When it comes to cancer, people are usually afraid of talking about it, let alone advanced cancer. Today we are going to talk about advanced bladder cancer, to see if there is any rule to follow for this cancer that is like a flooding beast? Can it be detected in time? Is there any way to restrain it?
Bladder cancer is a malignant tumor originating from the uroepithelium of the bladder. Early stage bladder cancer refers to tumors that are detected early and limited to the mucosal or submucosal layer of the bladder, which are usually treated by transurethral resection combined with intravesical infusion chemotherapy. As for the so-called advanced bladder cancer, we can try to classify it as muscle invasive bladder cancer limited to the bladder, which means there is no lymph node metastasis or distant organ metastasis; locally advanced bladder cancer, which means it is limited to the pelvis and can have pelvic lymph node metastasis but no distant metastasis; and then metastatic bladder cancer, which has distant lymph node or organ metastasis.
So how can we detect bladder cancer in time in our daily life? Because the bladder is an organ for urine storage and discharge, it is important to be sufficiently alert to changes in the nature of urine and sudden changes in urination habits, especially in the elderly group aged 50 to 70 years old where bladder cancer is highly prevalent. If the color of urine becomes darker, like tea or soy sauce, or even like polyp water, then we must pay attention to it; or if there are symptoms of urinary irritation, that is, frequent, urgent or painful urination, we should also pay enough attention to it; we are suggested to go to the hospital for urine test, ultrasound examination, and also to check whether there are cancer cells in the urine, and if needed, CT scan, cystoscopy, etc. Timely physical examination can usually detect and eliminate bladder cancer in its early stage; if we are careless, the tumor will quickly grow to advanced stage, which will be relatively troublesome to treat; however, don’t worry, we still have solutions.
When bladder cancer reaches advanced stage, it is not as terrible as people think, the 5-year survival rate of limited bladder cancer has reached 90%; more than; locally advanced bladder cancer has also reached 45%;; but the 5-year survival rate of bladder cancer with distant metastasis is relatively low, only 6%;. With the advancement of science and technology, the treatment of advanced bladder cancer is also progressing rapidly. For bladder cancer without distant lymph nodes or organ metastases usually radical cystectomy, regional lymph node dissection plus urinary diversion is used; currently we mostly use minimally invasive laparoscopic surgery, which is just a few small eyes in the abdominal wall to complete the resection through specially designed instruments, with less trauma, less bleeding and faster recovery; urinary diversion mostly uses a small incision in the lower abdominal wall, using the patient’s own terminal ileum to re-sew a The new bladder is placed in the original position and can urinate like a normal person after surgery, which greatly improves the quality of life of patients. For patients with high risk of recurrence and metastasis, we mostly use preoperative neoadjuvant chemotherapy combined with postoperative adjuvant chemotherapy to cure bladder cancer and improve the survival rate.
For bladder cancer with only superficial muscle layer infiltration, we can also choose transurethral bladder tumor electrosurgery, which can preserve the bladder and combine with perioperative radiotherapy and chemotherapy to improve the cure rate.
For patients who already have distant metastases, we usually use GC chemotherapy regimen, which is gemcitabine plus cisplatin, which is an internationally accepted regimen with high efficiency and relatively low side effects.
Prevention is an old saying that is good to say but not good to do, but it is the ideal goal for patients and doctors to deal with the disease. The same is true for bladder cancer; the earlier it is detected, the higher the cure rate and the longer the survival period. I hope you all come to take care of your health and I wish you good health.