What is Bladder Cancer? Bladder Cancer Symptoms, Diagnosis and Treatment

The urinary bladder is a pear-shaped organ with its own muscle layer, inner membrane and outer layer with a volume of 400-500 cc in normal adults, which enables the storage of urine coming from the kidneys through ureter tubes until it is excreted from the body.

Cancers that develop due to uncontrolled proliferation of atypical cells in the urinary bladder and, if untreated, metastasize to distant organs, resulting in death, can be called bladder cancer.

First of all, atypical cells are formed in the bladder mucosa (inner membrane). Then these cells begin to multiply uncontrollably and after reaching a certain volume, they begin to give the first symptoms such as bleeding in the urine.

When it gets bigger, it first holds the bladder muscle tissue, then the outer layer of the bladder, and then the organs such as the prostate rectum and the uterus that it is adjacent to.

It also metastasizes (passage) to organs such as liver, lungs and bones through the blood to regional lymph nodes via lymph.

It also generates uncontrolled reproduction in the organs it goes to, resulting in consequences leading to death.

As with all cancers, bladder cancer does not depend on an exact cause. However, smoking is one of the most important factors. In addition, genetic factors, chimney sweepers, people working in the paint industry, chronic bladder infections, long-term bladder stones, parasitic infections are held responsible.

All men or women over the age of 40 with bladder cancer symptoms and urinary clotting should be considered as bladder cancer and further examinations should be performed until proven otherwise. Clot bleeding in the urine is the most important symptom of bladder cancer.

When cancer progresses, difficulty in urinating, frequent urination, not urinating, pain in the bladder area and the feeling of continuous urine, enlargement of the kidneys due to involvement of the urinary tract from the kidney, nausea, vomiting, defecation problems due to the involvement of the last parts of the large intestine, bone involvement There may be many non-specific symptoms such as bone pain.

Patients usually present with complaints of clotted blood coming from the urine or blood in the urine in urinalysis. Then, ultrasonography or computed tomography (CT) is performed if necessary. The final diagnosis is made by cystoscopy, that is, by entering the bladder with the camera system and taking a biopsy from the suspect site.

Bladder cancer treatment, after the initial diagnosis is made, patients are operated with a closed camera system and TUR-M surgery, all of the cancerous tissue removed is sent to pathology and treatment and follow-up is determined according to the result. Bladder cancer is of two types, low and high grade.

Low-grade cancer is less aggressive, less likely to spread, more superficial. If it is treated early and followed up well, the risk of recurrence is very low.

Then, it is followed up by cystoscopy every 3 years and 3 months, then every 6 months. Medication can be administered into the bladder for 3 weeks after each cystoscopy. If it recurs despite this, the patient’s urinary bladder is removed and an artificial (orthotopic-intestinal bladder) bladder is made instead. These types of tumors recur in 70% within 5 years.

If the superficial tumors are completely cleared from the support, first 3, then 9, then annual cystoscopy follow-ups are performed. No additional treatment is required. High-grade cancers are either superficial or in the form of (deep) involving the bladder muscle. Superficial high-grade bladder cancers arise only from cells in the inner lining of the bladder and there is no involvement in the muscle tissue of the bladder. Drugs such as BCG / Mitomycin are administered into the urinary bladder for 6 weeks after the tumor is thoroughly cleaned with TUR-M surgery.

If the pathology that comes after TUR-M surgery is high and the urinary bladder involves muscle tissue, it is investigated whether the patient has distant organ metastasis with PET when MRI is required. In this group of patients, if there is no distant organ metastasis and only muscle tissue is involved, the bladder, prostate, seminal vesicle and surrounding lymph nodes are removed and the bladder is replaced by either an artificial bladder or a bag bladder called an ileal loop. If the muscle tissue has gone outside or outside the bladder, chemotherapy is applied to the patient first and then the bladder removal operation is performed when necessary.