Saturday, January 14, 2006

cancer, bladder

The earliest symptom of a malignancy of the bladder is painless hematuria (blood in the urine). Diagnosis is made by cystoscopic examination (looking with an instrument into the bladder) and biopsy. If the muscle wall of the bladder is not penetrated by the tumor, metastases have usually not occurred.
Small tumors may be removed by transurethral resection or fulguration. In larger tumors, segmental resection (partial removal of bladder) or cystectomy (total removal) may be performed. In elderly patients who are poor operative risks, some success can be achieved with radiation or chemotherapy. Following cystectomy, the patient is usually quite ill. He or she is prone to surgical shock, thrombosis, cardiac decompensation, and other circulatory disturbances. Management is similar to that of the patient with major abdominal surgery.
Cancer of the bladder is currently considered incurable and is usually fatal within five years. Surgery and treatment with anticancer drugs can prolong and improve the quality of life. Pain and other symptoms can be relieved or controlled. The medical literature cites a few instances of unexplained recovery.
Scherer, J. C. Introductory Medical-Surgical Nursing, 3rd ed. Philadelphia: J. B. Lippincott Co., 1982.
Steinberg, F. U. Care of the Geriatric Patient, 6th ed. St. Louis: C. V. Mosby Co., 1983.


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