Recently, bladder cancer has once again become a hot topic of public concern due to the “knockout” of a major tiger in the military. Is bladder cancer really that vicious and difficult to cure? “As far as the current treatment technology is concerned, most of the urological tumors including bladder cancer can be controlled and cured. Especially for bladder cancer, most of them can be recovered by minimally invasive surgery to remove the tumor, followed by drug treatment. Of course, there are special cases such as rare types of tumor cells or advanced stages of tumor detection that are not as effective as expected. It is important to remember that attention to painless hematuria is the key to preventing bladder cancer.”
Bladder cancer is a malignant tumor that occurs on the mucosa of the bladder. According to the data, it is highly prevalent in people aged 50 to 70 years old, and the incidence rate of men is three to four times higher than that of women. In China, the incidence rate of bladder cancer exceeds that of prostate cancer, accounting for the first place of genitourinary tumors.
Painless hematuria is an early symptom There are no specific markers for early screening of bladder cancer, so it is difficult to be detected through physical examination and screening. The main symptom of bladder cancer is hematuria, which can be seen with the naked eye in many cases, when the urine is red, washed and even has large blood clots; in fewer cases, the red cells in the urine can only be seen under a microscope, and the naked eye cannot detect the abnormality. In addition, patients may also experience bladder irritation symptoms such as frequent urination, urgency and painful urination.
The most important characteristic of hematuria in bladder cancer is that it occurs intermittently, without pain, and the whole urine is hematuria. Professor Sun emphasized that if this signal can be caught and timely examination can be done, early detection and early treatment can be achieved. If all three are present at the same time in people over 40 years of age, they should be highly alert to the possibility of bladder cancer. The first choice is to have an ultrasound of the bladder to clarify the presence of tumor. However, even if the ultrasound is normal, it should not be taken lightly. If the hematuria does not resolve, further tests such as cystoscopy, intravenous urography, pelvic CT or pelvic MRI are needed to confirm.
Symptoms of advanced bladder cancer are complex and obvious. Patients may have various symptoms such as urinary tract irritation, hematuria and swelling of lower limbs: 1. When the disease develops or the scope of the lesion is large and combined with infection, it can discharge flesh-like material, discharge lumps, blood clots, or have difficulty in urination due to the blockage of the urinary tract by lumps, dripping down, or even urinary retention; 3. Cough, shortness of breath, abnormal liver function, pain in liver area, bone pain, etc.; 5. hydronephrosis: if the tumor invades the ureteral orifice, it will cause ureteral dilatation, which will lead to hydronephrosis and kidney enlargement; 6.
Chemotherapy before surgical resection After the diagnosis of bladder cancer is confirmed, there should be no hesitation and the treatment method is best to choose surgery. At present, transurethral resection of bladder tumor, i.e., cystoscopy through the urethra and removal of tumor by plasma electrodesection or laser, can be used for lower-stage bladder cancer, but due to the high recurrence after surgery, regular infusion of BCG, Gemcitabine chemotherapy or immunotherapy drugs such as Zephyr into the bladder can reduce recurrence. For higher-stage bladder cancer, neoadjuvant chemotherapy with gemcitabine combined with cisplatin (GC regimen) or gemcitabine combined with oxaliplatin (GEMOX regimen) can be administered before total bladder resection. This is followed by total cystectomy and post-operative combination therapy, with better long-term results. Currently, we are using the most advanced robotic-assisted total cystectomy in the world to achieve good outcomes while further improving the safety of the procedure and reducing blood transfusion rates and surgical complications. Locally advanced and metastatic bladder cancer is treated mainly with chemotherapy, either GC or GEMOX regimen, with an efficiency of 40% to 65%.
After cystectomy, a urinary bag needs to be draped over the patient’s external stomach. In general, patients who refuse to undergo total cystectomy, even with the most optimal and reasonable other adjuvant treatment options, will generally develop local or systemic metastases in about 2 to 3 years, with a 5-year survival rate of about 40% to 50%, and rarely achieve 10-year survival. If a total cystectomy is performed, the 5-year survival rate can be increased to about 70% to 80% and the 10-year survival rate can be more than 50%.
Daily preventive measures are indispensable The risk of bladder cancer increases significantly with age. For the general population, the following preventive measures can be taken: 1. Eat more fresh vegetables and fruits and less meat. Because fresh vegetables and fruits are rich in vitamins and trace elements, which can break down carcinogenic substances in the body – nitrosamines. In the process of metabolism in the body, meat products can produce carcinogenic substances similar to aniline and benzidine structure, so they should be eaten as little as possible in normal times.
2. Stay away from second-hand smoke, smokers should quit smoking. Because of heavy smoking, the concentration of carcinogenic substances in urine is higher, and these toxic substances can easily damage various organs of urinary system and induce cancer.
3.Increase water consumption. The amount of drinking water directly affects the concentration of urine in the bladder, which has an important impact on the occurrence of bladder cancer. Because less water consumption will reduce urine, the concentration of carcinogenic substances in urine will be correspondingly higher; less urine volume will also make the interval between urination longer, which will create favorable conditions for the reproduction of bacteria in the bladder.