Bladder cancer-What is bladder cancer?
Bladder cancer is the malignant tumor from the bladder wall skin tissue and stromal tissue.Second only to prostate cancer incidence in the male genitourinary system tumors.Accounted for 3% of systemic malignancies, bladder cancer in recent years to increase the trend.Incidence of bladder cancer in men is about 3 to 4 times that of the female, and the highest incidence rate of 50 to 60 years old.
Bladder cancer - diseaseBladder cancer refers to malignant overgrowth of cells in the bladder. The most common overgrowth in the bladder cavity, which is of the mucosal epithelium of the bladder. The human body, the surface of the hollow organs is usually by the epithelial cells. Such as the inside of the cheek, stomach, intestines, gallbladder, including the bladder by a layer of epithelial cells. Each organ has its own type of epithelial cells. Bladder mucosal epithelial cells called urothelial cells, it generates cancer known as urothelial carcinoma, accounting for 90% -95% of all bladder cancer is the most common type of bladder cancer. Other less common bladder cancer squamous cell carcinoma and adenocarcinoma. The cancer cells spread from elsewhere in the body to the bladder, called the bladder metastases, generally rare, occasionally from neighboring organs grow into the bladder, such as prostate, colon, rectum or cervix.
Worldwide, bladder cancer ranked men the most common solid tumor in the fourth and women ranked seventh, newly diagnosed patients with bladder cancer each year more than 350,000. The American Cancer Society Statistics 2006 U.S. bladder cancer cases to 61,420 cases, the deaths of 13,060 cases.
Bladder cancer - Classification of Diseases
Broadly speaking, bladder cancer mainly include two types: primary cancer and metastatic carcinoma. Primary bladder cancer originated in the bladder itself, metastases derived from other organs, but the cancer spread to the bladder, usually through the bloodstream and lymphatic system, or directly from the adjacent organ invasion to the bladder, prostate, rectum, cervix.
Primary bladder cancer than metastatic bladder cancer is much more common. One of the most common urothelial carcinoma, accounting for more than 90%. Bladder cancer can have a variety of forms: 1) papillary appearance looks like cauliflower, and some, like plants, with a thin pedicle and connected to the bladder wall; 2) flat shape looks flaky or shaped, velvet-like surface redness, no pedicle and connected to the bladder wall; 3) entities like shape looks like a wart-like excrescence, massive, wide base, with a wide pedicle and connected to the bladder wall. Approximately 70% of urothelial carcinoma is papillary, have a better prognosis than the sessile and sessile tumors. Bladder cancer is relatively rare in squamous cell carcinoma, adenocarcinoma and urachal cancer, and so on. Squamous cell carcinoma accounts for 3% -7% of bladder cancer; in Egypt, which accounted for 75% of all bladder cancer. A parasitic infection called schistosomiasis in Egypt is very common parasite infection in the bladder to the formation of a chronic stimulation, a few years later, the patient is prone to squamous cell carcinoma. Can cause chronic irritation of the bladder, such as long-term indwelling catheter, and also make patients prone to squamous cell carcinoma. Unlike urothelial carcinoma of squamous cell carcinoma as the lymph node metastasis, but directly and easily spread, penetrating the bladder to reach the neighboring organs. Squamous cell carcinoma with local invasion, and not sensitive to the chemotherapy, so urothelial carcinoma with poor prognosis. Adenocarcinoma of the bladder is very rare, accounting for 2% of all bladder cancer. Tumors and chronic irritation are highly invasive, and a worse prognosis. Urachal carcinoma is a special type of adenocarcinoma of the bladder, the source and bladder urothelial originated in the outer layer of the bladder, and bladder lining assault. It can be transferred to the organs of the lymph nodes, liver, lung, and bone.
