bladder cancer, the most common malignancy of the urinary tract, characterized by multiple growths that tend to recur in a more aggressive form. Bladder cancer occurs more often in men than in women and is more prevalent in urban than in rural areas. The risk of bladder cancer increases with cigarette smoking and exposure to aniline dyes, beta-naphthylamine, mixtures of aromatic hydrocarbons, or benzidine and its salts, used in chemical, paint, plastics, rubber, textile, petroleum, and wood industries and in medical laboratories. Other predisposing factors are chronic urinary tract infections, calculous disease, and schistosomiasis. The majority of bladder malignancies are transitional cell carcinomas; a small percentage are squamous cell carcinomas or adenocarcinomas. See also cystectomy. ▪ OBSERVATIONS: Symptoms of bladder cancer include painless hematuria, frequent urination, and dysuria. Irritation from the tumor may mimic cystitis. Urinalysis, excretory urography, cystoscopy, or transurethral biopsy is performed for diagnosis. ▪ INTERVENTIONS: Superficial or multiple lesions may be treated by fulguration or open loop resection. A segmental resection is usually performed if the tumor is at the dome or in a lateral wall of the bladder. Total cystectomy may be performed for an invasive lesion of the trigone and necessitates the creation of a urinary diversion. Radiation therapy and/or chemotherapy may be valuable under certain circumstances, such as unresectable tumor growth. Internal irradiation, the introduction of radioisotopes via a balloon of a catheter, or the implantation of radon seeds may be used in treating small localized tumors on the bladder wall. Medications that are often used as palliatives are BCG, 5-fluorouracil, thiotepa, and Adriamycin. ▪ PATIENT CARE CONSIDERATIONS: Patients may have a recurrence up to 10 years after successful treatment.
