Very common in patients who smoke or who smoked in their youth, it usually presents with blood in the urine and irritative urinary symptoms. 80% of cases are curable.
La bladder It is a hollow organ located in the lower part of the abdomen where urine is stored. Bladder cancer It originates in the membrane that lines the bladder internally, or urothelium.
The most significant risk factor is smoking. Another very important risk factor is exposure to certain chemicals in the workplace. People with a family history of bladder cancer, middle age, and who are white or male are generally at higher risk. These tumors have a high tendency to recur.
What are the symptoms?
The most suggestive symptom is usually the appearance of blood in the urine, painless and accompanied by clots. Sometimes it can present with irritative symptoms, such as the urge to urinate. urinate urgently and frequently or feel pain or burning when urinatingIt can occasionally cause back pain.
How is it diagnosed?
The diagnosis is made by ultrasound, urinary cytology y cystoscopy A bladder examination under anesthesia is necessary to remove the tumor and analyze it. The pathologist will determine whether the tumor is superficial (80% of cases), meaning it does not invade the bladder's muscular layer, or if it is infiltrative (20%), invading this muscular layer. They will also assign a grade of malignancy.
This histopathological diagnosis will allow us to decide whether the treatment can be conservative or aggressive. conservative treatment It is applied in most superficial tumors and can be based on periodic surveillance using flexible cystoscopy with or without bladder instillations of chemotherapeutic agents (e.g., mitomycin) or immune response modulators (BCG). aggressive treatment It is reserved for high-risk superficial tumors or infiltrating tumors and may require removal of the bladder and the prostate (in men) and the lymph nodes of the pelvis or radical cystectomyThis procedure must be followed by some type of urinary diversion, which is performed differently depending on the case, either by creating a new bladder (orthotopic bladder) or by diverting urine to the skin, whether continent or incontinent, or to a collection bag. Currently, this intervention can be performed less invasively using laparoscopy.
Treatments for bladder cancer include the endoscopic surgery or transurethral resection, open radical cystectomy, la laparoscopic radical cystectomy, robotic surgery, the external radiation therapy and chemotherapy.
