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Bladder Cancer
What is Bladder Cancer
This indicates cancerous change in the linning of urinary bladder. It is seen more commonly in men than in women & especially in those beyond the age of 50.

What Causes Bladder Cancer
The exact cause of bladder cancer is not known. Cigarette/bidi smokers & people working in certain chemical factories, dye industries actually handling the chemicals have a higher risk of the disease.

What are the Symptoms of Bladder Cancer
The commonest symptom is blood in the urine (or hematuria). This often starts without any warning & may be associated with passage of blood clots. Some patients have urinary frequency or urgency along with hematuria. Rarely a patient can bleed profusely leading to urinary stoppage due to clot retention. If you have any of the above symptoms, you must contact a urologist as soon as possible.

What Investigations are Necessary
After an initial clinical examination including a rectal examination, your doctor will request a urine test & some blood tests. This will be followed by a sonography. Depending on the results of the above, he might ask for some more radiological tests such as IVP or a C.T.Scan.

Once the reports of the above are available, the urologist will proceed to a cystoscopy under an anaesthesia to actually visually inspect the linning of the urinary bladder. At the time of the cystoscopy, any abnormal area is biopsied & set for examination to a pathologist.

Is there any Treatment available for this Cancer
Yes. If detected early, this cancer can be treated very satisfactorily. At the time of the initial cystoscopy, a large proportion of bladder cancers can be removed completely through the cystocope at the same time. After this, a catheter (tube) is left in the bladder, usually for 2 days. If the pathology report suggests early type of cancer, the urologist might suggest periodic bladder inspections (or cystocopies). In certain types of early cancers, weekly instillation of a medicine is carried out for 6-8 weeks & repeated thereafter if necessary. This is also followed by periodic cystoscopies. The chemicals used for such treatment are BCG or Mitomycin. If you are a suitable candidate for this your doctor will discuss about the same in detail with you.

Is there any need for Open Surgery
If the growth is diagnosed later & if is found to involve the deeper layers of bladder wall, open surgery may be necessary. About 20 to 30% of patients fall into this category. This involves removal of either a part of the bladder or the entire bladder. This is quiet a major operative procedure usually carried out in larger hospitals. The patient usually requires blood transfusions & often has to be kept in the ICU for a few days after the operation. Once the bladder is removed, an alternative arrangement for drainage of urine is made using patient's intestine, most commonly using a part of small intestine to conduct urine from the urinary tract out to the front of the abdominal wall through an opening called stoma. Once this is done, patient has to wear a bag permanently. Some patients may be suitable for construction of a new bladder using intestines, whereby there is no need to have stoma or wear any external bag. This involves a major change in life style & before considering such operations, your doctor will have a very detailed discussion with you.

Is Chemotherapy or Radiotherapy Effective in such Cancers
Sometimes bladder cancer patients need chemotherapy. This is a toxic medicine, with a fair amount of side effects. If you are suitable for that, you will be referred to an oncologist.

Radiotherapy is also quite effective in treatment of certain types of bladder cancers with results comparable to open surgery. Only a small proportion of patients are suitable for this & for such treatments, you will be referred to a radiotherapist, who is usually based in a big hospital.

What about alternative Therapies such as Ayurved or Homeopathy
Not a lot of scientific research is done on alternative medicines such as ayurveda or homeopathy & hence no firm conclusions can be drawn regarding their efficacy.

What role can the Family Members Play
The knowledge about having any cancer certainly comes as a major blow both to the patient & his family. However, it is important to know that a fair proportion of bladder cancers can actually be treated very satisfactorily without the need for open surgery. It is always helpful to involve your close family members in the decision-making. In addition to the medical help, love & help from the family members of a long way in creating a positive attitude in the patients mind. A positive attitude in turn enhances the response to any form of treatment.