Cancer of bladder

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Information about Cancer of bladder
Health & Medicine

Published on February 15, 2014

Author: ciplashine

Source: slideshare.net

Description

bladder cancer, its incidence, etiology, clinical manifestations, diagnosis, medical nand nursing management are included in this ppt.

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

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