Bladder cancer


Is bladder cancer hereditary?
Bladder cancer is the most common malignant tumor in urology, occurring on the mucosa of the bladder and is also one of the top ten common tumors globally. The etiology of bladder cancer is complex, involving both intrinsic genetic factors and external environmental factors, which gives bladder cancer a hereditary tendency. Notable among the major risk factors are smoking and occupational exposure to aromatic amines, with 30% to 50% of bladder cancers caused by smoking. The incidence of bladder cancer significantly increases with the duration of smoking. The initial clinical manifestation of bladder cancer is usually hematuria, typically painless and intermittent gross hematuria. The presence of blood in urine should prompt further diagnostic testing to rule out malignant tumors in the bladder.


How is bladder cancer diagnosed?
Firstly, imaging examinations such as ultrasound can be conducted, which if reveal tumors larger than 0.5 cm can serve as an initial screening for patients; IVU (Intravenous Urography) can show larger tumors as filling defects. Cystoscopy can also be performed by inserting a cystoscope to directly examine the bladder's shape, size, etc. If it appears round, with clear boundaries and without erosion, it is generally benign; if it has a cauliflower-like or seaweed-like appearance, it is generally malignant bladder cancer. Urine tests can also be conducted; cells from tumors found in fresh urine can lead to cytological examination of urine as an initial screening. Additionally, if conditions permit, a physical examination including a bimanual examination of the bladder can be done to preliminarily assess the tumor's size, the extent of invasion, depth, and its relationship with the pelvic wall.


Early symptoms of bladder cancer
Hematuria is the most common and earliest symptom of bladder cancer, with 85% of patients experiencing intermittent gross hematuria which can decrease or stop on its own, often giving patients a false impression of improvement or cure, thus delaying treatment. Sometimes, hematuria is also found under a microscope, and the amount of bleeding is not necessarily consistent with the size, number, or malignancy of the tumor. The hematuria from bladder tumors can initially be mild, and other symptoms such as frequent urination, urgency, and painful urination may also occur; these are all manifestations of bladder tumors.


What is the best medicine for bladder cancer infusion?
Bladder perfusion chemotherapy involves infusing chemotherapy drugs directly into the bladder through a catheter to control tumor growth and reduce the recurrence rate after surgery. Generally, the drugs with significant effects on bladder perfusion fall into three categories. The first category is the anthracyclines, including doxorubicin, epirubicin, and pirarubicin. The second category includes platinum-based drugs such as cisplatin, carboplatin, and oxaliplatin. The third category is vinorelbine. According to current big data research, vinorelbine bladder perfusion tends to have a lower recurrence rate. Without postoperative bladder perfusion chemotherapy, 60%-70% of patients will eventually experience recurrence. With bladder perfusion chemotherapy, the recurrence rate can be reduced to 20%-30%.


Does bladder cancer require the removal of the bladder?
Whether or not to remove the entire bladder in cases of bladder cancer depends on whether the tumor has invaded the base layer and whether there is distant metastasis. For non-muscle invasive bladder cancer, where the muscle layer is not invaded and there is no distant metastasis, typically found in stage 0 and stage 1 bladder cancer patients, there is no need for complete removal of the bladder. The standard treatment in such cases generally involves transurethral resection of the bladder tumor. If the tumor has invaded the base layer but there is no distant metastasis, termed muscle-invasive bladder cancer, patients in this category require radical cystectomy, which involves the removal of the entire bladder. If there is distant metastasis, termed metastatic bladder cancer, surgical treatment is not pursued; instead, palliative chemotherapy is the primary approach.


Is bladder cancer contagious?
Bladder cancer is not contagious, so there is no need to worry about that. Bladder cancer occurs when there is a cancerous transformation of bladder tissue, leading to the formation of bladder tumors. If the tumors are malignant, they are generally termed bladder cancer. Causes of bladder cancer can include long-term exposure to certain carcinogens, such as occupations involving dyes, leather, or paintwork. Another carcinogenic factor is smoking, which is related to about one-third of bladder cancer cases. Chronic infection or prolonged irritation by foreign bodies can also increase the risk of bladder cancer, as seen in cases with bladder stones, bladder diverticula, or chronic cystitis.


Is there a benign form of bladder cancer?
Tumors are divided into two main categories: benign tumors and malignant tumors. The malignant tumors that occur in epithelial tissues are called cancers, such as lung cancer, bladder cancer, and breast cancer. Therefore, bladder cancer is malignant; there are no benign bladder cancers. Cancer, in contrast to benign tumors, tends to metastasize to distant locations, grow rapidly, and can spread through blood, lymph nodes, and local invasion. Thus, it is termed as cancer and is malignant, which means there is no such thing as benign bladder cancer.


How to prevent bladder cancer
Bladder cancer is one of the most common malignant tumors in the urinary system. Currently, the exact cause of bladder cancer is not clear. In terms of prevention, it is generally necessary to drink more water, urinate more frequently, try not to smoke, and reduce exposure to chemical irritants, such as paint, chemical substances, etc. Additionally, an annual physical examination is recommended to enable early detection and early treatment.


What are the symptoms of late-stage bladder cancer?
The symptoms of late-stage bladder cancer include: 1. Difficulty urinating. Due to the large size of the tumor, its location at the neck of the bladder, or the formation of blood clots, there can be blockage of urine flow, difficulty urinating, and even urinary retention. 2. Bladder irritation symptoms. Early-stage bladder often shows fewer urinary irritation symptoms, but when the tumor occurs in the trigone area of the bladder, urinary irritation symptoms may appear earlier. There are also symptoms of upper urinary tract obstruction, such as when the cancer invades the ureteral orifice, causing dilation and accumulation of fluid in the renal pelvis and ureter, and even infections leading to backache, waist pain, fever, etc. Additionally, there are general symptoms, including nausea, reduced appetite, fever, weight loss, anemia, cachexia, and more.


How is bladder cancer treated?
How is bladder cancer treated? Currently, the primary treatment option for bladder cancer is surgery, which can include procedures like transurethral tumor resection, bladder tumor resection, urethral tumor resection through the bladder, and cystectomy, among others. The specific surgical approach is selected based on factors such as the location and size of the bladder cancer. Besides surgical removal of the bladder, other treatment methods such as radiation therapy, chemotherapy, new technology treatments, and traditional Chinese medicine are also available as adjunct therapies. The formulation of a treatment plan should comprehensively consider factors such as the location, size, and stage of the bladder cancer.