BLADDER CANCER
Cancer of the bladder is second to cancer prostate in incidence amongst genitourinary tumors.The average age at diagnosis is 65 years. At diagnosis three out of four patients have localized cancers and one out of four patients have spread to regional lymph node or distant sites. Smokers have approximately a twofold increased risk of bladder cancer than non-smokers. Workers in the chemical, dye, rubber, petroleum,leather, and printing industries are at increased risk.The lining epethilium (inside covering of urinary bladder) of bladder is transisional cells and most cancer are from it-transisional cell cancer.Most common symptom of bladder cancer (about 90%) is blood in urine. Few patient may have frequency,urgency and burning urination.Evaluation is done by urine examination for shedded cancer cell, by CT scan, a cystoscopic biopsy or resection (TUR BT) of the tumor .Further followup and treatment depends on biopsy report.Tumor which have not grown into the musle layers may be simply followed up at regular interval;some may receive instillation of mitomycin C , BCG in the bladder.Tumors which have grown into muscle layers are best treated by removal of bladder (Radical Cystectomy) with various methods of urinary diversion.Radiotherapy,chemotherapy or a combination of them is used for advance and metatatic disease.
