What is bladder cancer
The tumor develops from the urothelium, the mucous membrane lining the inside of the bladder. Carcinogens that enter the body are excreted in the urine and remain in contact with the mucous membrane for a long time, damaging it. This explains the connection of the disease with smoking and occupational hazards.
The key division that determines all treatment tactics is muscle-non-invasive and muscle-invasive cancer. In the first case, the tumor grows within the mucous and submucosal layer, in the second, it grows into the muscular wall of the bladder.
Nonmuscle-invasive tumors account for the majority of newly diagnosed cases and are treated endoscopically with organ preservation. Muscle-invasive cancer requires significantly more extensive treatment, so early diagnosis is critical.
Symptoms
- Painless blood in the urine is the main and earliest sign; may be one-time and disappear for weeks or months
- Frequent urination and urgency
- Pain and discomfort when urinating, reminiscent of cystitis
- Feeling of incomplete emptying
- Pain in the lower abdomen, lower back
- Clots in the urine, up to acute urinary retention
- Swelling of the legs, bone pain, weight loss with a common process
Risk factors
- Smoking accounts for a significant proportion of cases; the risk persists for years after failure, but gradually decreases
- Professional contact with aromatic amines: production of dyes, rubber, leather, textiles, paint and varnish works
- Chronic inflammation of the bladder, prolonged catheter stay
- Bladder stones
- Previous radiation therapy of the pelvic organs
- Previous use of certain chemotherapy drugs
- Male gender and age over 55 years
- Schistosomiasis - relevant for endemic regions
Diagnostics
- Cystoscopy is the main method: direct examination of the bladder mucosa; allows you to see the tumor and take a biopsy
- Biopsy with histological examination - confirms the diagnosis and determines the degree of malignancy
- Ultrasound of the bladder with filling - can detect a mass, but does not replace cystoscopy
- CT urography - assessment of the upper urinary tract and the extent of the process
- Cytological examination of urine for atypical cells
- MRI of the pelvis to assess the depth of invasion
- CT chest, osteoscintigraphy - if metastases are suspected
- General analysis and urine culture
Important: a normal ultrasound does not exclude bladder cancer. Flat tumors and small formations are not visible by ultrasound, so cystoscopy is mandatory for hematuria.
Treatment
- TUR of a bladder tumor - transurethral resection: the tumor is removed through the urethra; is at the same time a therapeutic and diagnostic procedure, since it provides material for assessing the depth of invasion
- Repeated TUR after a certain period of time - for high-risk tumors, to ensure complete removal
- Intravesical chemotherapy - injection of a drug into the bladder after a TURBT to reduce the risk of relapse
- Intravesical BCG therapy - immunotherapy for high-risk tumors
- Radical cystectomy with formation of urinary diversion - for muscle-invasive cancer
- Systemic chemotherapy and immunotherapy - before or after surgery, as well as in advanced cases
- Radiation therapy - as part of an organ-conserving approach in selected cases
- Coagulation of bleeding vessels and washing out tamponade - in case of bleeding from a tumor
Why is lifelong control necessary?
A feature of bladder cancer is its high tendency to relapse. The tumor may reappear in another area of the mucosa even years after successful treatment.
- Regular control cystoscopies according to the schedule established by the doctor
- Urine cytology
- Periodic imaging of the upper urinary tract
- Immediate treatment if blood appears in the urine between routine examinations
- Quitting smoking has been proven to reduce the risk of relapse
Prevention
- Complete smoking cessation
- Compliance with safety precautions when working with chemicals
- Adequate fluid intake
- Timely treatment of chronic urinary tract infections and removal of bladder stones
- Minimizing prolonged catheterization
- Testing for any episode of blood in the urine
Where they are examined and treated in Tashkent
For diagnosis, a cystoscopy with the ability to take a biopsy is needed, and for treatment, an endoscopic operating room and a histological laboratory are needed.
In Tashkent, cystoscopy, biopsy and TUR of bladder tumors are performed at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If you have had blood in your urine, try not to delay cystoscopy, even if the episode was a one-time event and everything went away. It is this study that answers the question of the presence of a tumor. Clinic contacts are below.
