Bladder Cancer

The bladder cancer is usually a transitional cell (urothelial). Most patients have hematuria (most common) or irritative voiding symptoms such as frequent urination and / or urgency; later urinary obstruction can cause pain. The diagnosis is made by cystoscopy and biopsy. Treatment involves fulguration, transurethral resection, intravesical instillation, radical surgery, chemotherapy or a combination.

In the United States> 70,000 new bladder cancer cases annually, and about 15,000 patients die from it. Bladder cancer is the fourth most common malignancy in men; in women it occurs less frequently. The incidence ratio male: female is at about 3: 1. The bladder cancer is in whites more often than in blacks, and the incidence increases with age.

The bladder cancer is usually a transitional cell (urothelial). Most patients have hematuria (most common) or irritative voiding symptoms such as frequent urination and / or urgency; later urinary obstruction can cause pain. The diagnosis is made by cystoscopy and biopsy. Treatment involves fulguration, transurethral resection, intravesical instillation, radical surgery, chemotherapy or a combination. In the United States> 70,000 new bladder cancer cases annually, and about 15,000 patients die from it. Bladder cancer is the fourth most common malignancy in men; in women it occurs less frequently. The incidence ratio male: female is at about 3: 1. The bladder cancer is in whites more often than in blacks, and the incidence increases with age. Risk factors include smoking is the most common risk factor and responsible for ? 50% of new cases. Excessive use of Phenacetin (analgesic abuse) Long-term use of cyclophosphamide Chronic irritation (z. B. in schistosomiasis, chronic catheterization or bladder stones) contact with hydrocarbons, tryptophan metabolites or industrial chemicals, in particular aromatic amines (aniline dyes such as naphthylamine, which are used in the paint industry) and chemicals which are used in the rubber, electronics, cables, paint and textile industry. Among the forms of bladder cancer include transitional cell (urotheliales carcinoma), which include> 90% of bladder carcinomas. Most are papillary carcinomas, which tend to be superficial, to be well differentiated and grow outward. Broad-based tumors are more insidious, they tend to early invasive growth and metastasis. Squamous, which are rare, usually occur in patients with a parasitic infestation or a chronic bladder mucosal irritation. Adenocarcinomas that occur as primary tumors, or rarely reflect the metastases of intestinal cancer. Metastases should be excluded. > 40% of patients the tumors at the same or a different location of the bladder recur, particularly if the tumors are large or poorly differentiated, or if different tumors are present. Bladder cancer tends to metastasize to lymph nodes, lungs, liver and bones. The expression of mutations of the tumor p53 gene may be associated with progression. In the bladder, a carcinoma in situ is highly but non-invasive and usually multifocal; the recurrence rate is high. Symptoms and signs Most patients present with an unclear (macroscopic or microscopic) hematuria. Some patients are notable for anemia and hematuria is discovered during the investigation. Irritative symptoms during micturition (dysuria, burning, urinary frequency) and pyuria are also common to find at first presentation. (N. D. Talk .: The most common is the painless hematuria.) Lower abdominal pain occurs in advanced tumor disease, though a pelvic tumor may be palpable. Diagnostic cystoscopy with biopsy cytology The diagnosis of bladder cancer is clinical. A urine cytology, in which it is possible to detect malignant cells can be performed cystoscopy (cystoscopy) and biopsy striking areas are usually also carried out first, because these studies are also needed if a negative urine cytology exists that can possibly prove malignant cells, , Urea antigen tests are available, but are not needed routinely for diagnosis. They are sometimes used when cancer is suspected, but cytology results are negative. For tumors in the lower stage (stage T1 or superficial), including 70-80% of bladder tumors, cystoscopy with transurethral resection for staging is sufficient. If the biopsy shows, however, that the tumor is more invasive than a superficial tumor flat, then, is inclusive, carried out by muscle tissue additional biopsy. If a tumor, the muscle tissue attacks (? stage T2), a chest X-ray and CT scan of the abdomen and pelvis are performed to determine the extent of the tumor and a possible formation of metastases. Patients with invasive tumors are bimanually studied (rectal examination in men, rectovaginal examination in women), while they are at a cystoscopy and biopsy under general anesthesia. For staging the classic TNM is (tumor, node, metastasis) -Stadieneinteilung used (AJCC / TNM staging * of bladder cancer and TMN definitions for bladder cancer). Bladder cancer (CT scan) © Springer Science + Business Media var model = {thumbnailUrl: ‘/-/media/manual/professional/images/532-bladder-cancer-ct-scan-s126-springer-high_de.jpg?la=de&thn = 0 & mw = 350 ‘, imageUrl’ /-/media/manual/professional/images/532-bladder-cancer-ct-scan-s126-springer-high_de.jpg?la=de&thn=0 ‘, title:’ bladder cancer ( CT scan) ‘, description:’ u003Ca id = “v37896784 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDiese CT-scan is a right side bladder cancer u003c / p u003e u003c / div u003e ‘credits’ © Springer Science + Business Media’

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