Bladder cancer

Bladder cancer is an oncological disease accompanied by the development of malignant formation in the mucous membrane shell or in its wall. In recent years, there has been a trend towards an increase in morbidity. Almost 80% of patients are representatives of the age group of 50-80 years, the peak of the disease falls on patients who have reached the age of 70. The mortality rate in developed countries does not exceed 8%.

Types of pathology

Depending on the damage to the type of tissue that makes up the wall of the bladder, there are several types of bladder cancer, which include:

1. Urothelial carcinoma or transitional cell carcinoma — occurs in more than 90% of all cases.

These cancers begin in the urothelial cells that line the inside of the bladder. Urothelial cells also line other parts of the urinary tract, such as the part of the kidney that connects to the ureter (called the renal pelvis), the ureters, and the urethra. People with bladder cancer sometimes have tumors in these areas, so all urinary tracts should be checked for tumors. bladder). Transitional cell carcinoma can be low or high grade. If it’s low, it’s unlikely to spread into the deeper layers of your bladder or anywhere else in your body. It is also less likely to come back after treatment. If it is highly malignant, the process is more likely to spread to deeper layers of the bladder, other parts of the body and lymph nodes. It may return after treatment. High-grade transitional cell carcinoma is a type of bladder cancer that is more likely to be life-threatening.

2. Squamous cell carcinoma is associated with chronic irritation of the bladder — for example, due to infection or long-term use of a urinary catheter.

Squamous cell carcinoma of the bladder is rare in Europe and the United States. This is more common in parts of the world where the parasitic infection schistosomiasis is a common cause of bladder infections. Squamous cell cancer – this tumor is more insidious, prone to metastases, occurs very rarely (most often – in patients with chronically irritated mucosa or parasitic invasion of the organ).

3. Adenocarcinoma – begins in the cells of the bladder, which make up the mucus-secreting gland. Adenocarcinoma of the urinary bladder is very rare and is a primary tumor.

More than 40% of patients develop recurrent tumors (localization may vary). The situation is especially relevant for large poorly differentiated or pathological formations that are actively growing. Bladder cancer can metastasize to the lungs, liver, bone tissue, and lymph nodes.

Bladder cancer risk factors

Oncologists identify several key factors that contribute to the development of the disease and can lead to the removal of the bladder:

• Smoking is the main factor in the development of bladder cancer (provokes tumor formation in more than 50% of cases among men, and about a third of women);
• Abuse of nonsteroidal anti-inflammatory drugs for pain relief;
• Industrial carcinogens – refers to long-term or frequent contact with chemicals used in the paint, cable and rubber industries);
• Chronic infections of the organ – in particular, cystitis;
• Congenital organ defects;
• Long-term course of cyclophosphamide (antitumor chemotherapeutic drug);
• Chronic irritation of the mucous membrane – for example, due to stones in the urinary bladder, with schistosomiasis – a parasitic infection).

Symptomatology of pathology

An early manifestation of the disease is the release of blood during urination (micro or macro hematuria). Slight blood discharge, as a rule, is episodic, turns the urine pink, does not last long. In other cases, total hematuria develops rapidly, which is characterized by the release of a large amount of blood, which turns the urine red, and blood clots are possible. Prolonged or strong hematuria leads to tamponade of the urinary bladder and acute retention of urine (at the same time, the patient has a rapid decrease in hemoglobin, sometimes – anemia). As the tumor grows, urination becomes painful, accelerated, and sometimes difficult. In the first stages of cancer, painful sensations are characteristic only of a full bladder. When the muscle wall sprouts, the pains become constant. A growing tumor node squeezes the mouth of the ureter, while the outflow of urine from the corresponding kidney is disturbed. This leads to the development of hydronephrosis, an acute pain attack similar to renal colic occurs. Some types of cancer are prone to decay, which provokes development of urinary tract infections (urine becomes purulent, smelly).

Methods of treatment and prognosis

Bladder cancer treatment involves a complex approach: therapy includes surgical, radiation and medication methods. Treatment tactics depend on the specifics of the course of the pathological process.

Surgical

The first stage of treatment is tumor removal (TUR, transurethral resection). This must be followed by immunotherapy or radiation therapy. This is the most effective method of fighting cancer in the early stages and allows you to preserve the functionality of the organ. If the tumor has grown deep into the bladder wall, it will be necessary to remove the bladder (radical cystectomy) followed by the formation of an artificial replacement for the removed organ (part of the colon is used for this purpose).

Chemotherapy

It means the introduction of a cytostatic drug, the main task of which is to reduce the risk of relapse. Chemotherapy can be used both before and after surgical removal of the bladder. The method is considered the most effective treatment for common forms of bladder cancer.

Radiation chemotherapy

It helps to reduce the size of the pathological education in order to simplify the surgical procedure. It is often used when bleeding is detected, reduces the pain syndrome when bone cancer metastasizes. At the end of the treatment course, follow-up with an oncologist and a urologist is recommended for timely detection of a possible relapse.

Disease prevention

In order to significantly reduce the risk of developing bladder cancer and exclude its removal, experts recommend regular visits to the family doctor, as well as to exclude possible risk factors:

• For smokers to forget about this bad habit, clearly, stopping smoking reduces the risk of developing cancer;
• When working with chemicals, eliminate the possibility of contact with them by protecting yourself as much as possible (means of individual and collective chemical protection, mandatory dispensation) or change activities;
Radically treat bladder papillomas, cystitis;
• Drink a sufficient amount of water, regularly empty the bladder.