Bladder Cancer

Bladder Cancer




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■ Synonyms:

Transitional cell carcinoma, bladder cancer





■ DEFINITIONS:



Made in the kidneys to excrete urine passage sinbae, pelvis, ureter, bladder mucosa, the innermost layer of the same cells (yosangpi) consists, in the urine is in contact with the common, and this occurs in nature amdeului are very similar.



The incidence varies in the area of ​​bladder cancer is most common among them. Most of bladder cancer (90%) and the TCC, occurring in genitourinary cancer in Korea, the most common, male 7.76 people per 100,000 population, women 1.19 others will occur.



■ Symptoms:



The most common symptom of bladder cancer, hematuria, blood in your urine is coming out. Most patients with gross hematuria in a urine test urine that has shown some evident. Intermittent hematuria, usually appears as a sometimes severe enough to eject the clotted gore or blood or urine, the beginning or end of the stem to the extent that strikes are a variety of patterns.



Not uncommon frequency, yogeup, bladder irritation, such as yagannyo These symptoms may develop symptoms of acute cystitis in the differential diagnosis is difficult because it appears. Thus, even though the treatment does not heal well if the bladder cancer, possibly because the inspection should be performed.



If no progression of cancer, weight loss, bone pain, and hydronephrosis due to metastasis, depending on cheukboktong and can cause unusual symptoms.



■ Cause / pathogenesis:



The most important cause of bladder cancer is smoking. 50% of male patients, 31% of female patients is associated with smoking. The reason is absorbed into the body when you smoke carcinogens are excreted in the urine in the bladder cancer is still in contact will occur. Smokers compared to 4 times higher risk, higher the amount of smoking, smoked the occurrence of cancer increases the likelihood of longer duration, and stop smoking that is less likely to duration.



The next most important cause of exposure to carcinogens in Industry is, dyes, rubber, leather, paints, organic chemicals and are known to cause. In addition, bladder stones and chronic inflammation of the bladder can also cause bladder cancer.



■ Diagnostics:



1. General urine test, cytology



General urine test findings showed that most of hematuria, urinary tract infections are associated findings can be seen. Off from the urine cytology in the presence of cancer cells to find out by checking the tests, urine tests may baenyohan But in person during cystoscopy, bladder urine obtained by washing with normal saline test may improve the accuracy .



Chapter cytology in the industry due to exposure to carcinogens at high risk of bladder cancer, those that can be used as a screening test is cost-effective test to check the bladder after treatment at regular tracking is often performed with cystoscopy .



2. Urography



Commercial, such as urine cytology, and after the test Excretory urography (IVP) to find out the source of hematuria in diagnostic imaging of the 1st stage. If cancer is confirmed by cystoscopy, upper urinary tract is often done to confirm.



3. Cystoscopy



The diagnosis of bladder cancer by cystoscopy, biopsy with gross check is done. Characteristics of urinary tract carcinoma can occur in several places at the same time, so even if sinwoona suspected urinary bladder cancer in Amman is also important to recognize the existence of.



4. Transurethral Resection of Bladder Cancer



By inserting an endoscope into the bladder protrudes below the muscle layer after removing all the cancer resection to how deeply the cancer will determine whether infiltration has been. With accurate diagnosis and therapeutic use, and bladder cancer is the most basic and important technique.



5. Diagnostic method for staging



Primary superficial bladder cancer with surgery for staging of a confirmed case of more specialized tests are not necessary. However, muscle involvement has been confirmed by endoscopic surgery of tumors in nature is difficult to complete resection of the following tests may be performed.





CT (computed tomography, CT)

Around the involvement of the bladder, lymph node, liver, adrenal gland and metastasis to other organs, such as information about the offers. However, enlarged lymph nodes on CT, even if the observed lymph node metastases does not mean necessarily, even if there is lymph node can not confirm this leads to about 40% of cases. So, bladder and pelvic lymph nodes before performing the excision of the lymph node metastasis is necessary to determine. In addition, slightly more than half as close to the bladder, even hard to confirm.









MRI (magnetic resonance image, MRI)

Staging than CT does not provide excellent information. But when it comes to bone metastases to determine whether the CT or goljusaboda sensitivity is high. Clinical symptoms appeared in the CT findings of pelvic invasion or in ssanghapjin, or suspected bone metastases from goljusaui result findings should be valid when the MRI is thought to be performed.



Lymph node dissection

Diagnosis of pelvic lymph node dissection, lymph node involvement is the most accurate diagnostic method. When you enforce radical cystectomy with pelvic lymph node dissection for staging is performed in a surgical cure rates may help, but can increase to 10% or more are reported also.



Chest radiograph

Lung metastasis of bladder cancer to see if the chest radiograph and chest CT scans conducted with the necessary.



Bone scan (bone scan)

Bone metastases to determine whether there is may be done.







