The bladder, whose main task in the body is to store urine, is an organ that can stretch as it fills with hollow urine. Bladder cancer usually begins from the urothelial cells of the mucosa that line the inner side of the bladder. Bladder tumors can be malignant or benign. But benign bladder tumors that are not cancerous can also occur.
Symptoms of bladder cancer include:;
In some cases, when the first symptoms of bladder cancer appear, the cancer can already spread, metastasizing to another part of the body. Symptoms in patients experiencing metastasis may vary depending on the area where the cancer has spread. Advanced bladder tumors;
Although the exact cause of bladder cancer is unknown, there are risk factors that can cause it.
How common is bladder cancer?
Bladder cancer is the seventh most common cancer in men, less common in women. However, bladder cancer is a more deadly cancer in women. The American Cancer Society estimates that 80 thousand people (62 thousand men, 18 thousand women) in the United States will be diagnosed with bladder cancer in 2019.
What doctor should I go to for bladder cancer or benign bladder tumors?
Diagnosis and treatment of bladder cancer or benign tumors of the bladder, which can occur at any age, although they are usually seen after the age of 50, is carried out by Urology doctors. It is important to choose a urology doctor who specializes in this issue, as there are also surgical methods for treating bladder cancer and benign bladder tumors.
Bladder cancer is determined by symptoms experienced or as a result of suspicion during routine checks. First, an experienced urology doctor’s examination is required.
Urology doctor’s examination
The urology doctor will first evaluate risk factors for bladder cancer, such as genetics, smoking or exposure to radiation. Urology doctor in physical examination;
In cases of abnormal and suspected bladder cancer, additional tests may be required to clarify the diagnosis.
Urine tests for bladder cancer
Imaging methods for diagnosis of bladder cancer
Cystoscopy is one of the gold standard procedures for diagnosing bladder cancer. A thin flexible endoscope with light and a camera at the end examines the urethra and the inside of the bladder. During cystoscopy, the size, location and growth patterns of abnormalities in the bladder can be determined. Biopsy and urine samples can also be performed during cystostopia.
Biopsy-transurethral resection of bladder tumor (TUR-CT)
During cystoscopy, the urology doctor takes parts of the tissue that he considers abnormal and sends them to the laboratory for examination. During this procedure, also called transurethral resection of the bladder tumor (TUR-CT), it can also remove a sample of the bladder muscle close to the tumor with the bladder tumor. It can evaluate the bladder to see if any mass is felt during the biopsy process. TUR-BT can also be used in the treatment of novelistic non-invasive bladder tumors.
Different types of cells in the bladder can be cancerous. It can be divided into types of bladder cancer according to the bladder cell where the cancer begins. The type and stage of bladder cancer is also determined by the tests used to diagnose bladder cancer.
Classification of bladder cancer tumors can also be done according to microscopic images of cancer cells.
Bladder cancer can also be diversified by its proximity to the wall of the bladder.
There are many layers of different cells in the wall of the bladder. Most bladder cancers spread to the muscles of the bladder over time, starting from the innermost layer of the bladder that comes into contact with urine. After reaching the muscle layer of the bladder, it is seen to bounce out of the bladder and into nearby neighboring structures Nov. Cancer of the bladder can metastasize to nearby lymph nodes or other parts of the body. Bladder cancer usually spreads to distant lymph nodes, bones, lungs, or liver.
Bladder cancer is also diversified according to the way it grows.
3 criteria are taken into account to determine the stage of bladder cancer.
Information obtained from pathology and examinations is used to find out which parts of the bladder are cancerous, whether the cancer has spread from where it first started, and where the cancer has spread. Bladder cancer staging is performed according to the international TNM system.
Bladder cancer treatment options depend on various factors, such as the patient’s general health status, the type of cancer, the degree of cancer, and the stage of cancer.
The type of surgical treatment for bladder cancer can vary depending on the type of bladder tumor and the stage of the cancer.
TUR surgery (transurethral resection): Transurethral resection of the bladder tumor, ie TUR surgery, is generally used to remove non-muscle invasive tumors that are located in the mucosa of the bladder and have not extended to the muscle layer of the bladder wall. The TUR can also be used in the diagnosis and staging of bladder cancer.
TUR surgery can be performed with general anesthesia or under regional anesthesia. TUR surgery is performed by entering through the natural hole at the end of the urinary tract without making any incision in the body.
During TUR surgery, the bladder is reached by an endoscope with a small “U” – shaped wire at the end of the urologist. By electric current, cancerous tissue is cut and removed from the body. After removal of parts in very small tumors, the cancer cells area is burned and the treatment is eliminated.
After TUR surgery, the urologist may recommend chemotherapy that can be applied with a probe into the bladder once or once a week for 6-8 weeks to destroy the remaining cancer cells and prevent them from recurrence.
