Content

• Video Bladder cancer and its signs and symptoms
• What is bladder cancer?
  • tumor cells
• Pain syndrome
• Causes and risk factors
• Chemotherapy
• Symptoms and signs
• Types of tumors
• Diagnostics
• Radiation therapy
• Stages of bladder cancer
• Video Bladder Cancer - Overview (types, pathophysiology, diagnosis, treatment)
• Bladder Cancer Treatment
  • Surgery (surgery to remove a tumor)
  • Chemotherapy
  • Immunotherapy
  • Radiation therapy (radiation therapy, radiation oncology)
• Tumor treatment
• Rehabilitation and follow-up
  • Nutrition
  • Additional Recommendations
• Prevention
• Video Bladder Cancer, Causes, Signs and Symptoms, Diagnosis and Treatment.

Video Bladder cancer and its signs and symptoms

What is bladder cancer?

Bladder cancer (BC) is a type of cancer that starts in the cells that line the bladder (urea). According to the National Cancer Institute, there are an estimated nearly 10,000 new cases each year, most of which affect men.

The bladder (urea) is a hollow organ located in the lower abdomen; its function is to collect urine, the processed fluid secreted by the kidneys.

The ureter is part of the excretory system: urine enters the ureter from the kidneys through a long tube called the ureter, then exits through a short tube (the urethra).

The walls of the bladder are made up of several layers of tissue:

1. Inner fabric. The inside of the bladder is lined with a tissue called mucosa. When the urea fills with urine, the transitional epithelial cells stretch, and when the urea is emptied, the cells shrink and return to normal size.
2. Intermediate fabric. The middle layer is made up of muscle tissue. When the bladder empties, it is the muscle tissue that removes urine from the body.
3. Outer fabric. Outer wall - bladder lining. Composed of fatty substances, fibrous tissues and blood vessels.

The most common symptoms and signs that appear with RMP are:

• blood in the urine;
• urination disorders (increased urination, pain);
• backache;
• pelvic pain.

As with most types of cancer, the exact causes of bladder cancer are not known, but risk factors associated with its occurrence include the following:

• smoking, both active and passive;
• exposure to certain industrial chemicals;
• chronic inflammation of the bladder;
• schistosomiasis.

Basic therapy:

• surgical;
• radiation therapy;
• chemotherapy;
• combined treatments.

On average, five-year survival is observed in 4 out of 5 patients, unfortunately, there is a high risk of recurrence.

tumor cells

Healthy cells grow and divide to form new cells when the body needs it: if healthy cells become old or damaged, they die and are replaced by new cells.

In some cases, the process can be reversed, new cells can form even though the body doesn't need them, or old and damaged cells can continue to live.

The accumulation of cells often forms a mass of tissue called a tumor.

Benign tumors:

• they usually do not endanger the life of the patient;
• can be cured or removed and usually do not recur (do not reappear);
• do not invade surrounding tissues;
• they do not metastasize (do not create secondary tumors elsewhere in the body).

Malignant tumors (carcinomas):

• may endanger the life of the patient;
• they can usually be removed, but they may recur;
• they can penetrate and damage surrounding tissues and organs (for example, the prostate gland in men or the uterus and vagina in women);
• they can spread to other parts of the body.

Tumor cells can spread from the original tumor (metastasize), enter the circulation, and reach the liver, lungs, and bones; alternatively, they can enter the lymphatic system, move through the lymphatic vessels and infect the lymph nodes.

Pain syndrome

The pains are aching dull in nature and can radiate to the area of ​​the sacrum, genitals, perineum, lower back.

If cancer is accompanied by inflammatory diseases of the bladder and pelvic organs, then additional symptoms appear. With pyelonephritis, this is fever, back pain, with kidney failure - loss of appetite, nausea, thirst.

The characteristic signs of cancer for the female body are:

For men:

• Sharp weakening of the urine stream.

