Bladder Tumor

Bladder tumor is the most common urinary-tract tumor and one of the more common systemic tumors; most arise in the trigone, lateral walls and neck. Reports from Chinese cities show rising bladder-cancer incidence. Bladder tumors currently rank first among genitourinary tumors; male incidence is 3-4 times female.

Common Symptoms

Reduced bladder capacity; abdominal mass; dysuria; urinary frequency; bladder irritation signs; pelvic mass; bladder fibrosis; bladder distension; Qin Xunyun; urinary urgency

Causes and Pathogenesis

(A) Etiology: Complex and not fully clear. 1. Chemical carcinogens: β-naphthylamine, benzidine and 4-aminobiphenyl are established bladder carcinogens, widely used in dye, textile, printing, rubber and plastics industries; long-term exposure causes bladder cancer but with wide individual variation and long latency. Smokers have 1.5-4 times risk vs non-smokers; benzo(a)pyrene in smoke is carcinogenic. 2. Oncogenes and tumor-suppressor genes: molecular biology holds that oncogene activation or suppressor-gene inactivation causes cancer. 3. Other: tryptophan/nicotinic-acid metabolic abnormalities may cause bladder cancer; Schistosoma haematobium infestation, bladder leukoplakia, cystitis glandularis, stones and urinary retention may also be triggers. (B) Pathogenesis: 1. Growth patterns: carcinoma in situ, papillary carcinoma, infiltrative carcinoma. CIS is limited to mucosa; TCC is mostly papillary; SCC and adenocarcinoma are usually infiltrative. Invasion depth determines clinical (T) and pathologic (P) staging: CIS (Tis); papillary non-infiltrating (Ta); limited to lamina propria (T1); invades superficial muscle (T2); invades deep muscle or penetrates bladder wall (T3); invades prostate or adjacent tissues (T4). Pathologic P staging matches clinical. 2. Pathology: >95% arise from epithelium, of which >90% are TCC; SCC and adenocarcinoma are rarer but far more malignant. Non-epithelial tumors such as rhabdomyosarcoma are rare. Pathologically graded I-IV by cell size, shape, staining, nuclear changes and mitoses: Grades I-II well-differentiated (low-grade malignancy); Grades III-IV poorly differentiated (high-grade). Papilloma cells resemble normal transitional cells but tend to recur/malignant-transform, so treat as cancer. Growth patterns: CIS, papillary, infiltrative; mixed forms are common. Cystoscopic/gross view: pedunculated tumors are usually low-grade, broad-based sessile are high-grade, ulceroinfiltrative are always high-grade. Jewett-Marshall staging: O tumor limited to mucosa; A involves submucosa not muscle; B1 involves superficial muscle; B2 involves deep muscle not perimuscular tissue; C involves full muscle and perivesical fat; D1 invades perivesical tissue/pelvic organs with local node metastasis; D2 distant metastasis. Bladder tumors most often involve lateral/posterior walls, then trigone and dome; may be multifocal and coexist with renal-pelvic/urethral tumors. Spread is mainly deep invasion then distant metastasis, chiefly via iliac and aortic nodes; late few patients hematogenously spread to lung, bone, liver. Bladder cancer metastasizes late and spreads slowly.

Treatment

Surgery, drug therapy, supportive therapy

Preventive Measures

Strengthen labor protection to reduce exposure to exogenous carcinogens; drink more water and urinate promptly — may offer some prevention. For post-surgical patients, intravesical drug instillation and regular cystoscopic follow-up are essential to prevent recurrence.

Department to Visit

It is recommended to visit the Nephrology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.