Bladder cancer
| Bladder cancer | |
| ICD-10 | C67, C67.9 |
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| ICD-9 | 188, 188.9 |
| OMIM | 109800 |
| DiseasesDB | 1427 |
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Bladder cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Bladder cancer On the Web |
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American Roentgen Ray Society Images of Bladder cancer |
For patient information click here Steven C. Campbell, M.D., Ph.D.
Overview
Signs and symptoms
Causes
Risk factors
Exposure to environmental carcinogens of various types is responsible for the development of most bladder cancers. Tobacco use (specifically cigarette smoking) is thought to cause 50% of bladder cancers discovered in male patients and 30% of those found in female patients. Thirty percent of bladder tumors probably result from occupational exposure in the workplace to carcinogens such as benzidine. Occupations at risk are metal industry workers, rubber industry workers, workers in the textile industry and people who work in printing. Some studies also suggest that auto mechanics have an elevated risk of bladder cancer due to their frequent exposure to hydrocarbons and petroleum-based chemicals.[1]
Hairdressers are thought to be at risk as well because of their frequent exposure to permanent hair dyes. It has been proposed that hair dyes are a risk factor, and some have shown an odds ratio of 2.1 to 3.3 for risk of developing bladder cancer among women who use permanent hair dyes, while others have shown no correlation between the use of hair dyes and bladder cancer. Certain drugs such as cyclophosphamide and phenacetin are known to predispose to bladder TCC. Chronic bladder irritation (infection, bladder stones, catheters, bilharzia) predisposes to squamous cell carcinoma of the bladder. Approximately 20% of bladder cancers occur in patients without predisposing risk factors. Bladder cancer is not currently believed to be heritable (i.e., does not "run in families" as a consequence of a specific genetic abnormality). [This statement contradicts contents in the section that follows]
Diagnosis
Treatment
The treatment of bladder cancer depends on how deep the tumor invades into the bladder wall. Superficial tumors (those not entering the muscle layer) can be "shaved off" using an electrocautery device attached to a cystoscope. Immunotherapy in the form of BCG instillation is also used to treat and prevent the recurrence of superficial tumors.[2] BCG immunotherapy is effective in up to 2/3 of the cases at this stage. Instillations of chemotherapy into the bladder can also be used to treat superficial disease.
Untreated, superficial tumors may gradually begin to infiltrate the muscular wall of the bladder. Tumors that infiltrate the bladder require more radical surgery where part or all of the bladder is removed (a cystectomy) and the urinary stream is diverted. In some cases, skilled surgeons can create a substitute bladder (a neobladder) from a segment of intestinal tissue, but this largely depends upon patient preference, age of patient, renal function, and the site of the disease.
A combination of radiation and chemotherapy can also be used to treat invasive disease. It has not yet been determined how the effectiveness of this form of treatment compares to that of radical ablative surgery.
There is weak observational evidence from one very small study (84) to suggest that the concurrent use of statins is associated with failure of BCG immunotherapy.[3]
References
- ↑ Occupational Risks of Bladder Cancer in the United States: II. Nonwhite Men - Silverman et al. 81 (19): 1480 - JNCI Journal of the National Cancer Institute
- ↑ "BCG immunotherapy of bladder cancer: 20 years on". 353 (9165). 1999: 1689&ndash, 94.
- ↑ "Use of statins and outcome of BCG treatment for bladder cancer". 355 (25). 2006: 2705&ndash, 7.
External links
Template:Tumors Template:SIB bs:Rak mokraćnog mjehura da:Blærecancer de:Blasenkrebs hr:Rak mokraćnog mjehura no:Urinveiskreft fi:Virtsarakon syöpä sv:Urinvägscancer