Bladder Cancer
Diagnosis and treatment

Bladder cancer

The urinary bladder is a balloon -shaped organ which collects urine excreted from the kidneys. It basically access storage then before disposable by urination. It’s mostly made out of muscle and elastic tissue for it to expand and contract.

The kidney produces the urine and from there it travels down via the ureter’s to the bladder. There is 2 opening within the bladder for the 2 kidneys. The muscle layer making up the bladder is known as the detrusor muscle.

The commonest type of bladder cancer is transitional cell carcinoma. Other type of cancers that can present in the bladder include squamous cell carcinoma and adenocarcinoma.

Smoking is the most common as risk factor for bladder cancer. Exposure to paints, dyes and petroleum product also has been included as risk factors.

History of bladder infection secondary to schistosomiasis has been associated with squamous cell carcinoma. Chronic irritation to the bladder either secondary to bladder stones and long-term urinary catheterisation has also been said to induce it.

Symptoms and signs

Blood in the urine is the most common presenting symptom. Some individuals complain of having frequent urination. In rare instances, it is diagnosed while working up for some other symptoms.

Most commonly the history will review the diagnosis. Urine analysis may confirm the presence of blood and white cells within. Sometimes urine cytology is performed where the urine is centrifuged and looked under the microscope for abnormal cells.

As an outpatient basis, cystoscopy is used to look inside your bladder and urethra can be performed under local anaesthetic. A small scope is inserted through the urinary passage and tissue samples can be taken at the same time.

Imaging studies

CT scan this performed with contrasts to stage the bladder cancer and also look for spread to neighbouring structures and organ. This will help in the staging of the disease and treatment plan.

Sometimes other investigation like MRI, bone scan may be performed to get the clear picture.

Treatment options

Surgery is the most common as treatment option. This, depending on the size of the tumour, involves inserting camera under general anaesthesia into your bladder and resecting the tumour. During the same time, the surgeon takes tissue from the bladder wall to be sent for histological examination by the pathologist to look for the type of tumour.

Other modalities of treatment include:

  • Radiation therapy
  • Chemotherapy
  • Immunotherapy
  • Advance stage might require radical cystectomy

It is best to discuss the treatment option with your urologist since every individual requires different modality of treatment.

The most important thing is the follow-up test. Your urologist will provide you with the comprehensive follow-up plan which includes cystoscopy, urine and blood analysis along with radiological investigations. This surveillance might go on for some time since there is a high chance of recurrence in patients with bladder cancer. Patient is also advised to stop smoking.

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