■ progress / outcome:





Lapse



Approximately 70% of superficial bladder cancer is limited to 20% of invasive bladder-toxic, 10% are metastatic. In the case of superficial bladder cancer recurrence by about 70% which makes this time to recurrence in superficial bladder cancer is the most, 10-15% in the invasive or metastatic bladder cancer will progress.



Prognosis



Approximately 30% of superficial bladder cancer recurrence on the prognosis does not not have any problems. However, several treatment and vice versa, despite the invasive or metastatic cancer that may be ongoing. Therefore, the characteristics of superficial aspects of a disease can not be said to be showing a variety of groups and several subgroups of prognostic characteristics that can recognize.



At diagnosis, approximately 30% of the bladder muscle involvement with invasive cancer was shown that 2 / 3 of the practice confined to the bladder, but the remaining 3.1 is already the state is transferred to other organs. The problem with invasive cancer to spread in all directions; but the pattern first, direct tumor spread around, or second, through lymphatic spread, third, through blood, liver, lungs, bones, etc. are spread.



Invasive cancer metastasis to the many factors that influence the differentiation and invasion is a muscle. As a bad grade, depth of invasion, deepening, and the possibility of rimpeuna transferred to other organs are increased survival in the worst affected.





■ Complications:



Complications of metastatic bladder cancer usually appears in the state but much depends on the area or metastatic. In advanced stages, weight loss, bone pain, and may include hydronephrosis due to cheukboktong. Other complications included anemia, urinary incontinence, urethral stricture and can lead to.



■ medical treatment:



1. Bladder Cancer Treatment





Depending on the treatment of bladder cancer, the stage was wrong, largely superficial bladder cancer, invasive

With bladder cancer and bladder cancer metastasis will be explained by category.







Superficial Bladder Cancer



Endoscopic Resection of Bladder Cancer gyeongyodojeok are performed primarily is a process of making the correct diagnosis and treatment in most cases this will be terminated. However, the problem of superficial bladder cancer does not end here, the fact that surely must remember to start. The reason for recurrence of superficial bladder cancer and that approximately 70% of 10-15 percent because of the progress.



Therefore, follow up of patients with hematuria and symptoms that reappear every 3-4 months, rather than wait until the regularly performed cystoscopy and cytology in the diagnosis of early recurrence is important. If there is no recurrence within 1-2 years gradually increasing the duration of 4-5 years may be done after every one year. Periodic recurrence detected by cystoscopy every time when the gyeongyodojeok resection.



On the one hand to suppress the recurrence of preventive therapies may be attempted to try the most common and intravesical infusion of the drug is a way. Used the drug used in tuberculosis vaccination bissiji (BCG) is the most widely used, in addition to some anticancer drugs are used. How to inject medication usually once a week injected 6 times, and in some cases, six weeks after injection once a month, a further injection of one year is even.



Invasive Bladder Cancer



For muscle invasive bladder cancer of the bladder, but if confined to the bladder with radical cystectomy is the best treatment. In men, the prostate and seminal vesicles, extraction range is included, as required resection and the urethra in women, the urethra, bladder, uterus and ovaries, along with the extraction. Pelvic lymph node dissection usually is done at the same time, the next step rimpeujeon metastasis and prognosis in the treatment planning is very important.



Switching from the urinary bladder was removed, the state requires surgery but some former chairman of the President created by the catheter ablation, but this created a lot but it is the safest and easiest way to collect the bag, mat baeedaga are always gonna wear that burden. In recent years, the chapter was created in the shape of the bladder and the urethra remained in the normal way by linking to the urinating, the method allows selective sisuldoel if you can.



Metastatic Bladder Cancer



In the diagnosis of bladder cancer, approximately 10-15% of the time, and was clinically confined to the bladder is about 50% of invasive bladder cancer metastasis ileukimeu soon as it is important to prevent or manage. Such as a lymph node or wongyeokgi complete healing of the tumor has spread outside the bladder is difficult to expect just prolong the survival time of patients alive at the same time sacrificing the quality of the treatment to less need to decide policy. The treatment of metastatic bladder cancer, chemotherapy is used.













■ Prevention:





Cigarette smoking causes bladder cancer is revealed as one of the obvious causes. Cigarette smoke 20 cigarettes a day for 10 years the risk of bladder cancer than nonsmokers increased by more than two times are known. Therefore, to stop smoking will be the surest way of preventing bladder cancer.



Until now, eating habits or drinking affects the occurrence of bladder cancer but no evidence of excessive coffee consumption to bladder cancer is likely to cause an argument.



■ belts to your doctor:



Blood in the urine or frequent urination come, when there are symptoms such as yogeup or baenyotong I try to see the doctor. The smokers and more than 40 years of age or exposure to carcinogens, many minutes on the job working under the doctor on a regular basis is recommended.