Some patients are more susceptible to urinary tract infections more so compared to others. As most of them get used to their condition, some self-medicate or simply ignore more pressing symptoms experienced. After time, bloody urine, painful and frequent urination, and no urine results even after a great need is felt. When finally going to the doctor, and tests have been taken, the results are in. It is bladder cancer. What stage it is cannot yet be determined.
Causes, Treatments, Risks
The bladder is that hollow organ in the lower abdomen stores urine. Urine passes from each kidney into the bladder through a tube called a ureter. When the bladder is full, an outer layer of muscle surrounding the inner lining of the bladder can tighten to allow urination. Urine leaves the bladder through another tube, the urethra.
Studies have identified the risk factors for bladder cancer: age, smoking, exposure to carcinogens for some workers, infections of certain parasites, race (Caucasians being highest at risk, Asians the least at risk), male gender, and personal or family history of bladder cancer. Once the diagnosis has been established, the doctor would now have to determine the stage of the cancer: 0 to III. The choices for treatments are: bladder cancer surgery, radiation therapy, chemotherapy or biological therapy.
Bladder cancer surgery is a common treatment. The type of surgery to be performed will greatly depend on the stage and grade of the tumor. The patient has to ask the doctor the pertinent questions and fears of risks of the procedure. Getting a second opinion is also highly recommended. There are three basic procedures or types of bladder cancer surgery:
• Transurethral resection (TUR): the doctor may treat the early stage or superficial bladder cancer where an insertion of a cytoscope into the bladder through the urethra. The doctor will then use a tool with a small wire loop on the end to remove the cancer and to burn away any remaining cancer cells with an electric current. Hospitalization and anaesthesia may have to be done. After the TUR, chemotherapy or biological therapy may have to be performed regularly.
• Segmental cytectomy: in some cases the doctor may have to remove the small area invaded by cancer cells.
• Radical cystectomy: This is for the invasive bladder cancer and the doctor will have no option but to remove the whole organ. In women, a hysterectomy and partial removal of the vagina may have to be performed. For this procedure, the urine will have another way to get out of the body and be stored in a pouch or bag outside of the body which can be manually emptied.
Sometimes, the cancer has spread outside the bladder and cannot be completely removed; in this case the doctor may just have to establish a way to make another passage for urine to pass and not having to remove the bladder at all.
After bladder cancer surgery, the doctor can create a new channel for urine to pass through:
• Ileal conduit or non-continent diversion where the doctor uses a part of your intestine is used as the channel and connects it to your ureters by creating a hole (stoma) in your abdomen where a pouch can collect the urine. Of the choices, this is considered the simplest and the easiest to maintain.
• Continent reservoir (continent diversion) where a segment of your large intestine is converted into a pouch andattached outside your abdomen to collect the urine. There are two types: the abdominal diversion reservoir and the orthotopic diversion.
Side effects after bladder cancer surgery may include bowel dysfunction like constipation and diarrhea, effects on sexual intercourse, adhesions and the occasional bowel obstruction can complicate matters if the surgery was highly extensive.