Bladder cancer - differential diagnosisBladder cancer, bladder cancer mainly caused hematuria hematuria are many reasons in addition to urinary tract and adjacent organs and body a variety of diseases and drugs can cause hematuria, a common disease of identification are as follows:Kidney and ureter tumor the hematuria characteristics for the whole process painless gross hematuria and bladder cancer is similar to occur in isolation or cause of hematuria of upper urinary tract tumor and bladder cancer occur simultaneously, there may be a clear diagnosis of strip or worm-like clot B ultrasound CT urography inspection
Systemic symptoms of urinary tuberculosis in addition to the hematuria outside the main symptoms of chronic bladder irritation associated with night sweats, weight loss and fatigue of low Jorge urine to find acid-fast bacilli IVP and cystoscopy and bladder cancer identify
The main symptoms of benign prostatic hyperplasia progressive dysuria and frequent urination, sometimes gross hematuria in the elderly bladder cancer and benign prostatic hyperplasia are in need of identification of exfoliated cytology B ultrasound CT cystoscopy, urine
Urolithiasis hematuria mostly microscopic hematuria, urinary tract calculi ureteral colic bladder stones can occur urination interrupt phenomenon by KUB plain film B super cystoscopy, such as identification of bladder stones can lead to the stimulation of local mucosal tumor therefore long-term bladder stones hematuria should be thought of as may be necessary cystoscopy and biopsy in bladder cancer
Glandular cystitis have bladder irritation cystoscopy and biopsy cystoscopy alone is sometimes misdiagnosed
Prostate cancer, hematuria cancer infiltrating the bladder by rectal examination B ultrasound and CT biopsy clear
Others such as radiation cystitis (more than a history of pelvic radiotherapy cystoscope radial telangiectasia of bladder ulcer and granuloma which needed a biopsy) of cervical cancer (invasion of the bladder, hematuria, but as the first vaginal bleeding vaginal examination identification) and other
Bladder cancer - clinical manifestationsHematuria (1): recurring pain, intermittent gross hematuria, and some showed only for microscopic hematuria. Amount of bleeding can be more or less, in severe cases the whole
Bladder cancer, radiation enteritis, hematuria, or mix the blood clots. Hematuria and sometimes self-stopped or reduced, while the people resulting in improved illusion. The amount of bleeding and hematuria the duration and degree of malignancy, tumor size, scope, number is not proportional. Urinary tract irritation; the earlier onset of tumor associated with infection or tumor in the bladder trigone, urinary tract irritation.(2) bladder irritation: the tumor itself infiltration, necrosis, ulceration, and containing the infection can irritate the bladder, resulting in urinary frequency, urgency. Clinical lack of infection based on patients with bladder irritation, should take the comprehensive examination in order to ensure early diagnosis.
(3) dysuria: Due to the larger tumor, or tumor in the bladder neck, or pedunculated tumor, or blood clots form inside the mouth and blocking the bladder, causing dysuria, or even produce urinary retention. Shame region masses: about 3% as the initial symptoms, mostly for high malignant bladder entities carcinoma of the bladder at the top of adenocarcinoma or other parts of the digital rectal examination can reach the rugged lumps.
(4) transfer of the symptoms: late bladder cancer can be the users around the invasion or metastasis to other internal organs. When the tumor invasion to the bladder surrounding tissues or metastasis to pelvic lymph nodes, visible shame District suprapubic pain, lumbosacral pain, or pain radiating to the genitals or thighs. When the tumor is located in the side of the ureteral orifice can cause the side of the ureteral obstruction, hydronephrosis.
(5) systemic symptoms: nausea, loss of appetite, fever, weight loss, anemia, cachexia, quality and so on.
Bladder cancer - laboratory tests(1) urine hematuria: You can not seen to the naked eye.
(2) bladder with diagnosis: the check for bladder tumor-infiltrating caught and depth. Between doctors and patients to check with the gentle movements to avoid bleeding.
(3) Cystoscopy: This is the main method of diagnosis of bladder cancer, bladder tumor location, size, number, shape, dip Stream etc. can be seen directly. The check should be at the same time as tumor biopsies.
(4) CT examination: can find tumors and enlarged lymph nodes, accuracy rate of 80%, and help dry the bladder tumor staging.
(5) B-: no pain in patients with such a check. Accuracy is proportional to the size of the tumor. General tumor more than O.5cm can be found. Auxiliary thesis on the identification of bladder stones and tumors.
