Disease Process Worksheet Cancer of the Bladder Clinical Signs (How does the disease present? )| Patient often presents with hematuria (blood in urine) ranging from a rust like color to deep red. Frequent and/or painful urination and dysuria are also clinical signs, along with abdominal and back pain| Etiology (What causes the disease or illness? )| Exact causes of bladder cancer are unknown. However, there are etiological factors associated with bladder cancer.
Cigarette Smoking, certain chemicals called aromatic amines (benzidine and beta-naphthylamine) which are used in the dye industry are known to contribute to bladder cancer. Schistosomiasis is a parasitic infection, which can also lead to bladder cancer. This typically takes place in developing countries and is extremely rare in the United States. | Epidemiology (The incidence, distribution, and control of disease in a population. )| Bladder Cancer mostly affects those in their 60’s and 70’s. Whites are diagnosed with bladder cancer twice as much as African Americans and Hispanics.
Asians have the lowest rate. Men are three times more likely than women to have bladder cancer, however, more women die from it due to a later diagnosis. Those who work with the rubber, dye, chemical, and leather industries are also at a higher risk. Those with family members who have had bladder cancer are at higher risk as well. | Diagnostic Evaluation (examination, labs, etc. )| Physical ExaminationUrine tests (urine cytology being the most common)Intravenoous pyelogramCytoscopyBiopsy| Treatment (therapeutic or pharmacologic interventions) Surgery is a common form a treatment, but the type of surgery depends on the stage of the neoplasm. An early stage of bladder cancer may be treated by transurethral recection (TUR). A cytoscope is inserted into the bladder via the urethra, where a wire loop removes the cancerous cells and burns the remainder with electrical current. Radical cystectomy is the most common form of surgery and is done on invasive bladder cancer. The entire bladder, neighboring lymph nodes, part of the urethra and other close organs that are nfected by cancer are completely removed in radical cystectomy. Intravesical chemotherapy is often used after TUR when the patient has superficial bladder cancer. The bladder is filled (via catheter) with the drugs used, and are left for several hours. This is performed once a week from as short as a month to up to a year. If the cancer has spread to other parts of the body, the drugs are administered intravenously. These drugs can make a person ill, so they are given in cycles to allow for a recovery period.
Sometimes chemotherapy is done before a cystectomy, which reduced the size of the neoplasm. This is an example of neoadjuvant therapy. Neoadjuvant therapy is when another therapy is performed before surgical removal of the tumor. Immunotherapy or biological therapy, uses the body’s immune system to fight cancer. BCG is the most common form of immunotherapy. The BCG solution is inserted into the bladder via a catheter and fills the bladder. Bacteria within the solution stimulate the immune system so it can kill the cancer cells in the bladder.
This treatment is done once a week for six weeks. | 3 Sources of Information| http://www. uihealthcare. com/topics/medicaldepartments/urology/bladdercancer/index. htmlhttp://www. nci. nih. gov/cancertopics/pdq/treatment/bladder/HealthProfessional/page2http://www. mayoclinic. com/health/bladder-cancer/DS00177http://www. ncbi. nlm. nih. gov/pubmed/1636227http://www. cancer. org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_bladder_cancer_44. asp|