Content
Bladder cancer is a type of tumor characterized by the growth of malignant cells in the bladder wall, which can happen due to smoking or constant exposure to chemicals such as dyes, pesticides or arsenic, for example, as these substances are eliminated through urine, which is concentrated in the bladder before being eliminated, and can cause changes.
The signs and symptoms of bladder cancer are progressive and can be confused with other diseases of the urinary system, such as increased urge to urinate, pain in the lower belly, excessive tiredness and weight loss for no apparent reason. It is important that the diagnosis is made as soon as the first symptoms are identified, because that way it is possible to start the most appropriate treatment, avoid complications and increase the chance of cure.
Bladder cancer symptoms
Symptoms of bladder cancer appear as malignant cells proliferate and interfere with the activity of this organ. Thus, the main signs and symptoms of this type of cancer are:
- Blood in the urine, which is often only identified during urine analysis in the laboratory;
- Pain or burning sensation when urinating;
- Pain in the lower belly;
- Increased need to urinate;
- Sudden urge to urinate;
- Urinary incontinence;
- Fatigue;
- Lack of appetite;
- Unintentional weight loss.
The signs and symptoms of bladder cancer are common to other diseases of the urinary tract, such as prostate cancer, urinary tract infection, kidney stones or urinary incontinence, and therefore it is not important that the general practitioner or urologist recommends the performance of tests to identify the cause of the symptoms and thus indicate the most appropriate treatment.
Main causes
Many toxic substances pass through the bladder that are eliminated from the bloodstream through urine, with which we come into contact on a daily basis through the consumption of food, breathing and skin contact.
These substances, present in cigarettes, pesticides, dyes and medications, such as cyclophosphamide and arsenic, for example, come into contact with the bladder wall, and on prolonged exposure can trigger the formation of cancer cells.
How the diagnosis is made
In the presence of signs and symptoms that indicate a bladder cancer, it is important that the urologist is consulted, so that clinical evaluations, physical exams and laboratory exams, such as urine exam, urinary ultrasound, MRI or CT scan, are performed, and cystoscopy, which consists of introducing a thin tube through the urethra to observe the inside of the bladder. Understand how cystoscopy is done.
In addition, if cancer is suspected, the doctor recommends performing a biopsy, in which a small sample is taken from the altered region of the bladder to be evaluated microscopically in order to verify whether that alteration is benign or malignant.
Then, the next steps to define the severity and treatment of bladder cancer depend on the stage of cancer development:
- Stage 0 - no evidence of tumor or tumors located only in the lining of the bladder;
- Stage 1 - tumor passes through the lining of the bladder, but does not reach the muscle layer;
- Stage 2 - tumor that affects the muscular layer of the bladder;
- Stage 3 - tumor that goes beyond the muscular layer of the bladder reaching the tissues around it;
- Stage 4 - the tumor spreads to lymph nodes and neighboring organs, or to distant sites.
The stage that the cancer is in depends on the time that the person developed it, therefore, it is very important that the diagnosis and the beginning of the treatment are made as soon as possible.
How to treat
The treatment of bladder cancer depends on the stage and the degree of involvement of the organ, and can be done through surgery, chemotherapy, radiotherapy and immunotherapy, as indicated by the doctor. When bladder cancer is identified in the early stages, there is a great chance of a cure and, therefore, early diagnosis is essential.
Thus, according to the stage of the disease, symptoms presented by the person and general health, the main treatment options are:
1. Surgery
Surgery is the most used treatment to cure this type of cancer, however, it only has good results when the tumor is in the initial stages and is located. Some surgical procedures that can be used are:
- Transurethral resection: consists of scraping, removing or burning the tumor when it is small in size and located on the surface of the bladder;
- Segmental cystectomy: consists of removing the part of the bladder affected by the tumor;
- Radical cystectomy: performed in the advanced stages of the disease and consists of total removal of the bladder.
In the total removal of the bladder, lymph nodes or other organs close to the bladder that may have cancer cells may also be removed. In the case of men, the organs removed are the prostate, the seminal vesicle and part of the vas deferens. In women, the uterus, ovaries, fallopian tubes and part of the vagina are removed.
2. BCG immunotherapy
Immunotherapy uses drugs that stimulate the immune system to attack cancer cells and is more used in cases of superficial bladder cancer or to prevent new cancer growth, after surgery, for example.
The remedy used in immunotherapy is BCG, a solution that contains live and weakened bacteria, which are introduced into the bladder through a catheter, which will stimulate the immune system to kill cancer cells. The patient should keep the BCG solution in the bladder for about 2 hours and the treatment is carried out once a week, for 6 weeks.
3. Radiotherapy
This type of treatment uses radiation to eliminate cancer cells and can be performed before surgery, to reduce the size of the tumor, or after surgery, to eliminate cancer cells that may still be present.
Radiotherapy can be done externally, using a device that focuses radiation on the bladder region, or by internal radiation, in which a device is placed in the bladder that releases the radioactive substance. Treatment is carried out a few times a week, for several weeks, depending on the stage of the tumor.
4. Chemotherapy
Bladder cancer chemotherapy uses drugs to eliminate cancer cells, and only one drug or combination of two can be used.
In patients with superficial bladder cancer, the doctor may use intravesical chemotherapy, in which the medicine is introduced directly into the bladder through a catheter, and remains on for several hours. This treatment takes place once a week, for several weeks.