What is bladder cancer?
Bladder cancer is a malignant tumor of the bladder, with uroepithelial cell carcinoma being the most common, accounting for more than 90%, followed by squamous cell carcinoma and adenocarcinoma. The incidence of bladder cancer is high, the main age of onset is after middle age, children and young people are rare; more men than women, more urban than rural areas. Bladder cancer is characterized as multicentric and prone to recurrence.
How to detect bladder cancer?
The early symptom of bladder cancer is intermittent whole painless hematuria, which can be manifested as carnal hematuria or microscopic hematuria. The time of occurrence of hematuria and the amount of bleeding are not consistent with the malignancy, stage, size and number of tumors. A few patients also have urinary frequency, urinary urgency, difficulty in urination and pelvic pain as the first symptoms. Patients with advanced bladder cancer may present with weight loss, renal insufficiency, abdominal pain or bone pain.
What tests are needed to confirm the diagnosis of bladder cancer?
Ultrasound examination can detect most of bladder lesions and can detect tumors smaller than 0.5cm with high accuracy. CT and MRI examination can understand the size, depth of infiltration, surrounding invasion and relationship with ureter of bladder cancer, and can also differentiate from blood clots.
Urine cytology is to collect urine specimens and look for cancer cells under microscope. Tumors with high malignancy are more sensitive than those with low malignancy.
Cystoscopy and biopsy are the most reliable methods to diagnose bladder cancer. Cystoscopy can clarify the number, size, shape and location of bladder tumors as well as the abnormalities of the surrounding bladder mucosa. Biopsy of the tumor and suspicious lesions can also be performed to clarify the diagnosis.
Why is it possible to perform transurethral resection directly for patients with early bladder cancer and omit cystoscopy?
If imaging examination reveals early tumor-occupying lesions in the bladder that are not infiltrated by muscular layer, cystoscopy can be omitted and transurethral resection can be performed directly.