Causes and risk factors

When RMP is diagnosed, a natural question arises as to what could have caused the disease. However, doctors are not always able to explain why cancer strikes some patients and bypasses others, but it is known that patients with certain risk factors are more at risk of bladder cancer.

Risk factors a property, condition, or behavior that increases the risk of a particular disease.

Studies have shown that risk factors for developing ureteral cancer include:

• Smoking. Tobacco smoke is a major risk factor for developing bladder cancer, in fact cigarette smoke causes the majority of cancer cases. Those who smoke for many years are at greater risk than those who do not smoke or those who smoke only for a short period of time.
• Chemical substances. Some patients are at greater risk of contracting bladder cancer because they come into contact with certain chemicals at work. People working in the chemical industry (paints, rubber), metallurgy, textile and leather industries are most at risk of getting sick. Other high-risk categories include hairdressers, train drivers, printers, painters, and truck drivers.
• Anticancer therapy. Anyone who has had cancer in the past and has been treated with certain drugs, such as cyclophosphamide, may be at greater risk of developing ureteral cancer. Even those who have received radiation therapy to the abdomen or pelvis may be at risk.
• Arsenic. Arsenic is a toxic substance that increases the risk of bladder cancer. In some regions of the world, arsenic may be present in high amounts in running water, but in many countries laws limit the maximum amount present in drinking water.
• Previous family history of bladder cancer. Those with a family history of bladder carcinoma are most at risk.
• Personal history of bladder cancer. Those who have already suffered from the disease are at greater risk of getting it again.

However, many people with cancer may not have any of the risk factors listed above; conversely, many patients with one or more risk factors may not develop the disease.

Chemotherapy

Chemotherapy is the use of certain drugs to reduce the size of a tumor or eliminate it. This method is used before or after surgery. Chemotherapy is not used as an independent method.

Chemotherapy consists of several courses, each of which lasts 1-2 weeks. Between them, the body is given time to recover.

This treatment has a number of side effects. These include:

• headache, dizziness;
• Nausea and vomiting;
• Diarrhea;
• Intensive hair loss;
• Anemia;
• Various types of bleeding.

Chemotherapy is used along with other methods. The most commonly used surgical treatment.

Symptoms and signs

Bladder cancer very often causes the following symptoms:

• the presence of blood in the urine (urine may be dark red);
• constant urination or vice versa, not being able to empty the bladder;
• tension during urination;
• pain when urinating.

These symptoms can be caused by a tumor in the urethra, as well as other diseases such as urinary tract infection.

Those who have identified these symptoms should consult a doctor to diagnose and treat the disorder as soon as possible.

Types of tumors

World Health Organization identifies 7 types of bladder tumors.

1. epithelial.
2. Non-epithelial.
3. mixed group.
4. Metastatic and secondary.
5. Unclassified tumors.
6. Non-tumor changes in the epithelium.
7. Tumor lesions.

All tumors are also divided into two types:

• benign;
• malignant.

Benign neoplasms include such neoplasms as pheochromocytomas, endometriosis, adenomas, papillomas (conditionally classified). Malignant tumors include sarcomas and cancer.

They are also divided into 6 stages (stage 0a, stage 0is, stage 1-4).

Diagnostics

If a patient is suffering from symptoms suggestive of ureteral cancer, the doctor will try to find out what is causing them. You may have one or more of the following tests during your first visit:

• General urine analysis. The urine sample is sent to a laboratory where it will be tested for traces of blood, cancer cells, or other signs of disease.
• Cystoscopy. The doctor uses a thin tube with a light source at the end (cystoscope) to directly examine the inside of the bladder. The examination can be done in a lab and can be a bit annoying as the doctor will insert a cystoscope into the bladder as it passes through the urethra. The examination can be performed under local anesthesia.
• Biopsy. The doctor may take some tissue samples with a cystoscope and then examine them to look for tumor cells. In most cases, a biopsy is the only test that can reliably determine the presence of cancer cells.