(6) cystography: generally used for supplement cystoscopy inadequate, such as tumor size, available contrast to the view of the whole picture. Multi-exposure method visible bladder wall stiffness, and can not expand. Double tumor, mutatis mutandis, to shadow law clearer.
Urine cytology (7): as a method of early diagnosis of bladder tumors, painless, convenient and easy for patients to accept. But when the low level of tumor cell differentiation better identification of difficult variation caused by normal transitional epithelial cells or inflammatory cells. Urine off the check of the cells with acridine orange staining: morphological changes due to biochemical changes in bladder cancer cells as early as acridine acridine orange have a high degree of metachromasia with DNA molecules. Acridine orange staining fluorescence microscopy, can get a distinct image of the cell, and easy to judge.
(8) urine flow cytometry: in a very short period of rapid determination of RNA and DNA within each cell in the urine, which can accurately estimate the malignant potential.
(9) glucuronide enzyme B, (B-GRS): is generally believed that the urine B-GRS increased the occurrence of bladder cancer.
(10) hematoporphyrin derivative photosensitization diagnosis: early diagnosis of bladder cancer, especially tumors and carcinoma in situ can be difficult to determine for cystoscopy to improve its diagnostic positive rate.
(11) radionuclide 99mTc jeer mark hematoporphyrin derivatives diagnosis: This is one of the invasive diagnostic method for diagnosis of bladder cancer can be achieved without cystoscopy in the diagnosis of France.
Bladder cancer - ImmunotherapySince the 1980s, scientists led by the United States and Japan, Maitake Mushrooms (Maitake, also known as Grifola frondosa) has made a breakthrough, a new treatment to cancer patients, achieved a more satisfactory effect. Maitake contains a combination of beta-(1-6) as the main chain of β-(1-3) combined with dextran side chains and main chain to the combination of beta-(1-3) β-(1-6 experiments show that these active glucan can significantly inhibit tumor growth through activation of the immune function;) combined with the side chain of the activity of glucan, also found that the purification of the activity of glucan can be cured only by injection, and Maitake D- fraction (active glucan and protein conjugates) by oral administration can get the desired results. Maitake D-fraction is the chemical structure and composition or molecular weight is different from similar substances extracted from other mushrooms in the mushroom, Coriolus versicolor, Ganoderma lucidum, and its biological activity is similar substances can not be compared.
Animal experiments and clinical trials show that Maitake D-fraction is to play an anti-cancer effect through the following aspects:
1, activation of phagocytes, natural killer cells, harmful T cells, immune cells, induced by leukocidin, the secretion of interferon-gamma, tumor necrosis factor-alpha and other cytokines.
2, induction of apoptosis in cancer cells.
3, in combination with traditional chemotherapy drugs (mitomycin, and kamo Augustine, etc.), both to increase efficacy, but also to reduce the toxic side effects during chemotherapy.
4, synergy with immune therapy (interferon-α 2b).
5, the slow down of patients with advanced cancer pain, increase appetite, improve the quality of life of patients.
Mike healthy food is the authority of the enterprise of the first system Maitake Maitake fine drops of its production to improve the quality of life of cancer patients can play a very good effect.
Bladder cancer can be much longerBladder cancer is one of the common tumors in the human body, and there is increasing trend in recent years. Then bladder cancer can be much longer? It is also difficult to answer, and a number of factors, many patients and their families want to know that bladder cancer can be much longer, but bladder cancer can be much longer depends primarily on whether to take timely and appropriate treatment.Huang Pei Experts, bladder cancer long to live to a certain extent with the patient's body function, physical function, immunity to resist the development of cancer, and tolerance of various treatments. Therefore, improving immune function, enhanced immunity against the tumor in patients with early bladder cancer is extremely important.Bladder cancer can be much longer? Is also related to the following two factors:
: The function of the patient's body is related to good physical function, immune system strong to resist the development of cancer and tolerance of various drug treatment. Therefore, improving immune function and enhance tumor immunity in patients with bladder cancer, especially in advanced patients is extremely important.
