Bladder cancer Bladder tumors are common tumors in which the bladder wall is divided from the inside out into the mucosa, submucosa and muscle layer. Outside the muscular layer is divided into fatty cellular tissue and the membrane covering the top of the bladder. The inner wall of the bladder can be divided into triangular area, posterior triangular area, neck, both sides of the wall and anterior wall. The line between the two ureteral orifices is the base line of the triangle. The triangle is the main part of the internal cavity of the bladder. Most bladder tumors occur in the triangle, both walls and the neck.
The incidence of bladder cancer is 4 times higher in smokers than in men who do not smoke.
Artificial sweeteners such as saccharin have carcinogenic effects on the bladder, and long-term use of the analgesic finasteride can also increase the risk of bladder tumors. Chronic bladder infection and irritation and the drug cyclophosphamide can also cause bladder cancer.
Symptoms and signs The main sign of bladder cancer is hematuria, especially intermittent painless hematuria (bright blood or rust-colored urine), which can occur continuously or repeatedly. If the tumor encroaches on the bladder neck, the patient may have difficulty in urination and frequent urination. Some of the symptoms are similar to those of cystitis, bladder stones or kidney stones.
Diagnosis 1.Urine test – usually can find more than normal number of red blood cells in the urine or combined with bacterial infection, and can check the cancer cells in the urine.
2.Cystoscopy and biopsy are the means to confirm the diagnosis.
3.High-grade tumor requires intravenous pyelogram to rule out the possibility of upper urinary tract tumor.
Treatment The treatment of bladder cancer varies greatly depending on the disease. For early bladder cancer, i.e. the cancer still has not encroached on bladder muscle tissue, i.e. muscle layer non-infiltrating bladder cancer, the method of electrodesiccation is usually sufficient. Patients should still undergo regular endoscopy and bladder irrigation therapy afterwards to prevent recurrence.
For cancers that have begun to encroach on the inner muscle layer of the bladder or recurrent high-grade tumors, total cystectomy is usually considered. There are several methods of urinary diversion after total cystectomy: one is a urinary-fecal diversion, which includes an abdominal wall stoma, an ileal bladder, and an in situ ileal neobladder or an in situ colonic bladder. One is a combined urinary-fecal flow, such as the SIGMA bladder. At present, in situ ileal neobladder has the least impact on the patient and has minimal impact on the quality of survival, and is currently the first approach after total cystectomy.
Prevention 1.Take preventive measures against the causes, such as it has been affirmed that among the external carcinogenic factors, dyes, rubber, leather and other types of work cause the occurrence of bladder cancer, smoking and taking certain drugs, the incidence of bladder cancer is significantly higher, which requires improving the production conditions of dyes, rubber, leather and other industries, advocating the prohibition of smoking and avoiding large amounts and long-term use of carcinogenic drugs.
2, attach great importance to the close follow-up of patients with hematuria especially for men over 40 years old with unexplained carnal hematuria, in principle, strict measures should be taken, including cystoscopy and other means to screen for bladder tumors.