In a small percentage of patients, the doctor uses a biopsy to remove the entire area affected by the tumor. In this case, diagnosis and therapy take place simultaneously.

If cancer cells are present in a sample of bladder tissue, doctors examine it under a microscope to determine the extent of the tumor. This degree indicates the percentage ratio between tumor and healthy bladder tissue, may indicate the estimated rate of tumor growth.

Large tumors tend to grow faster than small tumors, and large cancer cells are more likely to metastasize (secondary sources of cancer). Doctors rely on grade and other factors to suggest possible treatments.

Radiation therapy

Radiation therapy involves exposing cancer cells to high-energy beams that either destroy the tumor completely or slow its growth. Radiation therapy is carried out in several stages, between them the body is given time to recover. This method is used as an independent technique, and in combination with other methods.

Radiation therapy is of two types:

• Internal - substances that can affect cancer cells are located inside the body, close to the affected organ;
• External - the source of radiation is located outside the body.

This technique causes side effects expressed in:

• Nausea and vomiting;
• Headache;
• Intensive hair loss.

After the end of treatment, all of the above symptoms disappear.

Stages of bladder cancer

If bladder carcinoma is diagnosed, the doctor must understand the extent (stage) of the disease in order to suggest the most appropriate treatment.

Stage is a scientific criterion that helps a specialist understand:

• whether the tumor has penetrated the muscular wall of the bladder;
• whether the tumor has penetrated into the surrounding tissues;
• whether the tumor has metastasized, and if so, where in the body.

If the tumor has spread from the original site to another part of the body, the new tumor has the same cellular abnormalities and the same name as the original tumor.

For example, if bladder cancer spreads to the liver, then the cancer cells in the liver will actually be bladder cancer cells. The disease will be called bladder cancer metastasis, not liver cancer, and is treated as such.

There are five stages of bladder cancer:

• Stage 0: tumor cells are found only on the surface of the inner wall of the ureter. Specialized term: stage 0 cancer or intraepithelial carcinoma.
• Stage I. The tumor begins to develop in the inner wall of the bladder, but has not yet penetrated into the muscle layer.
• Stage II. The tumor penetrates into the muscular layer of the urethra.
• Stage III. The tumor also develops outside the muscle layer and invades the tissues surrounding the bladder, such as the prostate, uterus, or vagina.
• Stage IV. The tumor invades the pelvic or abdominal wall, but does not involve the lymph nodes. Alternatively, cancer cells reach at least one lymph node or parts of the body away from the urinary tract, such as the liver, lungs, or bones.

Video Bladder Cancer - Overview (types, pathophysiology, diagnosis, treatment)

Bladder Cancer Treatment

Possible treatments for patients with bladder carcinoma:

• chemotherapy;
• surgery;
• immunotherapy;
• radiation therapy.

Treatment can also be combined to increase its effectiveness.

The choice of therapy depends primarily on the following factors:

• area of ​​the bladder affected by a tumor,
• possible spread of the tumor in the muscle wall or in tissues outside the urea;
• possible spread of the tumor to other parts of the body;
• degree of carcinoma;
• age and general health of the patient.

To develop a suitable therapy, the patient will be accompanied by a team of specialists. Your general practitioner will probably recommend contacting the following specialists:

• urologist (surgeon specializing in the treatment of diseases of the urinary tract);
• urologist-oncologist (surgeon specializing in the treatment of tumors of the urinary tract);
• oncologist;
• radiologist.

The medical team will talk about the various possible treatments, expected results and possible side effects of therapy.

Cancer treatments often harm healthy cells and tissues, so side effects after therapy are common and depend on several factors, including the type of therapy and its duration.

Side effects of treatment vary by patient and may change from therapy to therapy.

Before starting therapy, ask your doctors about possible side effects and how this or that therapy will affect your normal activities. Together with the doctors, you can create a treatment plan that meets your requirements.

