Bladder cancer is the most common tumor of genitourinary system in China; the age of prevalence is 50-70 years old, male:female is 4:1; early detection and treatment has a better prognosis, emphasis should be placed on hematuria and ultrasound physical examination.
Early detection of bladder cancer
1.Painless hematuria of the naked eye: hematuria of the naked eye without pain is the earliest manifestation of bladder cancer.
2.Microscopic hematuria: Some of them are detected by microscopic hematuria during routine urinalysis.
3. Physical examination: Some of them are found by ultrasound and confirmed by cystoscopy pathology.
What kind of people are prone to get bladder cancer?
1.Environment and occupation: occupations with more contact with the following industries.
Definite carcinogenic quality: chemical materials containing benzene, smoking.
Possible carcinogenic quality: fuels, rubber and plastic products, paints, detergents, etc.
Auxiliary carcinogenic quality: fragrance.
2, precancerous lesions” and related predisposing diseases: long-term suffering from the following diseases should be highly alert, abnormal tryptophan and niacin metabolism, Egyptian schistosomiasis of the bladder, bladder leukoplakia, adenocystitis, urinary tract stones, urinary retention.
[Morbidity characteristics].
1. superficial papillary tumors are most common.
2, the degree of hematuria is not consistent with the size, number and malignancy of the tumor, non-epithelial tumor hematuria is less severe.
3.Bladder irritation symptoms can be caused by tumor necrosis and ulceration, infection.
4. The first symptoms of dyspareunia, urinary retention and lower abdominal mass are mostly in advanced stage.
Treatment methods
Surgery is the main treatment, supplemented by radiotherapy and chemotherapy, combined with chemotherapy
1.Surgical options
Early transurethral cystectomy: suitable for Ta, T1, limited T2, postoperative perfusion and review
Total cystectomy: multiple, repeatedly recurring superficial tumors; invasive tumors above T3 stage.
Partial cystectomy: invasive tumors of advanced age and high risk that cannot tolerate total cystectomy are mostly not advocated.
Urinary diversion: suprapubic cystostomy, ureteral skin stoma, ileal cyst, controlled cyst, in situ cyst. Functional exercises such as anal lifting and voiding training need to be strengthened after surgery.
Thoroughness: At present, the main focus of bladder cancer surgery is on two aspects, one is the thoroughness of radical treatment of tumor and the other is the recovery of postoperative functions such as urination and sexual function, trying to achieve a perfect balance of the two to the greatest extent.
2.Surgical instruments
Electrosurgery (commonly used in early stage), laparoscopic surgery (widely used in China), robot (started to be used abroad).
3.Radiotherapy and chemotherapy, interventional therapy
Palliative treatment for advanced patients also has different degrees of effect.
Prevention and follow-up]
1.Reducing exposure to carcinogens: occupational protection, bad habit change, etc.
2.Bladder instillation chemotherapy (especially important): Pyridoxine, BCG, mitomycin, etc. are mostly used once a week for eight consecutive times, then once a month for eight times, and then once every three months for eight times. Usually need to come to the hospital outpatient clinic for related treatment and operation.
3.Scheduled physical examination, alert to high-risk factors, early detection and treatment, adhere to the post-operative follow-up, positive mindset.
4, regular specialist review: urinary routine, ultrasound, generally once every three months, early postoperative also need regular cystoscopy