Transitional cell carcinoma of the bladder what is it, prognosis and treatment

The human body is made up of many cells. For a number of reasons, the normal cellular structure can undergo mutation. If this process becomes malignant (malignancy), an oncological focus occurs.

The Cancer diagnosis sounds ominous even by its name. Unfortunately, this is justified and is explained by the main difference between cancerous tumors and benign tumors. For malignant tumors, rapid and aggressive penetration into other tissues is typical, and ultimately total damage to the body and a threat to its viability as a whole.

In urological practice, oncopathology also takes place. Transitional cell carcinoma or urothelial carcinoma is one of the most common (up to 90%) problems of this kind with bladder involvement.

Pathogenesis of the disease

The type under consideration is characterized by the nucleation of cancer cells in the transitional epithelium of the urinary bladder. The malignant focus is most often located in the mucous membrane of the organ. The course of any oncological disease usually goes through 4 stages. In relation to urothelial carcinoma, the following are distinguished:

  • The oncogenic site is limited to the mucous membrane.
  • The transition of the neoplasm to the muscle layer.
  • Involvement of the fatty layer and the adjacent reproductive system in the process.
  • Metastasis to the lymph nodes and further throughout the body.

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Specialists-histologists have determined the degree of differentiation of education:

  • A highly differentiated form with a reduced level of malignancy (differs in slow growth and is better than others amenable to treatment)
  • Moderately differentiated form (characterized by significantly altered cellular structures and more active development than the previous one)
  • A poorly differentiated form with an increased level of aggression (the most dangerous type with complete cell mutation and a tendency to metastasize).

    In urology, there is such a concept as a precancerous condition, which includes papillomatous outgrowths in the bladder, which subsequently allow them to grow into its wall.

    Who is in danger?

    According to medical statistics, urothelial carcinoma is observed in men 4 times more often than in women. Among the risk factors that can lead to cancer, the following are currently known:

    • Age over 50-60 years old.
    • Chronic diseases of the urinary system and birth defects.
    • Work involving contact with toxic reagents (paints and varnishes, rubber products)
    • Constant and uncontrolled use of artificial sugar substitutes.
    • Nicotine addiction (the likelihood of occurrence increases 4-6 times).

    What symptoms to look for?

    The danger of this ailment is largely due to the lack of vivid manifestations in the early stages of development. At the same time, there are signs in which it is necessary to consult a urologist:

    • The appearance of urine with traces of blood (both abundant and weak)
    • Discomfort with urination.
    • Suprapubic pain radiating to the perineum, genitals.

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    Great possibilities of modern diagnostics

    An appointment with a medical specialist will begin with a history and palpation examination. A neoplasm that has reached an impressive size, the doctor will be able to probe.

    Next in line are clinical and laboratory research methods, namely, the collection of urine and blood for analysis. In addition, the patient is tested for the BTA antigen.

    Instrumental methods, which are widely used in modern clinics, will help to supplement the diagnostic picture for doctors:

  • Research on ultrasound equipment – cystoscopy.
  • The technique with the introduction of a contrast agent is excretory urography.
  • Computed tomography and magnetic resonance imaging.
  • Venography and lymphangiodenography (determination of metastases).
  • The most accurate and detailed information about the tumor can be given by the method of taking a tissue sample for a biopsy.

    Medical events

    Treatment tactics in the case of urothelial carcinoma can be of different directions.

    The decision to carry out a surgical intervention for partial excision of areas captured by cancer or total removal of the organ itself is taken by a specialist doctor after a full range of examination and an accurate diagnosis.

    If the development of cancer did not have time to go far, experts try to use the most gentle method – transurethral resection. Such operations are performed with laparoscopic equipment and minimize blood loss.

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    In a cystectomy, a new bladder is usually formed from a piece of bowel.

    In some embodiments, it is possible to use an innovative technique aimed at coagulating the vessels feeding the tumor.

    In the postoperative period, chemotherapy is prescribed in order to destroy possible metastases that were not detected by surgeons during work. It is worth knowing that in patients who have undergone such operations, reproductive abilities are lost.

    Chemotherapy is often resorted to due to the impossibility of performing surgical actions. This path is quite effective in the fight against papillomatosis, but the effect of chemical agents does not just affect the patient’s well-being. Side effects of this method are vomiting, anemia, hair loss.

    Oncologists are actively using radiation. This manipulation is performed in two ways:

  • Internal direct action of radioactive substances on the area of ​​the neoplasm from within the body.
  • External – distance radiation.

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    As additional methods of treating patients at the initial stages in medicine, stimulation of human immunity is used, which allows you to adjust your own defenses to fight the disease.

    In addition, cancer patients need to adhere to a special dietary regimen with the use of:

    • Vegetables and fruits.
    • Adequate amount of liquid.
    • Non-fatty fish and meat in boiled, steamed and baked form.
    • Fermented milk products.
    • Whole grain black bread.

    It is forbidden to eat spicy, fried, salty and smoked products, preserves, strong coffee and tea, carbonated and alcoholic beverages.

    Food must be healthy and of good quality.

    Complications and consequences

    Transitional cell carcinoma can provoke a number of problems that impede the work of the urinary apparatus, which include:

    • Inflammatory manifestations in the kidneys and bladder (pyelonephritis and cystitis)
    • Fistula formation (vesicovaginal, vesicovaginal)
    • Intoxication syndrome (uremia).

    Chances for later life

    Doctors never tire of repeating that early diagnosis and timely medical care provide a guarantee of a positive resolution of the situation.

    In oncology, it is customary to give further predictions of patient survival commensurate with a five-year period.

    If an ailment is detected in a precancerous state, the patient can count on a 100% cure. At the first stage, the probability of a successful outcome decreases to 60%, and at the last stage, no more than 20-30% remains.

    Summarizing the above, it must be remembered that each person is responsible for their own health. Cancer pathologies can also be prevented by observing some precautions:

  • Refuse to smoke.
  • Timely treat diseases of the genitourinary sphere.
  • Do not contact with toxic paints and harmful substances.
  • Upon reaching 40 years of age, periodically visit a urologist.
  • If papillomas are found, take measures to remove them.
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    Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.