Bladder Cancer

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The bladder is the organ that stores the urine filtered from the kidneys and allows it to contract and expel the urine from the body. Bladder tumors can be benign or malignant. Uncontrolled proliferation of the tissues that make up the bladder bladder cancer It is called. This cancer originates from the layer of cells lining the inside of the urinary bladder. The most well-known risk factor for bladder tumor formation is smoking. Men and women with bladder tumors have the same symptoms. Men over the age of 50 have a higher risk of developing this cancer.

You should be examined by a urologist for early diagnosis of bladder cancer through routine checkups or symptoms. The bladder has a flexible structure and is the part where urine accumulates. After urine is stored in the bladder, it is excreted through the urethra. Muscles that stretch the bladder according to the amount of urine also take part in this emptying process. Uncontrolled proliferation of cells in the bladder for various reasons bladder cancer It is called.

Kanser hücreleri genellikle mesanedeki üroepitelyal hücrelerden oluşur ve ilerleyen zamanlarda kaslara, lenf nodlarına, çevre dokularına ve organlara yayılabilir. Tümörler sıklıkla mesane ile birlikte üriner sistemi etkiler. Araştırmalara göre vakaların %95’i kötü huylu tümörlerdir. Ancak metastaz aşamasına gelmeden tedavi edilebilen hastalığın tekrarlama olasılığı yüksektir. Mesane kanseri de boşaltım sisteminin en sık görülen kanser türlerinden biridir.

Important risk factors for bladder tumor include age, gender and ethnicity. This type of cancer is more common in older people, especially those over 50, than in younger people. It has been analyzed that men are 4 or 5 times more likely to develop bladder cancer than women. Bladder tumor is the 7th most common cancer in men. However, the mortality rate is the exact opposite. Bladder cancer mortality is higher in women than in men. Research has shown that most bladder cancer patients are white.

Bladder Cancer Symptoms

Some symptoms may be observed in bladder cancer patients. These symptoms can be listed as follows;

  • Visible blood in the urine (hematuria),
  • burning in urination,
  • Frequent desire to urinate,
  • Decrease in the amount of urine,
  • Weight loss or weakness,
  • loss of bladder or bowel control,
  • People with advanced bladder cancer experience symptoms such as pain or stiffness in the hips, back, ribs, or upper thighs.
Blood in the urine is the most common symptom in bladder cancer patients and the most obvious symptom of this disease. Other symptoms may also occur due to diseases such as infections and bladder stones. However, when there is painless bleeding, bladder cancer should be considered first. In some cases, there are no symptoms even though the cancer is advanced. Symptoms such as severe back, leg, pelvic and abdominal pain, loss of appetite and sudden weight loss may indicate that the cancer has spread. Depending on the prevalence of metastases, pain areas may vary from patient to patient.

Why Does It Happen?

As with most cancers, the exact cause of bladder cancer is unknown, although several factors are known to cause cancer. These:
  • Commonly used drugs for various diseases, especially chemotherapy drugs,
  • genetic factors,
  • bladder stones,
  • Less fluid consumption,
  • bladder infections,
  • Consuming excessively fatty and additive foods,
  • Smoking: The most common risk factor for bladder cancer is the use of tobacco products. People who use tobacco products are four to seven times more likely to develop a bladder tumor than non-smokers. Likewise, passive smokers also carry the risk of bladder tumors.
  • Age: Bladder tumors are more common after a certain age. Most patients with bladder cancer are over 50 years old.
  • Gender: Men are 3 times more likely to get bladder cancer than women. However, the possibility of bladder cancer in women is increasing due to the increasing prevalence of smoking among women in recent years. Women are more likely to die from bladder cancer than men.
  • exposure to chemicals, Chemicals used in the textile, leather, paint rubber, battery industry, chemical or printing industries carry the risk of bladder cancer.
Use of tobacco and smoking products and exposure to chemicals are the two most common causes of bladder cancer. The rate of bladder cancer, which can also be seen in passive smokers, is approximately 56 times higher in smokers than in non-smokers.

What are its stages?

Stage 1 is a superficial bladder tumor that has not spread to any other organs or involved lymph nodes.

Stage 2 indicates a stage in which there is no spread to other organs and tissues as in stage 1, but the cancer progresses to deeper muscle structures.

Stage 3 indicates that there is no spread to organs distant from the bladder, but the tumor has progressed outside the bladder.

Stage 4 indicates that the disease has spread to other distant organs and tissues.

bladder cancer

Diagnostic Methods

Urologists use methods such as biochemical tests, imaging methods, cystoscopy and biopsy to make a diagnosis. The scope of physical examination in bladder cancer is limited, and in general, advanced bladder cancer can be detected by physical examination. If the disease is suspected, the doctor will first order laboratory and radiological tests. These tests include urinalysis, various blood tests and ultrasound. If a patient with hematuria is suspected of having a bladder tumor and a bladder tumor is not detected by ultrasound, computed tomography or MR urography may be performed.
 
