bladder cancer | Bladder Cancer-symptoms, diagnosis and treatment

Bladder Cancer-symptoms, diagnosis and treatment

Bladder cancer is the seventh most common cancer in France. The average age for diagnosis is 70 years and is more common in humans (more than 80% of cases).

Definition
Bladder cancer is rare before 40 years. It is about four times more common in humans than in women. One of the main causes of its onset is tobacco, a factor found in about 1/3 of the patients; Some substances used in the industry are also imputed in their occurrence. It develops at the expense of the mucous membrane of the bladder. Two types of bladder cancer are distinguishable: superficial, i.e. limited to the bladder mucosa, and invasive, reaching a deeper tissue layer of the bladder, the muscular. The second is more violent and requires a much heavier treatment.
Symptoms
The cancer symptoms of the bladder are as follows:
The presence of blood in the urine or hematuria, very frequently;
Urination disorders with more frequent needs, urgent needs;
Trouble urinating.

Diagnosis
To diagnose bladder cancer, the doctor will look at the patient's history and lifestyle to establish, among other things, a link between the disease and possible exposure to chemicals. After clinical examination with urinary strip, pelvic touches (rectal and vaginal touch) and abdominal palpation, urine cytology is carried out: it allows the study of the cells present in the urine. Bladder endoscopy, allowing direct visualization inside the bladder is very often useful. An ultrasound and a urography, a kind of bladder radio using a product injected by the veins can also be practiced.
Alert symptoms
Macroscopic hematuria reveals in 80% of cases bladder cancer. Bladder cancer can also be revealed by symptoms of bladder irritation, pollakiuria, imperious urination, urinary burns and repetitive urinary tract infections, especially in the elderly patient.
Interrogation and clinical examination
The questioning must be used to investigate risk factors, including smoking, exposure to certain chemical agents in the professional context, a history of pelvic radiotherapy, administration of certain chemotherapy anterior, urinary bilharzia and tumor of the upper excretory pathway.

Exams

In the first line, an ultrasound of the urinary tract is indicated.
Urine cytology
Urinary cytology is a test that looks for tumor cells.
Cystoscopy
Cystoscopy is systematic in the face of any suspicion of bladder cancer and is carried out either under local anesthesia at the urethra without hospitalisation, or in the operating room under general anesthesia or locoregional. This examination specifies the number, topography, size and appearance of the tumor and the bladder mucosa.
transurethral resection of the bladder
The transurethral resection of the bladder a surgical procedure performed under anesthesia to carry out the histological diagnosis and which represents the first time of treatment.
Pathology
The Anatomopathologic examination specifies the stage and grade of the tumor.

Treatment
In the context of superficial tumors, endoscopic treatment can be performed, coupled secondarily with instillation of products avoiding recurrences in the bladder. For invasive tumors As for most cancers, surgery, radiotherapy, chemotherapy or the combination of the three are used. The choice of treatment depends on the stage of the cancer and its location. Surgical procedures on this type of cancer can be accompanied by ablation of the uterus, fallopian tubes, ovaries and a part of the vagina in women, and the removal of the prostate in humans.
Therapeutic education
The aim of therapeutic education is to accompany the patient in the acquisition of self-care and adaptation skills and to enable him to understand the complications at best. The development of skills allows the patient to:
Understand the disease, treatment and adverse effects
To take part in the planning of its follow-up after the treatment;
Better live the lifestyle changes
To take over its stoma after a cystectomy;
To learn the functioning of its néovessie;
To involve its entourage in the management of the disease.

Treatment of non-infiltrating muscle bladder tumors
Transurethral bladder resection.
Endovésicales instillations.
Mitomycin C (chemotherapy).
BCG (immunotherapy).

Treatment of infiltration tumours of non-metastatic muscle
Surgery:
Total Cystectomy performed no later than 3 months after diagnosis, i.e. ablation of the prostate and seminal vesicles in humans or anterior pelvectomy, with total hysterectomy and urétrectomie in women;
Partial cystectomy carried out rarely, in some cases of intradiverticulaires tumors or of the tumor of the Oura.
Chemotherapy.

Treatment of metastatic cancers
The HAS recommends treatment based on cisplatin-based chemotherapy. A CT assessment of the treatment response is recommended 2 months after the onset of chemotherapy.
Prevention
Some reflexes can help prevent this type of cancer. In the case of people exposed to dangerous chemicals, a urine test is required every year, with an annual health check. It is also essential to stop smoking, as tobacco is the most important risk factor in this type of cancer in women.