II: relationship with the treatment of choice, select the surgical treatment of a high recurrence rate within two years of chemotherapy and radiation therapy to patients suffering great. Or with the treatment of traditional Chinese medicine. Such as the effect of ginsenoside RH2 products this fortunate capsules to alleviate the side effects of radiotherapy and chemotherapy is very good. The main treatments are:(A) surgical treatmentSurgical therapy for the treatment of bladder cancer. Specific surgical scope and approach should be based on the staging of the tumor, the degree of malignancy and pathological type of tumor size, location, with or without involving the adjacent organs and so on comprehensive analysis.
(B) radiation therapyBladder radiation therapy are combined with surgery after surgery. Late stage of disease, the loss of the timing of surgery or refuse surgery and postoperative recurrence cases underwent palliative radiotherapy can get a certain effect.(C) of interventional radiologyInterventional radiology treatment is the use of radiological techniques, transcatheter drug injected directly into the tumor feeding vessels, in order to kill tumor cells. II-IV bladder cancer may also use this method to shrink the tumor lesions increase the resection rate and reduce the recurrence rate.(Iv) chemotherapyChemotherapy for bladder cancer to intravesical chemotherapy, systemic chemotherapy, intra-arterial chemotherapy. The main means of chemotherapy:An intravesical infusion chemotherapy applicable to each of the patient, the best, especially on the 0-I of superficial tumor effect on other existing deep infiltration of the lesions can not play a good therapeutic effect, but there are still treatment of superficial lesions on role.2, systemic combination chemotherapy of systemic combination chemotherapy can increase the resection rate and improve the treatment of bladder cancer.
Bladder cancer can be much longer and choice in your hands, the choice of surgical treatment, the doctor can only conservative on patients, 5-year survival rate of patients with bladder cancer is, if you choose a traditional Chinese medicine treatment, you can have a longer the survival of at least 15 years do not recur. As long as the active treatment everything is possible.
Treatment of bladder cancer late
Bladder cancer is a common malignancy with other tumors, the sooner the better therapeutic effect. Bladder cancer advanced treatment is very difficult, but does not treat positive and effective treatment can prolong life and improve quality of life. Hunan Traditional Chinese Medicine Cancer Hospital expert said: bladder cancer late because the majority of distant metastases, painful and large, usually based on conservative therapy, the common treatment methods are the following.
Treatment of bladder cancer late conservative, traditional Chinese medicine treatment of bladder cancer, bladder cancer with advanced multi-how of metastasis, and immunocompromised patients, surgical treatment is restricted, starting from the patient's own point of view, to alleviate the pain and the basis to extend the lifetime of the Chinese medicine treatment is the best choice. Chinese medicine treatment of radical treatment, mild in nature, the patient can bear, and have a good effect on the inhibition of tumor, but also improve the patient's immune function, the patient's own resistance to the tumor's ability to get a good repair.
Bladder cancer with advanced treatment, palliative radiotherapy for bone metastases in patients with advanced bladder cancer treated with radiotherapy to be effective in relieving the pain caused by bone metastases. Palliative radiotherapy for local tumor recoverable, you can control the hematuria, urgency, dysuria, dysuria.
Treatment of bladder cancer late, late for chemical treatment of bladder cancer chemotherapy according to the administration of the timing is divided into preoperative chemotherapy and postoperative chemotherapy, is the use of intravenous injection of a variety of anticancer drugs.
Above is the introduction of the advanced treatment of bladder cancer, the experts advise: bladder cancer later treatment in addition to the proper treatment method, the effect is good or bad is the patients themselves. Physical function in patients with high immunity, and also strong ability to resist swelling cancer, the treatment effect. In addition, the diet should be to reduce dietary fat intake, increase dietary fiber intake, cut out alcohol, spicy, hot, spicy food, improving diet and improve quality of life.