Partial or segmental cystectomy: this is the process of surgical removal of the tumor and part of the bladder. The place of partial cystectomy surgery in the treatment of bladder cancer is extremely limited, but it is used to treat some cancers with special histology.
Radical cystectomy: a surgical method in which the entire bladder and nearby tissues and organs are removed along with the tumor. In radical cystectomy surgery, the bladder, as well as men’s, prostate and semen sacs, and the entire urinary tract are removed in necessary patients. In women, in the classic definition, the uterus, fallopian tubes, ovaries and all or part of the uterus are removed, but the removal of the bladder with safe limits, leaving the gynecological organs in place, has also been practiced in recent years.
In both men and women, the removal of lymph in the pelvis, called pelvic lymph node dissection, is also part of the operation. Pelvic lymph node dissection is the most accurate way to determine cancer that has spread to the lymph.
In radical cystectomy surgery, which can be performed laparoscopically or robotically, the surgical procedure can be completed with smaller incisions instead of a large incision in open operations.
A new bladder from the intestine (neobladder reconstruction):since the bladder of patients who have undergone radical cystectomy surgery is removed, a new way to exit urine from the body is required. There are also different urinary diversion surgeries along with methods in which a new bladder is created from part of the intestine. The patient’s biological age, current diseases, the stage of the disease and the possibility of treatments such as chemotherapy, radiation therapy that may be required later are decided by the urology doctor. This decision is made by talking in detail with the patient and the final decision is made.
Radical cystectomy and new bladder or ileal loop diversion surgery from the intestine
It is used to destroy bladder cancer cells that have spread throughout the body. Living without a bladder can sometimes negatively affect the patient’s social life. Chemotherapy and radiation therapy can be used as an alternative to bladder removal for patients who are suitable for maintaining all or part of the bladder.
Chemotherapy for bladder cancer can be applied in two different ways.
It can be used in addition to round a or in combination with chemotherapy after round to treat bladder cancer in patients who are not suitable for surgery or do not want surgical treatment. It may be preferred to reduce complaints caused by a tumor, such as pain, bleeding, or blockage, or to treat metastasized cancers.
Immunotherapy, also called biological therapy, is the use of drugs to help the immune system recognize and destroy cancer cells. In the treatment of bladder cancer, immunotherapy is usually applied directly into the bladder. BCG vaccine is used as the standard immunotherapy drug for bladder cancer. BCG vaccine, administered with a catheter as a liquid inside the bladder, provides treatment by activating immune system cells in the bladder.
In recent years, studies on T cells that support the immune system, which are known to have a protective effect against infection and cancer, have shown positive results.
How should the follow-up process be after bladder cancer treatment?
Because there is a risk of recurrence (recurrence) of bladder cancer after treatment in patients with bladder cancer, the follow-up process is very important. Follow-up is an important part of cancer treatment. Follow-up after treatment for bladder cancer can vary depending on the stage, degree, and type of treatment. Bladder cancer is also likely to relapse for the first 2 years after treatment, and follow-up is extended for up to 10 years, although the probability of relapse decreases after that.
Although the follow-up process varies depending on the patient, it is important to check every 3 months in the first year. In follow-up, the liver is observed inside the bladder by cystoscopy to determine if there is any recurrence in the bladder while the lymph nodes are checked. In cases where the doctor conducting the treatment deems it necessary, imaging methods such as CT, MRI, ultrasound, PET CT are also used satirized.
What is the duration of survival for bladder cancer?
The duration of getting rid of or surviving bladder cancer varies from person to person. Success varies depending on the type of bladder cancer, stage, number of tumors, size, characteristics of the cancer, recurrence, selected treatments and the patient’s response to treatment. This is why survival rates for bladder cancer are actually personalized. In consideration of all stages of bladder cancer the American Cancer Society study conducted for people with bladder cancer 5-year survival rate is 77%, 10-year survival rate is 70%, and 15-year survival rate of 65%.
Is Bladder cancer commonly metastasizes at which organ?
Bladder cancer most often metastasizes to the lungs, liver, or bones.
How should bladder cancer be fed?
It is not known exactly what reduces the recurrence rate after treatment for bladder cancer. The benefit of nutrition in the development of bladder cancer or after treatment is not clear in scientific studies. However, it can be useful to quit smoking, eat a natural and balanced diet, and engage in regular physical activities.
Is there a herbal or natural treatment method for bladder cancer?
There is no scientific evidence that diet, herbal products, vitamins and minerals prevent the development of bladder cancer or reduce the likelihood of recurrence. Many studies have been conducted on this subject, in general, natural and healthy eating and active mobility are recommended.