Before starting treatment, we advise you to ask your doctor the following questions:

• What stage is my tumor at?? It has penetrated the muscular wall of the bladder or has already spread to other organs?
• What treatments can I follow? Which is the most suitable? Why?
• What are the expected results of each type of therapy?
• How can I prepare for therapy?
• Do I need hospitalization? How long?
• What are the risks and possible side effects of each therapy? How can I deal with the side effects?
• How much will each therapy cost??
• Will therapy affect my daily life??
• Would you recommend taking part in a clinical trial??
• Can you recommend other doctors who can talk about other new possible treatments?
• How often do I need to get tested?

Surgery (surgery to remove a tumor)

Surgery is one of the treatment options for most cancer patients. The surgeon will inform you about the surgical methods that are best suited for:

• Transurethral resection (TUR). The surgeon uses a cystoscope to remove a bladder tumor at an early stage (stage 0 or stage I). No incision is made, but the procedure is usually performed under general or spinal anesthesia. The doctor inserts a cystoscope into the bladder through the urethra, through which a tiny scalpel is passed. A small loop at the end of the scalpel removes the tumor, and the remaining tumor cells are burned with an electrical current of minimal intensity. Transurethral resection in some cases should be performed again. After this type of intervention, it is sometimes necessary to undergo chemotherapy or immunotherapy. There may be blood in the urine for several days after surgery, and urination may be painful or difficult. Otherwise, transurethral resection will not cause any special problems.
• open surgery. The surgeon makes an incision in the body to remove the tumor from the bladder. Resection of the bladder (partial cystectomy). If the tumor in the bladder is small, the surgeon will not remove the entire bladder, but only the tumor, the part of the bladder in which it is located, and the surrounding lymph nodes. After partial removal of the ureter, you will probably no longer be able to hold the same amount of urine in your bladder as you did before surgery, so this will cause you to urinate frequently. The problem, over time, usually only regresses (worsens).
• Removal of the entire bladder (radical cystectomy). If the tumor has invaded the wall of the muscle tissue (stage II or III tumors), the most common operation is radical cystectomy. The surgeon removes the entire urea, the surrounding lymph nodes, and part of the urethra, and if the patient is male, it is usually removed and prostate, if a woman is a mother. Other surrounding tissues may also be removed. In the case of a radical cystectomy, the urea will be replaced by alternative methods. You may have to wear a flat bag on the outside of the body and hide it behind clothing, or the surgeon will use part of the intestine to create a cavity inside the body.

Bladder cancer can have a negative impact on your sex life, so it can be helpful for you and your partner to share your feelings and try to find alternative forms of intimacy during treatment and beyond.

It will take time to recover from surgery. The recovery time depends on the person, the method of surgery, it is normal to feel weak or tired for a while after surgical interventions.

In addition, pain or discomfort may occur during the first few days. Medicines to help control the pain. Before surgery, you should plan appropriate pain relief therapy with your doctor. After surgery, the doctor can make the necessary changes if the planned therapy is ineffective.

After a transurethral resection or partial cystectomy of the urethra, it will take time for the urethra to heal, so a catheter, a small tube inserted into the bladder through the urethra, will most likely be implanted, which allows urine to flow out. The device must be worn five to three weeks. The doctor or nurse will familiarize you with all the rules of the procedure.

Chemotherapy

Chemotherapy is a therapy based on powerful drugs that can kill cancer cells. It can be used to treat bladder cancer before or after surgery. Chemotherapy can be done in several ways:

• Inject directly into the bladder. After transurethral resection surgery, the doctor inserts a tube (catheter) into the urethra to inject liquid medication into the bladder. The drug remains in the ureter for several hours. This therapy should be done once a week for several weeks.
• oral. Some chemotherapy drugs are sold in tablet form and are taken before or after surgery.
• Through a drip. If the tumor has penetrated the muscle wall of the ureter or has spread to other tissues, drugs are usually administered intravenously (drip). They enter the circulation and spread throughout the body. Chemotherapy may be done before or after surgery.