Bladder cancer - treatmentConventional treatmentA) The surgical treatmentSurgical therapy for the treatment of bladder cancer. Specific surgical scope and approach should be based on the staging of the tumor, the degree of malignancy and pathological type of tumor size, location, with or without involving the adjacent organs and so on comprehensive analysis.A. Open bladder surgery(1) bladder tumor local excision and fulguration: applicable only in the tumor infiltrating the mucosa or submucosa, low degree of malignancy, Kitty smaller bladder papilloma.(2) partial cystectomy: applicable Ding a more limited range of infiltration hole head-shaped tumor, located away from the tumor of the bladder trigone and bladder neck region.(3) full bladder resection: Indications: ① tumor extent, if doing partial hepatectomy causes the bladder capacity is too small; ② The dispersion of multiple tumors, not so local excision; ③ large or located in the bladder triangle near the infiltrating tumor border was unclear; ④ The application of local excision, the tumor to relapse quickly. Contraindications: No absolute contraindications.(4) through the after pubic whole bladder, urethral resection: Indications: to adapt to multiple cancer lesions in the bladder, especially involving the bladder neck or mouth of the urethra.(5) Radical cystectomy: indications: The operation is at the same time of cystectomy, pelvic lymph node dissection. For lymph node metastasis in bladder cancer (or with suspected).Two. By urethral resection of bladder tumor (TURBt) adapted to the tumor cells differentiated good or better (G1, G2), superficial tumors (Ta, T1, T2),3. After cystectomy and urinary diversion(B) radiation therapyBladder radiation therapy are combined with surgery after surgery. Late stage of disease, the loss of the timing of surgery or refuse surgery and postoperative recurrence cases underwent palliative put boils can get a certain effect.(C) of interventional radiologyInterventional radiology treatment is the use of radiological techniques, transcatheter drug injected directly into the tumor feeding vessels, in order to kill tumor cells. II-IV bladder cancer may also use this method to shrink the tumor lesions increase the resection rate and reduce the recurrence rate.(Iv) chemotherapyChemotherapy for bladder cancer to intravesical chemotherapy, systemic chemotherapy, intra-arterial chemotherapy.An intravesical infusion chemotherapy applicable to each of the patient, the best, especially on the 0-I of superficial tumor effect on other existing deep infiltration of the lesions can not play a good therapeutic effect, but there are still treatment of superficial lesions on role.2, systemic combination chemotherapy of systemic combination chemotherapy can increase the resection rate and improve the treatment of bladder cancer.(E) immunotherapyStudies have shown that bladder transitional cell carcinoma antigen, and impaired immunity in patients with tumor stage, grading and angiolymphoid proliferation of a great relationship. Therefore, the disease is suitable for the application of immunotherapy.Bladder cancer - prevention and health carePreventive care bladder cancer occur in more than 50 years of age in the elderly as age increases the incidence of a corresponding increase in the occurrence of bladder cancer with diet smoking and drinking factors closely related to the prevention of bladder cancer from the roots.
Should first adhere to the scientific eating habits to eat more fresh fruits and vegetables because fresh vegetables, fruits rich in vitamins and trace elements can be decomposed into the body contains carcinogens - nitrosamines should be minimal Meat food because meat in metabolic processes in the body structure of aniline and benzidine-like substance, a survey found that the risk of bladder cancer by using aniline and benzidine, chemical raw materials, factory workers more, followed by the habit of smoking to quit smoking as soon as possible that contain nicotine in cigarettes higher concentration of carcinogens in the tar tobacco - specific Asian marketing base amine, such as heavy smoking of a variety of toxic carcinogenic substances in human urine a day smoking index of 600 (number of cigarettes smoked daily × number of years of smoking ) reached the point where the risk of bladder cancer.
Again to increase water intake, water intake, the number of direct impact on the concentration of the urine within the bladder urine in the bladder of the important influence drinking less must reduce the occurrence of bladder cancer and carcinogenic substances excreted from the kidneys to the bladder in urine The concentration of the higher of these high concentrations of carcinogens on bladder mucosa caused a strong stimulation while drinking less voiding interval time will be extended which gives the propagation of bacteria (eg E. coli) in the bladder, creating favorable conditions for frequent occurrence of bladder cancer, the majority usually do not like drinking tea.
Increase not only of the bacteria concentration in the urine can cause cystitis also continuous adverse stimulus to bladder mucosa so that over time in bacteria and carcinogenic substances Prodded gradually from inflammation erosion and lead to cancer of the bladder mucosa.
