Urothelial carcinoma, which mainly occurs between the ages of 60 and 70, is often the result of nicotine consumption and/or ignored urinary tract infections and bladder infections. Various treatment methods are possible in the early stages, while in later stages the success of healing is low.
What is urothelial carcinoma?
Doctors call urothelial carcinoma malignant (malignant) tumors that are located in the area of the tissue of the urinary tract. Occasionally, however, the tumors can also appear as cancer of the ureters, the renal pelvis, the urethra or in the form of bladder cancer. For skin cancer 101, please visit photionary.com.
The majority of those affected fall ill between the ages of 60 and 70. About five percent of all urothelial carcinomas are located in the ureters or in the renal pelvis; in the remaining cases, however, the urothelial carcinoma forms in the urinary bladder.
One of the most common causes is smoking. Above all, chronic irritation of the mucous membrane cells in the bladder, which subsequently triggers bladder infections that have not completely healed and cause bladder stones, can also promote urothelial carcinoma.
Schistosomiasis ( worm infestation of the bladder, intestines, liver or genitals) can sometimes increase the risk of urothelial carcinoma. Other beneficial factors are hair dyes and chemical substances that have been proven to have carcinogenic substances.
Symptoms, Ailments & Signs
The first sign of urothelial carcinoma is a clearly visible admixture of blood when urinating (so-called hematuria). Furthermore, the person concerned complains about problems or disturbances when urinating. Emptying the bladder is associated with pain ; Pain often occurs in the bladder area for no reason.
If the tumor is located at the entry point of the ureters, the carcinoma can impede the outflow of urine to such an extent that urinary retention occurs. In that case, patients complain of flank pain. Urothelial carcinoma causes symptoms similar to those of a bladder infection. For this reason, it is important that people who have such symptoms and are over the age of 40 consult a doctor so that urothelial carcinoma can be ruled out.
Diagnosis & course of disease
The doctor not only checks the patient’s medical history, but also tries to find any cancerous growths that are in the urinary bladder by means of a thorough abdominal examination and attention to the symptoms. For this he uses the ultrasound, with which tissue changes can be detected. The doctor can rule out a bladder infection by means of blood and urine tests.
It is important that the interior of the urinary bladder is examined using an endoscopic procedure. As part of the examination, tissue samples ( biopsy ) are also taken, which should then provide information about whether a urothelial carcinoma is actually present. If the suspected diagnosis proves true, further examinations are carried out. The doctor must then determine the extent of the urothelial carcinoma. Using magnetic resonance imaging or computed tomography, it is possible to determine the stage of development of the tumor.
The doctor then divides the urothelial carcinoma into a TNM classification, whereby the size of the tumor, any metastases and lymph node involvement are checked and documented. If the tumor has already affected the deep tissue, the prognosis is negative. However, in around 70 percent of all cases, urothelial carcinoma is discovered at an early stage, so that a full recovery is possible; if the entire tumor is removed, the patient enjoys the possibility of surviving the disease.
Since urothelial carcinoma is a form of cancer, in the worst case it can lead to the death of the affected person. The further complications and symptoms depend very much on the exact characteristics of the tumour. For this reason, a general prediction is usually not possible.
Sometimes those affected suffer from bloody urine. This symptom can also lead to a panic attack in some sufferers. Furthermore, urination is also associated with pain. The bladder itself can also hurt for no particular reason. The pain often spreads to the flanks, so that the patient’s quality of life is significantly reduced by the urothelial carcinoma.
If metastases have already formed, treatment of the urothelial carcinoma is usually no longer possible and the affected person dies prematurely. In some cases, however, the tumor can be surgically removed. Although there are no complications, those affected continue to suffer from kidney failure and need a donor kidney or dialysis. The life expectancy of the patient is significantly reduced by the urothelial carcinoma.
When should you go to the doctor?
A urothelial carcinoma must always be treated by a doctor. It is a serious illness, which in the worst case can even lead to the death of the person concerned. Therefore, a doctor should be consulted at the first symptoms and signs of the disease. A doctor should be consulted for urothelial carcinoma if the patient suffers from bloody urine. This complaint can also occur sporadically.