Chemotherapy can be done in a day hospital, outpatient clinic, or at the patient's home. Hospitalization is needed only in rare cases.

Chemotherapy is usually given in multiple cycles. Each cycle consists of a therapy period followed by a rest period. Side effects depend mainly on the route of administration of the drugs. When injected directly into the bladder, side effects are usually minor.

For several days after therapy, the patient will likely feel the need to urinate frequently, urination will be painful, and blood will be found in the urine. However, some patients also suffer from a rash. These problems usually disappear with the end of therapy.

If drugs are given by drip or by mouth, side effects depend mainly on the type and amount of drug given. Chemotherapy kills rapidly multiplying tumor cells, but it can also damage all rapidly dividing healthy cells, such as:

• blood cells. If the drugs kill a lot of healthy cells, you are at increased risk of infection, bleeding or bruising, and you feel very weak and tired. Doctors involved in treatment will periodically check the composition of the blood. If there are not enough remaining healthy cells, it is necessary to temporarily suspend chemotherapy or reduce the dose of the drug. There are also drugs that help the body produce new healthy blood cells.
• hair root cells. Chemotherapy can cause hair loss. If hair falls out, it will still grow back after therapy ends, but color and texture may change.
• Cells of the mucous membranes of the digestive system. Chemotherapy can lead to loss of appetite or cause nausea, vomiting, diarrhea, diarrhea, damage to the lips and mouth. Doctors can give medications and suggest other ways to relieve symptoms that usually regress after therapy ends.

Some medicines used to treat bladder cancer can cause itching or numbness in the hands and feet. Physicians involved in the treatment will be able to control many of these side effects.

Immunotherapy

Those suffering from bladder cancer can be treated with so-called immunotherapy, this therapy consists of applying a solution of BCG (an acronym for Bacilli Calmette and Guerin), t.e. fluid containing weakened bacteria.

Bacteria help the body's natural defenses (immune system) eliminate cancer cells.

The procedure takes place a few weeks after the transurethral resection, the doctor inserts a tube into the urethra to inject liquid medicine into the urethra. Next, the patient will have to keep the drug in the bladder for about two hours.

BCG solution is usually given once a week for six weeks. This therapy helps fight recurrent tumors.

During therapy, patients usually feel more tired than usual, and the BCG solution may irritate the bladder. You may feel an urgent need to urinate, pain, especially after, during urination. Other side effects include: blood in the urine, nausea, fever or chills.

Tell your healthcare providers about any problems you have during therapy.

After the end of immunotherapy, the side effects disappear.

Radiation therapy (radiation therapy, radiation oncology)

Radiation therapy uses very powerful waves to kill cancer cells. It can be administered after surgery. Usually the procedure is carried out at the same time as chemotherapy if the tumor has invaded the muscular wall of the ureter, but in some cases it may be an alternative to surgery or chemotherapy.

The radiation comes from a very large device that directs beams of radiation to the bladder area.

Radiation therapy will require you to go to a hospital or clinic five days a week for several weeks. Each session lasts about half an hour.

No pain is felt during the session, but radiation therapy may cause side effects such as nausea, vomiting, diarrhea, or extreme fatigue. The doctors involved in your therapy will help control these side effects.

Tumor treatment

Do not despair if the doctor nevertheless makes a diagnosis: a tumor of the bladder. Despite the fact that the number of cases is growing, so is the number of successful treatments.

Treatment of the tumor is carried out using two methods: conservative and operative.

Conservative treatment involves the use of radiation therapy and medication. Generally, surgery is used in most cases. Because patients tend to be late. And without surgery, it becomes impossible to get rid of the tumor.

And radiation therapy and chemotherapy are prescribed after surgery to improve the result. Very favorable for immunotherapy. All three of these methods can be applied simultaneously or alternately. They do not harm each other, but only enhance the effect.

Rehabilitation and follow-up

The therapy team helps patients return to normal activities as soon as possible, rehabilitation depends on the severity of the disease and the surgical intervention.