Therefore in order to prevent bladder cancer should be full of drinking water to be discharged in time so that the urine, bacteria and carcinogens relative reduction can reduce the irritation and damage to the bladder mucosa play a role in the prevention of bladder cancer in urine dilution.
Bladder cancer - methods of preventionFirst, we should adhere to the scientific eating habits, eat more fresh vegetables, fruits.Fresh vegetables, fruits rich in vitamins and trace elements, can be decomposed into the body of carcinogens - nitrosamines. Sparingly eat meat food, meat in the metabolic processes in the body, can produce similar aniline and benzidine structure of the material, had the survey found that workers in the use of aniline and benzidine, chemical raw material plant, the risk of bladder cancer more.
Secondly, smoking habits, and they should stop smoking as soon as possible.Studies have shown that cigarettes contain nicotine, tar, tobacco - specific Asian marketing base amines and other toxic carcinogen, and a large number of people who smoke, the higher the concentration of carcinogens in urine. Daily smoking index 600 (of cigarettes smoked per day number × number of years of smoking), it reached dangerous to the point of the risk of bladder cancer.
Again, the increase in the amount of drinking water.A direct impact on the concentration of urine in the bladder, because the amount of drinking, an important influence on the occurrence of bladder cancer. Drinking less urine must be reduced by the bladder carcinogen excretion from the kidneys to the bladder, the concentration in urine is correspondingly higher. These high concentrations of carcinogens on bladder mucosa caused by a strong stimulus. , Drinking less, voiding inevitable to extend the interval of time, which gives bacteria such as E. coli, creating favorable conditions for breeding in the bladder, frequent occurrence of bladder cancer, most usually do not like drinking water, tea drinking. The increase of the concentration of bacteria in the urine, not only can cause cystitis, continuous adverse stimulus but also on the bladder mucosa, bladder mucosa, so that over time, the dual stimulation of the bacteria and carcinogens can be gradually by inflammation, erosion and lead to cancer. Therefore, in order to prevent the occurrence of bladder cancer, should be fully water, promptly eliminated in the urine dilution, urine, bacteria and carcinogenic substances is relatively lower, and can reduce irritation and damage to the bladder mucosa, play a preventive the role of bladder cancer.
Bladder cancer - Life Care1, keep the perineal area, especially the urethra mortar clean to prevent infection.2, psychological care, help patients to bad state of mind to lift the tension, fear, disappointment, and guide them to forget the disease, ease of mind, with a variety of treatment.
Bladder cancer - detected
Simply collect 50 ml of urine, bladder cancer diagnosis and postoperative follow-up can be carried out in [1]. Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine conducted the first in the bladder cancer urine test based on DNA molecular level detection technology, and worried that acceptance of cystoscopy in patients suffering more humane inspection methods. This technology for the principle of fluorescence in situ hybridization with fluorescently labeled DNA probes to detect four kinds of chromosomal abnormalities and bladder cancer, the sensitivity is almost two times that of conventional urine cytology can be used as the beginning of the hematuria the beginning of diagnostic tests. Only about 50 ml of early morning urine, it can be checked, as detected with high specificity and sensitivity, reproducibility and high stability, this technology also can be used as the postoperative follow-up of patients with bladder cancer. At the same time, the technology can also be such as the ureter and renal pelvis tumor malignant tumors of the urinary tract in the early diagnosis. Painless hematuria is the most common symptoms of bladder cancer, bladder cancer accounts for only about 10% of the patients with hematuria, initial hematuria symptoms and a clear diagnosis often exists between the long time delays. The gold standard of diagnosis and monitoring of urothelial carcinoma is cystoscopy and urine cytology, but both methods have limitations, with high sensitivity and specificity of urine cytology on well differentiated tumors, but for poorly differentiated low sensitivity of the tumor. Cystoscopy with invasive and subjective operational, it is possible to miss some of the minor or atypical sites of lesions. Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine has more than 200 cases of hematuria patients received the check, and reached 82.1% specificity for detection of bladder cancer, many patients, which has been the chance of early diagnosis and treatment.
