Cancer of the urinary bladder occurs mostly in older people of both the sexes. It is easy to detect and difficult to cure.
Causes
It is not known. Aniline dyes and other chemicals in the industry arc known to cause cancer at this site.
Symptoms
· Increased frequency in passing urine.
· Blood (haematuria) in the urine.
· Pain on passing urine.
· Pain in lower abdomen when the cancer has spread.
Diagnosis
· Routine: Blood: Hb, RBC, TLC, DLC, ESR may not reveal any abnormality.
· Urine: RBC may be present.
· Special: Microscopic examination of urine may reveal cancer cells.
· Intravenous pyelography is done to see the whole of the urinary tract, including the bladder. Cystography is done so as to directly visualize the inside of the urinary bladder, which may reveal the cancer.
· Additional: Bone scan and liver ultrasound is done to see if the cancer has spread to these organs.
Treatment
Surgery: Endoscopic resection of the cancer if the cancer has involved only the inner lining. The surgeon after passing the cystoscope, can resect the cancer mass.
Bladder cancers are usually widespread, and unless there is only one tumour, this is not resorted to.
Radiation: It is usually combined with surgery. This is useful, particularly:
1. When there are wart-like growth, on the inside surface of the bladder.
2. When there is widespread cancer, not completely removable by surgery and the patient is in pain.
Chemotherapy: Single or a group of drugs are tried:
· Adriamycin
· 5-Fluorouracil
· Methotrexate
· Thiotepa
· Cisplatin
These drugs are effective but cause side-effects.
Prognosis
The chances of survival depend very much on the extent of the cancer spread and the stage at which the patient presents.
Early Detection
Signs & Symptoms
· Increased frequency of passing urine.
· Blood in the urine.
Investigations
· Cystoscopy for direct vision of the inner surface of the bladder.
· Biopsy taken through cystoscopy and its examination.