Urinary Bladder Cancer

A growth of malignant cancer cells in the inner lining of the bladder, forming a tumour which is the 8th commonest cancer in male. Commonly occur in male than female with ratio of 2:1 and more than 55 years old. Ninety percent of the bladder cell cancer is transitional cell cancer and the other is squamous cell cancer (associated with chronic infection and irritation) and adenocarcinoma (in urachus or chronic irritation).

The high risk factors are:

  • Smoking

  • Radiation

  • Bladder stone with chronic infection

  • Infection with schisomiatsis (common  in middle east esp. Egypt)

  • Some form of carcinogen involving the dyeing and paint industries

  • Some form of chemotherapy

Symptoms and signs

The common presenting complains of the patients with bladder cancer which not limited to the following are:

  • Blood in the urine or;

  • Irritative lower urinary tract symptoms (e.g. frequency, urgency and dysuria or difficulty in passing urine with intermittent flow or;

  • Symptoms related to spread to the bone, lymph nodes or lungs or;

  • Swollen kidney or kidney failure, or others

 

On physical examination, the bladder tumour is palpable, huge lymph nodes involvement or kidney is palpable due to involvement of ureter by the bladder cancer. Sometimes the lower limb is swollen due to the bilateral lymph nodes involvement due to the cancer spread.

Investigation

The following investigations are usually done for the patients presented with blood in the urine associated with irritative lower urinary tract symptoms:

  • Uroflow and residual urine

  • Intravenous urogram / ultrasound of the kidneys and bladder

  • Cystoscopy (to confirm the presence of bladder tumour in the bladder or to do biopsy of the bladder)

  • CT scan (to determine to extent of the depth of the bladder tumour)

 

Treatment

There are two modalities of treatment for cancer of bladder: surgery vs radiotherapy. The types of surgery are:

  1. Transurethral resection of bladder tumour (TURBT with EUA)

  2. Radical cystectomy

  3. Intra-vesical chemotherapy

  4. ​Radiotherapy​

  5. Chemotherapy

 

This is usually indicating for patient with advanced cancer of the bladder when there is distant spread to the bone, lung or lymph nodded. The effect is quite toxic and require good kidney function. It is usually given to patient after radical​

Disclaimer: This is not a guide to self-diagnose. We encourage to seek urologist advice further.

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