Bladder Cancer: This type of cancer can develop on the surface of the bladder wall as benign or malignant papillomas or grow within the bladder wall to quickly invade underlying muscles. Usually almost all bladder tumors arise form the result from malignant transformation of benign papillomas. The less common bladder tumors include adenocarcinomas, epidermoid carcinomas, squamous cell carcinomas, sarcomas, tumors in bladder diverticula, and carcinomas in situ.
Bladder tumors usually affect people over age 50 and are 4 times more common in men than in women.
Cause: True cause of bladder cancer is unknown. Risk factors include exposure to environmental carcinogens such as, tobacco, nitrates, benzidine to name a few (which are known to predispose to transitional cell tumors). People who works in certain industrial groups such as, aniline dye workers, spray painters, hairdressers, petroleum workers are at high risk for developing these tumors.
Bladder cancer is also associated with chronic bladder irritation and infection in people with kidney stones, and in dwelling catheters.
During early stage of bladder cancer the patient may be asymptomatic.
Patient may experience gross, painless, intermittent hematuria (often with clots in the urine)
Suprapubic pain after voiding occurs in patients with invasive lesions.
Nocturia and dribbling.
If tumor has not invaded the muscle: transurethral (cystoscopic) resection and fulguration (electrical destruction) remove superficial bladder tumors. However, if additional tumors develop, fulguration may have to be repeated every 3 months for years.
Tumors too large to be treated through a cystoscope require segmental bladder resection to remove a full thickness section of the bladder. This procedure can only be done if the tumor is not near the bladder neck or Urethral orifices.
Bladder instillations of thiotepa or other chemotherapeutic agents after transurethral resections may also help control such tumors.
In the medical field they are administrating immunologic agent into the bladder but it is experimental.
Radical cystectomy: for infiltrating bladder tumor. The week before cystectomy, treatment may include 2,000 rads of external beam therapy to the bladder. The surgeon may perform a urinary diversion, usually an ileal conduit, which requires the patient to wear an external pouch continuously. (other diversions include ureterostomy, nephrostomy, vesicostmy, ileal bladder, ileal loop, and sigmoid conduit.)
Radical cystectomy and urethrectomy cause impotence in males, because such resection damages the sympathetic and parasympathetic nerves that control erection and ejaculation. At a later date, the patient may desire a penile implant, to make sexual intercourse (without ejaculation) possible.
For advanced bladder cancer - treatment includes cystectomy to remove the tumor, radiation therapy, and systemic chemotherapy.
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