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Bladder Cancer Overview for Clinicians

This document summarizes bladder cancer including its definition, epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, and treatment. Bladder cancer is an abnormal mass that can be found in the bladder and over time can infiltrate surrounding tissues and spread. Risk factors include smoking, occupational exposures, age, gender, infections, and family history. Symptoms include blood in the urine, painful urination, and lower back pain. Diagnosis involves tests like cystoscopy and biopsy. Treatment may include surgery, radiation, and chemotherapy depending on cancer stage and grade. Complications can include infections, urinary retention, and hydronephrosis.

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210 views11 pages

Bladder Cancer Overview for Clinicians

This document summarizes bladder cancer including its definition, epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, and treatment. Bladder cancer is an abnormal mass that can be found in the bladder and over time can infiltrate surrounding tissues and spread. Risk factors include smoking, occupational exposures, age, gender, infections, and family history. Symptoms include blood in the urine, painful urination, and lower back pain. Diagnosis involves tests like cystoscopy and biopsy. Treatment may include surgery, radiation, and chemotherapy depending on cancer stage and grade. Complications can include infections, urinary retention, and hydronephrosis.

Uploaded by

salsabil aurell
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Bladder Cancer

Definition
• Bladder cancer is an abnormal mass that can be found in the bladder.
• Bladder carcinoma is a superficial tumor.
• This tumor is old over time can hold infiltration into phopria, muscle
& fat lamina perivesika which then spread directly to the surrounding
network.
Epidemiology
• Urinary tract malignancies most often occur after prostate cancer.
• About 7% of new malignancy cases in men and 2% in women are
bladder cancer urinary tract.
• White people have a higher risk of suffering bladder cancer than black
people.
• Average age patient when diagnosed with bladder cancer is 65 years
old, with 75% are local malignancies and 25% have metastasized to
the gland regional lymph.
Etiology
Predisposing factors bladder cancer :
• Smoke
• Work
• Age
• Gender
• Chronic irritation and bladder infections
• History of ferocity
• Congenital bladder abnormalities
• Family history
• Chemotherapy and radiotherapy
Pathophysiology
Hydronephrosis and hiroureter -> presence of obstruction of urine flow (anatomic or
physiological) -> increased ureteric pressure -> decreased GFR because of resistance ->
impaired tubular function. if the flow is short -> reversible abnormalities. if chronic
blockage -> tubular atrophy and permanent nephron loss.

On the urogram
• Early hydronephrosis -> flattening.
• Advanced circumstances -> multiply in the form of a stick (clubbing).
• More severe conditions -> destruction of the parenchyma and enlargement of the
urinary tract, papilla compression, thinning of the parenchyma around kalises, and ->
progressive cortical atrophy -> hydronephotic sac formation (balloning).

On ultrasound
• Mild hydronephrosis -> hypoechoic appearance in the center of the kidney.
• Moderate hydronephrosis -> dilation of peilocalikises
• Severe hydronephrosis -> kalises (a lobulated economic free zone, renal parenchyma is
no longer clear)
Clinical Manifestations
• Intermittent blood urination
• Feeling hot when urinating
• Feel like urinating
• Frequent urination especially at night and in the later phases it is
difficult to urinate
• Constant suprapubic pain
• Body heat and feeling weak
• Low back pain due to nerve pressure
• Pain on one side due to hydronephrosis
Diagnosis
 Anamnesis

 Physical examination
 Thickening of the bladder wall and bump
 If the cancer has spread to other organs -> supraclavicular
lymphadenopathy & hepatomegaly
If it spreads to the bone -> pain or fracture
 Supporting investigation
• Laboratory :
Hb decreases
Lukositosis
Right Finger Tapping (RFT) normal
Lymphopenia (N = 1490-2930)

• Radiology :
Excretory urogram
Retrograde cystogram
Fractionated cystogram
Angiography

• Cystocopy and biopsy

• Cystology
Governance
Operation
1. Transurethral resection for single / multiple papillomas
2. Performed on stages 0, A, B1 and grade I-II-low grade
3. Total cystotomy with removal of kel. Prostate and urinary diversion
for:
- Transurethral cel tumors of grade 2 or more
- Aquamosa cal Ca on stage B-C
Radiotortion
- Given to radiosensitive tumors such as undifferentiated grade III-IV and stage B2-C.
- Radiation is given preoperatively for 3-4 weeks, dose 3000-
4000 Rads. Patients are evaluated for 2-4 weeks with
cystoscopy interval, chest radiograph and IVP, then 6 weeks
after radiation is planned surgery. Post additional radiation surgery
2000-3000 Rads for 2-3 weeks.

Chemotherapy
Anti-cancer drugs:
- Citral, 5 fluoro uracil
- Topical chemotherapy is Thic-TEPA, 5 - Fluorouracil (5-FU) and doxorubicin (adriamycin)
- Thiotepa
Complications
• Secondary infection when the tumor is ulcerated
• Urinary retention if the tumor invades
• Hydronephrosis bladder neck because the ureter has occlusion

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