidney cancer, injury of the ureter.
If you detect any of these symptoms should contact a physician, an urologist or oncologist and undergo a medical examination by one or more methods for diagnosis of bladder cancer.
Complications provoked by bladder cancer
Growing tumor in the bladder can cause:
- kidney failure;
- the appearance between the bladder and rectum, or vagina fistula;
- the formation of lymphatic edema.
The methods of diagnosis of bladder cancer include:
- pelvic ultrasound;
- excretory urography;
- computed tomography;
- x-ray examination;
- cytological examination of urine and the presence of tumor markers;
- biochemical analysis of blood.
Biopsy called in vivo sampling of tissues of the body which has the tumor to confirm or refute the presence of cancer tumors. Biopsy of the bladder, examines mucosal tissue, which are collected by tsitoskopii.
Cytoscopy bladder (examination of the inside of the bladder) is performed with an endoscope. Inside the bladder, the endoscope enters through the urethra.
With the help of computer tomography and ultrasonography is a non-destructive layer-by-layer examination of the bladder, which allows to determine the presence of tumor, its size and localization.
Excretory urography is used to study the urinary tract using radiopaque substances. Obtained in the study of programme allow us to estimate the shape and contours of the bladder.
X-ray examination when injected into tissue surrounding the bladder, oxygen allows you to see in case the presence of the tumor, thickening of the bladder wall. Also x-ray diffraction study of the body is carried out in order to confirm or refute the presence of metastases (chest x-ray and bone).
Palpation is the most unreliable method of diagnosing bladder tumor. For tumors that develop inside the bladder or a small bladder tumors, to detect the formation with palpation is not possible. This method can only detect greater penetrating tumor.
Cytological examination of urine, the fluid is examined for the presence of blood, protein, leukocyte count.
Biochemical blood analysis was performed to determine the condition of the kidneys and liver.
Treatment of bladder cancer, like any cancer, is complex and involves chemotherapy, radiation therapy and surgery.
In the early stages of cancer is resection of the affected areas of the mucous of the bladder with subsequent cauterization of ulcers. Transurethral resection is carried out through the urethra without skin incisions that allows to remove the tumor with minimal blood loss.
Laser photocoagulation of the tumor is performed in the case of small-sized papillary tumors.
Cystectomy (bladder removal) is performed when tumors of large sizes (2 and 3 stage) or in the presence of multiple tumors (in 1st stage) in the bladder. The new bladder is created from the colon. After radical cystectomy survival rate within 5 years is 90%. At the last stage due to spread of tumor, surgery is not effective.
From conservative methods of treatment intravesical introduction of the BCG vaccine. This method gives a high therapeutic effect: absence of relapse within 5 years and 70% within 10 years – 30%. The application of this method is contraindicated in hematuria and the presence of active TB in a patient. Intravesical chemotherapy for bladder cancer and is in the early stages of the disease, and after surgery. Chemotherapy has less effect compared tothe introduction of the BCG vaccine.
The exposure is assigned if the malignancy has spread to other organs (metastasized). Irradiation is applied together with chemotherapy.
Recommended food for bladder cancer consists mainly of vegetables, fruits and berries. All products containing carcinogens and dyes should be excluded. Rarely can afford meat and mushrooms. Need to unsubscribe from carbonated beverages and alcohol, you need to drastically reduce the use of fried, salty, fatty, and spicy food.
The prognosis of bladder cancer depends on the stage of disease and tumor size. In identifying the disease at a zero stage and provide adequate treatment, the probability of recovery 100%. When the first and second stages, the probability of survival at 5 years ranges from 50 to 80%, and at third and fourth, 20% to 30%.