Blood in the urine can be a warning sign of this common cancer

Bladder cancer is the fifth most common in Israel - and in quite a few cases it ends with complete excision of the bladder.

Scary?

Absolutely, and this is exactly the reason not to ignore the warning signs (and stop smoking. Now)

Iris Cole

30/09/2022

Friday, September 30, 2022, 00:53

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What is bladder cancer - and how is it treated?

(Walla system)

Bladder cancer is the fifth most common cancer in Israel, yet many do not know enough about it.

Dr. Roi Meno, head of the uro-oncology service at the Ichilov Hospital's urology department, was a guest on the "Expert Clinic" podcast to explain what causes bladder cancer - and what the warning signs are that we all need to know.

Let's start with the most prominent and common sign of cancer - blood in the urine Although there can be various reasons for the appearance of blood in the urine, it is a "sign that appears in most patients who have bladder cancer", explained Dr. Mano.

"Blood in the urine can be caused by all kinds of factors, it doesn't necessarily have to be cancer, but cancer is the thing that worries us the most if someone has blood in the urine, so it's important to find out about any such case. If it happens - you need to go to the doctor," he emphasized.

Unlike other tumors, because of the location of bladder cancer, it secretes blood at a fairly early stage, and it is important to find out because a delay in finding out will cause a delay in diagnosis.

"In this case, the blood comes at an early stage - and that's why this sign must not be ignored," clarified Dr. Mano. He added that "a large part of the people who come to us, it's because they actually see blood in their urine, like raspberries that color the urine, but also a relatively small amount of blood turns the urine very red, it's very scary, and the patients usually come for clarification."

How is bladder cancer diagnosed?

When a person comes to the urologist because of blood in the urine, the first examination is physical - to see that there is nothing noticeable that can explain the bleeding, such as a visible lesion.

Then you go to a cystoscopy - an invasive examination of the lower urinary tract.

"We use a camera that is on top of a thin tube, and we look into the urinary tract. You can see the urethra, the tube of urine and the bladder itself, and then we look for tumors or stones, or something else that is the cause of bleeding," explained Dr. Mano.

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The insertion of the tube is under local anesthesia.

"In women, you feel almost nothing, because the urethra is short, in men, the test is unpleasant, but you can tolerate it. Dr. Mano clarified that there is no screening test that can detect bladder cancer before the symptoms, and the investigation will have to include at such a stage or after cystoscopy.

Another possible examination CT of the urinary tract - waiting for the contrast material that is injected into the body to be excreted through the kidneys and highlight the urinary tract, so that it allows to see if there is anything noticeable.

This test also makes it possible to identify stones in the urinary tract.

A urine test for cytology is also possible, as the urine is collected and checked for malignant cells.

Who is at risk for bladder cancer?

Bladder cancer is more common in older ages.

"It usually appears at the age of 70 on average, and as you get older, the chance that blood in the urine will show malignancy in the urinary tract is increasing," explained Dr. Meno. In addition to age, the most significant cause of bladder cancer is smoking. "All the substances we inhale reach the kidneys and leave Through the bladder," clarified Dr. Mano, "unequivocally you should avoid smoking because it is the number one cause."

Not only the lungs are affected.

A man smoking (Photo: ShutterStock)

How are you treated?

The question of treating this complex cancer depends on whether the tumor has penetrated into the bladder or not.

Roughly speaking, there are two main groups - superficial tumors that do not penetrate into the muscular wall of the bladder, and tumors that do.

"A tumor is characterized by the aggressiveness of the cells and the depth of its penetration - whether it has penetrated into the muscle layer or not," explained Dr. Mano, "75 percent of the tumors do not have the ability to penetrate deeply, and these are the better tumors." In these cases, they are treated in a way that preserves the bladder Urinate by scratching the tumor. "These tumors have a tendency to come back, so there is close monitoring, but if they come back the treatment will also only include scratching it from the wall," he added.

When there is a tumor that penetrates the wall of the bladder - in a quarter of the patients - it is already a disease of a different nature.

"It can spread locally in the pelvis and the rest of the body, and cause a lot of trouble, and with them you have to be aggressive in the treatment, and then in some cases the bladder is completely excised," explained Dr. Meno. In cases where resection is necessary, "a segment of intestine, part of the small intestine is used , and from it they create a tube that goes out to the wall of the urine into a bag.

It's an inelegant solution, which has many mental and physical consequences, and it takes time to recover from it.

A second option, which is less common because not everyone is suitable for it, is to take a longer section of intestine and create like an alternative urine pouch," explained Dr. Mano, clarifying that this is not always appropriate because the intestine naturally absorbs things, and then it tries to absorb the the urine

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• urine

• Bladder

• cancer