Published on February 15, 2014
Mrs. Shaina Sharma R.N, MSc. N
Rapid, uncontrolled growth of abnormal cells in the bladder Begins in the lining of the bladder & Invasive bladder spread through the lining into the cancer : spread to muscular wall of the lymph nodes, other bladder. organs in the pelvis or other organs (liver and lungs)
INCIDENCE • In India bladder cancer is the fifth most common cancer In men according to Delhi based registry with age adjusted incidence rate of 5.8/100,000 • Incidence is much lower in females 1.5 cases/100,000 • Male to female ratio= 8.6:1
High urinary pH High cholesterol intake Pelvic radiation therapy Cancers arising from prostrate, c olon & rectum
In the Western world, tobacco use is the single most important cause of bladder cancer, accounting for an estimated 40-70% of all cases. Smokers' risks of bladder cancer are 2-3 times higher compared to nonsmokers
CLASSIFICATION 90% of bladder cancers are transitional cell carcinoma. The other 10% are squamous cell carcinoma, adenocarcinoma, sarcoma, small cell carcinoma,
STAGES OF BLADDER CANCER
Stage CIS: Flat cancer limited to the innermost lining of the bladder. It is high grade. Stage T1: Cancer penetrated into the submucosal tissue. Stage T2: Cancer penetrated the muscular bladder wall. Stage T3: Cancer penetrated through muscular bladder wall into the surrounding fat. Stage T4: Cancer penetrated into the adjacent structures (prostate, uterus, or vagina). Regional lymph nodes not involved yet. Stage T1-4N1-2M1-2: Cancer spread out of abdomen/pelvic wall to lymph nodes or distant organs like liver, lungs, or bones.
Hematuria Urinary tract infection
• Pain with metastasis • Any change in voiding/urine
PHYSICAL EXAMINATION URINALYSIS URINE CYTOLOGY CYSTOSCOPY
CT SCAN PYELOGRAPH Y BIOPSY ULTRA SOUND
Stop smoking Avoid exposure to industrial chemicals Avoid exposure to arsenic Eat healthy food Adequate fluid intake
MANAGEMENT Depends on:- Grade of tumor Stage of tumor Multicentricity
SURGICAL MANAGEMENT Transuretheral resection Cystectomy
Intra venous Intra vesical Topical
Intra-vesical BCG effective in: Superficial transitional cell carcinoma Carcinoma in situ Decreasing tumor progression
Radiation treatment can be used: As part of the treatment for early stage bladder cancer, after limited surgery As the main treatment for people with early stage cancers who can’t have surgery As part of the treatment for advanced bladder cancers To help prevent or treat symptoms caused by advanced bladder cancers
•Transurethral resection •Chemotherapy •Radiotherapy Trimodality therapy
Treating hematuria Hydrostatic therapy Instillation of formalin, phenol or silver nitrate
Other modalities of treatment….. Photodynamic therapy (PDT) Targeted therapies Gene therapy
COMPLICATIONS Regional metastasis through pelvis Metastasis to liver, lungs and bone
NURSING ASSESSMENT HEMATURIA RISK FACTORS IRRITATIVE VOIDING SYNDROME FATIGUE WEIGHT LOSS
ASSESSMENT CONT…… SIGNS OF METASTASIS FEELINGS ABOUT IMPOTENCE COPING ABILITY KNOWLEDGE OF DISEASE
NURSING DIAGNOSIS Impaired urinary elimination related to hematuria and transuretheral surgery Acute pain related to irritative voiding symptoms and catheter related discomfort Anxiety related to diagnosis of cancer
NURSING CARE/NURSING INTERVENTIONS Maintaining urinary elimination after TUS Controlling pain Relieving anxiety
PATIENT TEACHING Advise the patient about:- • Irritative voiding symptoms & Intermittent hematuria after TUR • Follow up schedule • Yearly cystoscopy
Calcification Inhibitors in CKD and Dialysis Patients
Information about bladder cancer treatment, causes, screening, clinical trials, research, statistics, and other topics from the National Cancer Institute.
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NCI's gateway for information about Bladder Cancer.
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Information on bladder cancer, including how it is diagnosed, treatments you might have, possible side effects and how to get further support.
Englisch-Deutsch-Übersetzung für bladder cancer im Online-Wörterbuch dict.cc (Deutschwörterbuch).
Bladder Cancer. You may have heard it from physicians, from family members who have been doing their reading, or from spinal cord injury survivors who go ...