If you have your bladder removed, you will need an alternative way to collect urine: after removing the ureter, the surgeon uses part of the small or large intestine to create a new urethra (a new tube that allows urine to exit the body), as well as other alternatives.

Doctors may suggest the following solutions:

• Outer bag for wearing under clothing. The surgeon can connect a small piece of intestine to the ureter and stoma (artificial opening). Urine will flow from the ureters to the intestinal tract, and from there to the stoma. A bag is attached to the abdomen, held in place with a special adhesive. The bag needs to be emptied several times a day.
• New bladder or inner bag. The surgeon can create a new bladder or bag using the intestinal tract. The surgeon connects the bag to the urethra so that urine can flow out of the urethra and collect in the inner bag; the bag is then connected to the urethra or stoma (artificial opening).
• New bladder from urethra. The internal cavity is connected to the urethra (urethra), the emptying of the bladder will occur in exactly the same way as before the operation.
• New bladder connected to stoma. The surgeon creates a new pathway through the stomach to allow urine to flow out of the body. The internal cavity will be connected to the stoma, you will need to use a catheter (small tube) to empty the bladder several times a day. You won't have to wear bags attached to your belly.

Empty your bladder every two or three hours in the beginning. After that, you can retain urine for a period of four to six hours.

Before the operation, the doctor will explain how the operation will be carried out to introduce a new urea, in which area of ​​the abdomen it will be performed and how to live after the procedure.

Nutrition

Take good care of yourself before, during and after surgery. Taking good care of yourself also means eating the right diet to get all the calories you need to maintain your desired weight. You also need to take in enough protein to maintain strength. Good nutrition will help you feel better and get more energy.

In some cases, especially during therapy or immediately after it, you will not have an appetite, because, for example, it will simply be absent, or you will be tired, or the food will seem to taste somehow different. Side effects of therapy (loss of appetite, nausea, vomiting, mouth ulcers) can also cause food aversion.

Your doctor, nutritionist, or other member of the healthcare team will be there to help and suggest the best ways to meet your dietary needs.

Additional Recommendations

After treatment for bladder cancer, regular examinations should be performed (for example, at intervals of 3-6 months). With the help of the obtained analyzes, it is possible to diagnose and treat any health problems.

If you have problems between examinations, contact your doctor.

Bladder cancer can recur.e. recur after treatment. One of the goals of rehabilitation is precisely the exclusion of relapses. We recommend:

• undergo medical examinations;
• take a blood test and urine test;
• perform a cystoscopy (examination of the inside of the bladder).

Prevention

Given all of the above, it is recommended that people at risk be regularly examined by urologists, especially men. Treatment prescribed on time is able to protect against the spread of metastases and bringing to surgical intervention.

At the slightest suspicion of the occurrence of neoplasms, it is necessary to protect yourself from the effects of harmful external factors: smoking, carcinogens, chemicals, aniline paints and other materials. A tumor of the bladder in men is not a sentence and a favorable result is guaranteed if treatment is not postponed until later.

Video Bladder Cancer, Causes, Signs and Symptoms, Diagnosis and Treatment.

Content

• Video Bladder cancer and its signs and symptoms
• What is bladder cancer?
  • tumor cells
• Pain syndrome
• Causes and risk factors
• Chemotherapy
• Symptoms and signs
• Types of tumors
• Diagnostics
• Radiation therapy
• Stages of bladder cancer
• Video Bladder Cancer - Overview (types, pathophysiology, diagnosis, treatment)
• Bladder Cancer Treatment
  • Surgery (surgery to remove a tumor)
  • Chemotherapy
  • Immunotherapy
  • Radiation therapy (radiation therapy, radiation oncology)
• Tumor treatment
• Rehabilitation and follow-up
  • Nutrition
  • Additional Recommendations
• Prevention
• Video Bladder Cancer, Causes, Signs and Symptoms, Diagnosis and Treatment.