What is the bladder?
The bladder is an organ located behind the muscles under the belly, in front of the intestines in men, under the uterus in women. It is the bag where the urine coming from the kidneys accumulates.
How does the bladder work?
When the urine coming from the kidneys starts to fill the bladder, a signal goes to the brain through the nerves, and in turn, the brain will prevent the bladder from contracting. It also sends signals that will cause the muscles that enable urine retention to contract. However, when the urine accumulated in the bladder begins to strain the capacity, the signals to the brain become more frequent and the brain directs the person to the toilet, removing the pressure it exerts. Thus, the bladder muscle contracts, the muscles that hold urine relax, and the person urinates. Up to 350-500ml of urine can accumulate in the bladder (urinary bladder) in a normal adult.
Bladder Cancer - What is a Bladder Tumor?
The cells that make up the bladder Its uncontrolled growth is called bladder cancer. Bladder cancer originates from the cell layer lining the inside of the urinary bladder. If this cell proliferation is limited only to the superficial layer of the bladder, it is called superficial bladder cancer. If cell proliferation deepens and spreads to the muscle and fat layers, this is called deep (invasive) bladder cancer. Bladder cancer that has spread to the muscle layer can spread to surrounding tissues. Thanks to the blood circulation, it can reach tissues and metastasize to distant organs, such as the lungs and liver.
Bladder Cancer Symptoms and Risk Groups
The exact cause of this disease has not been determined. Although it can be seen at any age, it can be considered an advanced age disease since it is mostly seen in people over the age of 60. The most important culprit of this disease, which is 3 times more common in men than in women, is smoking.
This cancer, which is 10 times more common in smokers than in non-smokers, also affects those with genetic predisposition and those who have been exposed to chemicals (paint, paint, etc.) for a long time. (such as those working in rubber, leather, etc. industries) are frequently observed.
The risk of bladder cancer increases in those with recurrent urinary tract diseases, those with kidney stone disease, and those who have to use a catheter for a long time.
Bladder. Cancer Symptoms
- Visible blood in the urine,
- Burning in urine
- Pain during urination and frequent desire to urinate
These complaints are simple urinary tract symptoms. It is not taken into consideration as it has similar complaints to inflammation, but especially people in the risk group should consult a doctor when they have these complaints.
What needs to be done for diagnosis;
- Urine Analysis, Urine Culture
- Ultrasound examination
- Kidney x-ray (IVP or Tomography)
- Tumor cell investigation in urine (NMP 22 (Nuclear Matrix Protein 22) or cytology)
- Cystoscopy (the process of looking at the bladder with a lighted camera system)
What does cystoscopic examination mean?
There is a special device called a cystoscope. It is the process of directly visualizing and evaluating the inside of the bladder by entering it through the urinary tract with an instrument. Cystoscopes have lighting and lenses, and with them the inside of the bladder is perfectly visualized. When tumors are seen, small ones can be treated in our clinic, while large ones are completely removed with general or spinal anesthesia and these tissues are sent for pathological examination. In our center, our cystoscope lighting system has advanced technology features and since there is a coloring method that shows tissue differences during the procedure, early diagnosis of bladder cancer is possible.
It is very important to detect and completely remove all visible tumors in the bladder. The bladder mucosa should be examined in detail and meticulously to detect tumors that may be overlooked. Attention should be paid to blind spots such as the bladder dome, anterior bladder neck, and the inner part of the diverticula. At the same time, raised tissue or irregularities in the bladder mucosa should not be overlooked. For example, the appearance of capillaries is sometimes the only indicator of early cancer. Detection and treatment of such abnormal tissues results in the cancer not reoccurring for a long time.
Can bladder cancer be diagnosed with laboratory tests other than cystoscopic examination?
No, only superficially. Cystoscopy, a standard method used to diagnose recurrence in the follow-up of patients with bladder tumors and NMP 22 test are used together. Evaluating cystoscopy and NMP 22 test together increases the probability of correct diagnosis.
Does a cystoscopic examination cause pain?
It does not cause any discomfort in women. Although there is some discomfort in men, this can be prevented by using local anesthesia. Cystoscopy in children is performed under general anesthesia.
What is the initial treatment if a tumor is detected in the bladder during ultrasound or tomography?
Diagnosis and treatment are made by completely excising the tumor (transurethral tumor resection (TUR)) under anesthesia under hospital conditions. The hospital stay is generally 1-2 days. Pathological examination after the surgical intervention is necessary for staging.
A tumor was detected in the bladder and I underwent surgery. Can a treatment be performed before the pathology report is released to reduce the risk of recurrence?
Yes, various chemotherapy drugs are administered within the first 6 hours after the operation. It is kept in the bladder for 2 hours and in this way, the remaining tumor cells from the surgery are tried to be killed and the possibility of recurrence is reduced. The main treatment method is according to the pathology report.
Bladder Cancer Treatment:
The biggest risk in bladder cancer is that it is one of the cancers with the highest recurrence rate. Therefore, the patient should not skip the check-ups as recommended by the doctor. The treatment of the disease is determined according to the pathology report obtained after the tumor is scraped (TUR).
Important factors in the treatment of bladder cancer are;
Stage and grade of the tumor,
Location of the tumor, Number of the tumor,
Size of the tumor, Age and general health condition of the patient.
Treatment methods according to the pathology report:
1- Superficial bladder tumors:The tumor has not penetrated the inner surface of the bladder. Treatment is done by removing the tumor and administering medication into the bladder.
Treatment methods;
a. Follow-up with cystoscopy every 3 months
b. Weekly administration of chemotherapy drugs into the bladder.
c. Administration of attenuated tuberculosis microbes into the bladder weekly for 6 weeks.
2- Deep-seated bladder tumor Next:The tumor has entered the bladder muscle layer. Treatment is done by removing the bladder and/or radiation therapy and medication.
Treatment methods: Surgery:
Surgical:
The method called radical cystectomy. After the regional lymph nodes and bladder are removed without being disintegrated, the artificial bladder is made with parts taken from the intestines. The artificial bladder can then be attached to the anus, skin, or old urinary tract. As a result of the developments in laparoscopy in recent years, this operation can also be performed laparoscopically or with the help of a robot.
Chemotherapy:
There are treatment alternatives such as radiotherapy (ray).
3- Distance spreading. Bladder tumors:The tumor has spread outside the bladder and spread to distant organs. At this stage, drug treatment called chemotherapy is given.
Read: 0
