Bladder cancer (BBC) develops from urothelial cells of the transitional cell epithelium and rarely goes beyond the mucous membrane.
Among all malignant tumors of the urinary tract, RMP prevails, accounting for about 70%. The specific gravity of other formations of the urinary tract (urethra, ureter) is much lower. The mortality rate from RMP in the CIS countries is very low.
Bladder cancer is diagnosed 5.2 times more often in men than in women. This is due to:- specificity of the anatomical structure of the male urinary tract;
- abuse of tobacco smoking;
- frequency of contact with chemical oncogenes.
The peak incidence of men is in the age group from 55 to 80 years. Despite the achievements of medicine, the trend towards a constant increase in the number of patients persists.
Causes of occurrence
RMP refers to a polyetiological disease. The negative impact on the urothelium (multilayered epithelium of the genitourinary tract) of substances with a carcinogenic effect that enter the body and are excreted in the urine has been reliably determined. First of all, this is a class of amines (ammonia derivatives) present in the cycle of potentially dangerous production processes.
High-risk factors that can also cause bladder cancer in women include:
- consumption of chlorinated water;
- tobacco smoking;
- radiation effect;
- taking certain medicines;
- schistosomiasis (parasitic disease).
The relationship with the phenomena of urostasis (urine stagnation) is traced.
Bladder cancer: symptoms
Clinical symptoms are determined by the stage of development. In the initial stages, any symptoms are absent or their manifestation is of a non-specific nature, inherent in other diseases of the urinary system:
- frequent urination with pronounced urges;
- pain with dysuria.
Pain may appear in the area of the pubic joint, spreading to the perineum, sacrum. The leading symptom of RMP is the appearance of hematuria, microhematuria (presence of blood in the urine). At the same time, this manifestation can be one-time or large.
As the cancer progresses, pain may appear in the area of the kidneys, which is due to the development of hydronephrosis due to blockage of the ureter by the tumor. Pain in the bones appears only in the presence of metastases in them. At least the generalization of the process produces anorexia, increased fatigue, weakness, and a pronounced decrease in body weight. Metastases of RMP spread to nearby lymph nodes, adjacent and distant organs and tissues through the lymphatic and blood pathways.
The following types of oncopathology are distinguished histologically:
- transitional cell cancer;
- squamous cell cancer;
- adenocarcinoma;
- undifferentiated form of cancer.
Bladder cancer: stages
Classification according to the prevalence of the process and the clinic distinguishes 1-4 stages of the process.
Superficial cancer:
- Papillary carcinoma is non-invasive.
- Carcinoma (cancer in itself).
- 1st stage - the process occurs at the level of subepithelial connective tissues.
Muscle-invasive cancer:
- 2nd stage — the process turns into a muscle layer.
- 3rd stage — the neoplasm grows on the adjacent fatty tissue.
- 4th stage — other tissues and organs are involved in the process (uterus, prostate gland, abdominal and pelvic walls)
It is the presence or absence of tumor invasion (cell spread) and damage to the muscle layer of the MP that divides patients into 2 groups, determining the tactics of their treatment. According to statistics, a superficial tumor is diagnosed in 75% of patients with an initially detected cancerous process in the MP, and only 25% of patients have a multilayered lesion of its membrane.
Bladder cancer: diagnosis
Establishing an accurate diagnosis with determination of the stage of the oncological process is carried out through a comprehensive examination of the patient. An examination and palpation are carried out, the doctor prescribes a general and bacteriological analysis of urine and blood, as well as research on tumor markers. Among the instrumental methods, ultrasound, MRI of the pelvic organs, cystoscopy, biopsy for cytological examination of the biopsy are used. To determine the diagnosis, the level of spread of the process and metastases, a chest x-ray is performed.
Bladder cancer: treatment
Management tactics and adequate selection of treatment methods depends on how far the tumor process has spread. Most often, this is complex therapy, which includes transurethral and operative surgical interventions, chemoradiation therapy.
Transurethral resection using minimally invasive methods, followed by chemotherapy and immunotherapy sessions, is considered the standard of therapy for muscle-noninvasive tumors. If chemotherapy for bladder cancer is carried out in a timely manner, the likelihood of recurrence is greatly reduced, and the future prognosis for the patient is quite optimistic. If the process has spread to the muscle layer, a complete removal of the MP is performed with the organs and tissues adjacent to it - the prostate, urethra, uterus.
Chemotherapy plays the most important role in advanced cancer. Median survival directly depends on early diagnosis. In situations where a bladder tumor is not detected in the early stages, the prognosis is not very optimistic.
Preventive opportunities
The likelihood of developing RMP can be reduced by:
- refusal from smoking;
- elimination of contact with carcinogenic substances in the process of participation in potentially dangerous productions;
- choice of drinking water that has not undergone chlorination;
- treatment of diseases that occur with growth.
Knowing what the diagnosis, symptoms and causes of RMP can be, it is necessary to have constant cancer vigilance. Periodic ultrasound of the pelvic organs and laboratory tests of urine are extremely important. With the appearance of symptoms of urinary tract dysfunction, consult a urologist in a timely manner. If necessary, he will refer you to a consultation conducted by an oncologist.
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