Laboratory parameters of 1st order – obligatory laboratory tests. Urine status (rapid test for: pH, leukocytes, nitrite, protein, blood) [microhematuria: No visible discoloration of urine by blood; only erythrocytes/red blood cells are noticeable in the microscopic image (> 5 erythrocytes/μl urine); also perform erythrocyte morphology in case of microhematuria] In high-risk collectives (smokers, occupational risk … Bladder Cancer: Test and Diagnosis
Therapy recommendations Depending on prognostic criteria, adjuvant therapy for superficial (superficial) bladder carcinomas is indicated after transurethral resection (TUR); it is dispensable for well-differentiated noninvasive primary tumors. Cytostatic agents (cisplatin, doxorubicin, mitomycin C, epirubicin) and the immunomodulator BCG (Bacillus Calmette-Guérin) are available. While in patients at low risk of progression chemotherapy or immunotherapy is considered … Bladder Cancer: Drug Therapy
Mandatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of abdominal organs) including small pelvis – for basic diagnosis [detection of larger tumors and urinary retention if necessary]; also for follow-upNote: Abdominal ultrasonography is considered sufficient for the initial finding of non-muscle-invasive bladder cancer (NMIBC) – no imaging workup of the upper urinary tract should be … Bladder Cancer: Diagnostic Tests
Complementary micronutrient therapy to reduce the recurrence rate of superficial bladder carcinoma: Probiotics The above vital substance recommendations were created with the help of medical experts. All statements are supported by scientific studies with high levels of evidence. For a therapy recommendation, only clinical studies with the highest levels of evidence (grade 1a/1b and 2a/2b) … Bladder Cancer: Micronutrient Therapy
The type of therapy depends on the tumor stage (depth of invasion) and the patient’s general condition. In cases of metastasis, systemic chemotherapy is given. Resection of bladder tumors Indication Superficial (growing on the surface) tumors (TNM classification): Ta-T1, Tis (carcinoma in situ, “flat tumor”); Ta (noninvasive papillary tumor). T1 G1-2 (infiltration of subepithelial connective … Bladder Cancer: Surgical Therapy
To prevent urinary bladder cancer (bladder cancer), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Nitrosamine exposure Smoked and cured foods and foods high in nitrates and nitrites Nitrate is a potentially toxic compound: Nitrate is reduced to nitrite in the body by bacteria (saliva/stomach). Nitrite is a reactive oxidant … Bladder Cancer: Prevention
Radiotherapy (radiation therapy) In muscle-invasive (“growing into the muscle layer”) bladder cancer (non-muscle-invasive bladder cancer, nMIBC) (cT2-4), radiotherapy can be used in patients in whom tumor removal by radical cystectomy (removal of the urinary bladder) is not possible. A transurethral resection (TUR) of the tumor (removal of the tumor through the urethra) should then be … Bladder Cancer: Radiotherapy
The following symptoms and complaints may indicate urinary bladder cancer (bladder cancer): Leading symptoms Painless macrohematuria (visible blood in the urine) or microhematuria (no discoloration of the urine; only in the microscopic image, erythrocytes/red blood cells are noticeable (> 5 erythrocytes/μl urine). Symptoms of “irritable bladder” such as pollakiuria (frequent urination) and dysuria (pain during … Bladder Cancer: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Urinary bladder cancer results from altered cells in the bladder wall area that proliferate in an expansion-like manner. These changes are caused by mutations (permanent genetic changes). In tumor biopsies (tissue cylinders from a tumor), one or more mutations associated with DNA mismatch repair or hereditary (inherited) tumor disease are found … Bladder Cancer: Causes
General measures Nicotine restriction (refrain from tobacco use; smoking cessation reduces risk of recurrence and progression/risk of recurrence and progression) Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program … Bladder Cancer: Therapy Options
The following are the most important diseases or complications that can be caused by bladder cancer (carcinoma of the bladder): Neoplasms – Tumor Diseases (C00-D48). Urothelial carcinoma of the upper urinary tract (UTUC, “upper tract urothelial carcinoma”), i.e., of the renal calices and upper ureters Metastasis by direct infiltration: Pelvic/abdominal wall Prostate (prostate gland) Uterus … Bladder Cancer: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) of the skin and mucous membranes. Auscultation (listening) of the heart Auscultation of the lungs Inspection and palpation of the abdomen (stomach), inguinal region (groin region), etc. [Assessment of … Bladder Cancer: Examination