Another test that may be done is urine cytology. In urine cytology, the presence of cancer cells is examined under a microscope. Even if all these tests give normal results, the most important test that must be performed in a patient with suspicion of bladder cancer is cystoscopy. Cystoscopy is the process of imaging the inside of the bladder by inserting a camera into the urethra. Cystoscopy, which is usually performed under local anesthesia, is also used for biopsies by taking tissue samples.
 
The process of removing tissue during cystoscopy is defined as transurethral resection (TUR). TUR, which is used as a treatment for non-invasive cancers detected at an early stage, allows taking samples from both bladder tumors and muscle tissue in addition to diagnosis. If the disease is diagnosed at an early stage, the probability of a successful outcome in the treatment is quite high.
 

bladder cancer

Treatment Methods

Treatment of bladder cancer depends on various factors, such as the patient's condition, the type of cancer and its stage. Surgical treatment of cancer may vary depending on the type, type, number and stage of the cancer. Cancerous tissues are removed during the tour operation, which is one of the treatments for bladder cancer. It is performed by entering through a small hole in the urinary tract without making any incision on the body.

This surgery can be performed with general anesthesia or regional anesthesia. He or she may recommend one-time or 6-8 weeks chemotherapy treatment to destroy remaining cancer cells after the surgery. In radical cystectomy treatment, the bladder and all adjacent tissues and organs are removed along with the tumor.

Transurethral Resection (TUR)

Transurethral Resection is the process of cutting the tumor in the bladder, tumor bladder tissue and, when necessary, healthy bladder tissue by entering through the urethra with a tool called resectoscope, using electrical energy.

 After TUR, chemotherapeutic/immunotherapeutic drugs can be administered into the bladder when necessary (in cases of intracellular cancer, widespread tumor or multifocal tumor). These drug applications can be administered as a single dose or weekly after surgery.

cystectomy
The cystectomy method, divided into radical and partial, is based on the direct removal of all or part of the bladder. In patients with rare adenocancer, segmental cystectomy may be considered if only a limited portion of the tumor has invaded the bladder. It is not a suitable surgery for other bladder cancers. In this method, only the tumor part of the bladder is removed and the patient continues to urinate in its natural course.
 
In radical cystectomy, the entire bladder and part of the ureter are removed. In some cases, the urinary tract can be completely removed. In women, organs such as the uterus and ovaries are removed, and in men, parts such as the prostate and seminal vesicles are removed. After the bladder is completely removed, the patient's urine flow is restored by surgical methods. This is done by connecting the ureters with a section taken from the intestine, and by opening a space in the right half of the abdomen, urine is poured into the bag. Or an artificial bladder is created from the intestine.
Radiotherapy and Chemotherapy
It is a treatment method applied to patients who have muscle invasion, have not metastasized, do not want their bladder removed or cannot undergo surgery. It should not be forgotten that the success of surgery (cystectomy) is better than radiation and chemotherapy in invasive bladder cancer.
 
Radiotherapy treatment for bladder cancer can be applied internally and externally. For external applications, the radiation is administered to patients while they are standing, while internal applications require hospitalization. The radiation, which is usually given using a urinary tract implant, can also be applied by making an incision in the abdomen in some cases.
 
Chemotherapy, like radiotherapy treatment, is used to shrink or completely destroy cancer cells. The difference between the two methods is that chemotherapy is a drug treatment. During chemotherapy, one or more drugs are used depending on the patient's condition.
 
In cases where radical cystectomy is deemed appropriate, chemotherapy can also be administered before the operation. In this way, it is aimed to shrink tumors.
immunotherapy
Immunological is done through the use of medications to ensure that the body's immune system works effectively against cancer cells. The medicine, given directly into the bladder using a catheter, causes the cells in the area to fight cancer cells.
Frequently Asked Questions About Bladder Cancer

1-Is Bladder Tumor Dangerous?

Bladder cancer is the 7th most common cancer in men and is less common in women. However, bladder cancer is the leading cause of cancer deaths in women.
 
2-Does Bladder Tumor Spread to the Body?
Bladder tumor first begins in the innermost layer of the bladder, and by the 4th stage, the tumor has usually grown and spread outwards from the innermost layer of the bladder. Bladder cancers often spread to bones, other bones, lungs and liver.
 
3-Does Bladder Tumor Recur?
Yapılan araştırmalarda göre, toplam vaka sayısının %95’i kötü huylu tümör içermektedir. Ancak bu hastalık yayılma evresine gelmeden tedavi edilebildiği için tekrarlama olasılığı da yüksektir.
 
4-At what ages is bladder tumor seen?
Bladder tumor can be seen in all individuals, including children. It is mostly seen in people aged 65-70.
 
5-Is Bladder Cancer Contagious?
Bladder cancer is by no means contagious like other cancers.
 
6-What Happens If Cancer Spreads to the Bones?
When cancer spreads to the bones, the bones become weaker and more fragile. Cancer cells that spread to bone disrupt the balance between the activity of osteoclasts and osteoblasts, two types of cells that normally maintain bone quality.
 
7-In what cases is the bladder removed?
Sometimes cystectomy may be required for reasons other than cancer. Cystectomy may be necessary in cases where the bladder volume is greatly reduced due to an infection, for example, bladder tuberculosis, brain or spinal cord injury.

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