What is bladder cancer?
Among bladder cancer or bladder carcinoma is a malignant proliferation of the epithelial cells of the urineblaas lining means.
Prevent
In the Netherlands is determined annually by 4800 people bladder cancer. The disease occurs mainly in people who are older than 60 years, and four times as often in men; to them it is the fourth, eighth in women occur in frequency. The tumor is usually a urothelial carcinoma.
Bladder cancer causes
The cause is usually exposed to certain carcinogens, the aromatic amines, which appear in the paint industry, rubber industry and in the smoke. The chances that smokers develop the disease is 2 to 2.5 times greater than nonsmokers. The cancer occurs about 25 years after the exposure to these substances.
Bladder cancer symptoms and signs
Blood puddles without other complaints, is usually the first sign that something is going on. When malignant cells are found in the urine is diagnosed, but when those not be found that does not mean that the person bladder cancer free.
Bladder cancer research
The most important research is a cystoscopy. It indicates a video camera and a light source inserted through the urethra into the bladder via a slack tube. Eventually you can glue staining the bladder membrane, allowing suspicious areas more visible. One will take biopsies during cystoscopy all suspicious areas to investigate in the laboratory.
Bladder cancer staging
The TNM system is used for this version in 2002 and 2004
- T: local tumor.
T1: The tumor has spread into the connective tissue of the mucosa of the bladder.
T2-T4: the tumor has spread into the muscle tissue of the bladder.
- N0 or N1 (and higher) or without metastasis to the lymph nodes
- M0 or M1 (and higher) or without metastases (spread) remotely.
When the tumor has spread into the muscle layer, further research is needed. Before an MRI is usually made. This shows how far the tumor has spread; and whether there is metastasis to other organs or structures.
Bladder cancer treatment
The treatment depends on the stage.
Treatment if no ingrowth in the muscle tissue is
There should always be a Transurethral resection of bladder tumors, TURT, a to be carried out. The tumor is removed through a cystoscopy. The tissue is examined microscopically, especially the edges are important. After the TURT is basically the bladder flushed with a solution with medication that kills cancer cells. When there is a moderate to strong chance of coming back from the tumor or the bladder is weekly on aggravation is, rinsed with tuberculosis vaccine (BCG). This treatment brings an immune response against malignant cells, but has quite a few adverse reactions in 5% of patients. Patients with less chance of coming back or worsening one will be 3-6 months offer with Mitomycin, a medium bladder rinses that kills cancer cells. Immunocyanine, coming from the sea slug, is a third possibility.
Treatment at ingrowth in muscle tissue
It finds a "radical cystectomy" place, thereby the bladder with the lymph nodes, and in the prostate or the uterus surgically removed. The patient may get complaints ranging from problems with urination, with the intestines and problems with sexuality. At certain forms in Netherlands instead of surgery is called internal radiation applied; There is a radioactive material put into the bladder. Sometimes irradiated prior to the operation. After surgery, the urine to leave the body in a different way:
- To this end, a stoma created by using a piece of small intestine. This is called a Brickerdeviatie. This Ostomy is not continent, the patient wears a bag.
- Another possibility is a continent stoma. There is a reservoir of a piece of intestine created. The patient must empty the reservoir with a catheter. With this solution you may experience more problems than the previous.
- Bladder reconstruction: this method of the reservoir on the urethra connected.Almost half of the patients must be over time yet catheterisation.
Palliative treatment
When it has spread at a distance, can be achieved an extension of life with chemotherapy, from an average of 12 to 14 months.