Furthermore, urination itself is associated with severe pain, so that in some cases those affected also suffer from mental disorders or depression. Pain on the flanks or in the lower area of the abdomen can also indicate urothelial carcinoma. Above all, patients older than 40 years should see a doctor with these symptoms so that the urothelial carcinoma can be detected and removed at an early stage. Further treatment depends on the severity of the tumor. The disease may also lead to a reduced life expectancy for those affected.
Treatment & Therapy
The treatment mainly depends on the extent of the tumor. If the tumor has already reached the bladder wall or nested in the surrounding tissue, the doctor already speaks of an advanced stage. However, it is possible that tumors that have only spread to the mucous membrane of the bladder can be removed endoscopically – via the patient’s urethra.
That treatment is called Transurethral Electroresection (TUR). However, this procedure is only used for superficial tumors. It is important that the bladder is flushed afterwards. Immune or chemotherapeutic agents can thus be used to prevent the tumor from regressing. Tumors that have already grown directly into the muscle of the urinary bladder must be removed along with the bladder.
The patient then receives an artificial urinary bladder, which consists of the small intestine and the urethra. With this variant it is possible that the patient can be cured. However, if it is not possible for the bladder to be removed or for a corresponding replacement to be formed because the patient is in need of care or people with kidney failure or patients who already have a tumor in the urethra, the urine is pumped through the abdominal wall ( via a short piece of intestine) directly into a bag.
In a few cases, partial removal of the bladder can also be successful. There are also so-called combined chemo – radiotherapies. However, this therapy is only carried out in selected patients. If it is a metastatic urothelial carcinoma, the doctor can destroy the fast-growing cancer cells using chemotherapy.
Radiation – i.e. radiotherapy – is usually only carried out before a surgical intervention; sometimes radiotherapy can also be used as part of the follow-up treatment.
It is important that all risk factors – such as smoking – are given up if urothelial carcinoma is to be prevented. Above all, people who deal with carcinogenic substances should rely on their protective measures and attend regular check-ups. It is important that urinary stones and any urinary tract infections are treated consistently so that there is no chronic course of the disease, which not only provokes the mucous membrane cells, but sometimes also promotes the formation of a urothelial carcinoma.
After the actual treatment of the urothelial carcinoma, follow-up care is initiated. The focus is on the timely detection of a possible recurrence. For this reason, check-ups are carried out at short intervals. They include regular ultrasound scans and urine tests.
In the case of bladder-preserving therapy, a cystoscopy (cystoscopy) is also used. If a radical cystectomy was performed, imaging procedures such as computed tomography (CT) or magnetic resonance imaging (MRI) follow. If there are no abnormal findings over a longer period of time, the intervals between the individual examinations can be extended.
After a cystectomy and a urinary diversion, follow-up treatment is required that is tailored to the specific needs of the patient. However, it only makes sense if concomitant chemotherapy has ended. In the context of rehabilitation, the focus is on postoperative functional disorders.
These primarily include bladder emptying disorders, urinary incontinence, dealing with a urostomy and sexual dysfunction. In the case of older patients, the therapists adapt the treatment to their physical and psychological capabilities. Working patients should be able to return to work.
If lymphedema appears on the legs after treatment for the urothelial carcinoma, the affected persons are given special compression stockings or elastic wraps. Manual lymph drainage is also helpful if a lymphocele can be ruled out. In the context of aftercare, the focus is usually also on the patient’s quality of life. Among other things, questionnaires about the quality of life can be filled out.
You can do that yourself
Urothelial carcinoma is associated with various symptoms. Patients can relieve these symptoms on their own by maintaining a healthy lifestyle and taking some supporting measures.
First of all, it is advisable to change your diet, because carcinomas lead to gastrointestinal problems such as irritable stomach or heartburn. An adapted diet reduces the symptoms by relieving the stomach and increasing well-being. In addition, a diet rich in vitamins and minerals provides the body with all the substances it needs to fight urothelial carcinoma. Simple home remedies such as cooling or hot compresses, massages and treatments with pain-relieving oils and ointments can help with pain in the area of the bladder or urinary tract. Sufficient sleep inhibits the perception of pain. Those affected pay attention to a well-ventilated bedroom so that the night’s sleep is restful.
Concomitantly, distraction helps to forget the pain. Patients can pursue their hobbies or spend time with other people. Conversations with other affected people are perceived as particularly liberating. Suitable contact points are, for example, self-help groups or Internet forums. There, sufferers can find like-minded people who can give valuable tips on how to effectively support urothelial carcinoma therapy.