Bladder cancer is several types of malignant tumors of bladder epithelial layer caused by abnormal uncontrolled cells multiplying.
1. Urothelial carcinoma. About 90% of all bladder cancers. It develops in urothelial cells of the bladder. Another name of this type of carcinoma is transitional cell carcinoma or TCC.
2. Squamous cell carcinoma. Flat cells develop in the wall of the bladder in response to irritation and inflammation. Over time, these cells can become malignant. Squamous cell carcinoma accounts for about 4% of all bladder cancers.
3. Adenocarcinoma. This type is about 2% of all bladder cancers which develops from the glandular cells.
We recommend a narrow field expert to each patient to achieve the best results in management illness.
Symptoms of bladder cancer
Bladder cancer is characterized by the presence of blood in urine. This can be seen by the naked eye or only with a microscope (microscopic hematuria). Hematuria is the most common symptom of bladder cancer.
Other possible symptoms include pain during urination, frequent urination or need to urinate but not being able to do it. These signs and symptoms are not specific to bladder cancer, and may also be caused by non-cancerous conditions, including prostate infections, overactive bladder and cystitis. There are many other causes of hematuria, such as ureteral stones, infection, kidney disease, kidney cancer and vascular malformations.
Causes of bladder cancer
Smoking is the major known factor for bladder cancer; in most cases smoking is associated with more than half of bladder cancer cases in men and one-third of cases among women. There is a linear relationship between smoking and risk, and quitting smoking reduces the risk of this. No evidence about the effects of passive smoking. Thirty percent of bladder tumors appear as a result of occupational exposure to carcinogens such as benzidine, in the workplace. 2 – naphthylamine contained in cigarette smoke increases the risk of bladder cancer. Risk are bus drivers, rubber manufacturers, mechanics, workers manufacturing leather products (including footwear), mechanics. Hairdressers are also at risk because of their frequent exposure to hair dyes.
Cystoscopy is one of the most common procedures in which the bladder is introduced flexible tube with a camera. Suspicious education are taken as biopsy and pathological analysis are sent to the laboratory.
Biopsy is the gold standard of diagnosis of bladder cancer. Cytology is not very sensitive (negative result can not rule out bladder cancer).
Blood oncomarkers with an opportunity to assess the level of complement H, high- carcinoembryonic antigen, and nuclear matrix protein 22 (NMP22).
Diagnosing bladder cancer may also be carried out using fluorescence cystoscopy (photodynamic diagnosis), as an adjunct to conventional cystoscopy. This procedure improves the detection of bladder cancer and reduces the rate of early recurrence of the tumor, compared with the white light cystoscopy. Visual detection should be supplemented by transurethral invasion. The procedure is called transurethral resection (TUR). It is used to assess whether there is a palpable mass or whether the tumor is fixed to the wall of the pelvis.
PET-CT – full body scan for common malignant process in the body. 90% of bladder cancer cases – is transitional cell carcinoma . The remaining 10 % – squamous cell carcinoma, adenocarcinoma , sarcoma, nekrupnokletochny cancer and secondary tumors (metastases ) in other parts of the body .
Treatment of bladder cancer depends on how deep the tumor invades into the bladder wall.
• Superficial tumors (not germinated in the muscle layer) can be removed with electrocoautery, a device connected to a cystoscope, which in this case is called a resectoscope. The procedure is called transurethral resection. In the case of muscle invasive cancer (tumor invasion into the muscular layer), this procedure is not sufficient for the final removal of the tumor.
• Immunotherapy used for treatment and prophylaxis of superficial tumor recurrence. TB vaccine is effective up to 2/ 3 of the cases in this step and in randomized trials have shown that the results of standard chemotherapy results above. The mechanism by which prevents relapse BCG unknown, but the presence of bacteria within the bladder can cause a localized immune response that clears the residual cancer cells.
• Chemotherapy is one of the treatment methods of superficial bladder cancer.
• Thermotherapy is the treatment technology, which uses radio frequency energy to heat the walls of the bladder itself. This technique in combination with chemotherapy shows a synergistic effect strengthening the capacity of each other aimed at the destruction of tumor cells. Untreated superficial tumors may gradually penetrate into the muscular wall of the bladder. Such a tumor requires a radical operation in which partially or completely removed the bladder (cystectomy) and the urinary stream is withdrawn into the isolated intestinal loop (called the iliac tube or urostomy).
In some cases, experienced surgeons can create a substitute bladder segment of intestinal tissue, but this largely depends on the patient’s age, renal function and location of the tumor. For the treatment of bladder cancer can also use a combination of radiation and chemotherapy.
For last years Israeli doctors use precision medicine for bladder cancer treatment that allows to select for each patients drugs which will work for him personally. This treatment prescribed based not on the general statistics but on patient’s DNA.