概述
Bladder cancer originates in the urothelial (transitional) cells lining the inside of the bladder. It is a common urologic malignancy, especially in older adults, and more prevalent in men. The majority are non-muscle invasive urothelial carcinomas, but muscle-invasive forms are more aggressive.
症状
- Blood in urine (hematuria) — most common
- Painful or frequent urination
- Urgency to urinate
- Pelvic pain (advanced cases)
- Lower back pain on one side
病因与风险因素
- Smoking (major risk factor)
- Chemical exposure (dyes, rubber, textile, arsenic)
- Chronic bladder inflammation or infections
- Male gender and age >60
- Prior pelvic radiation or chemotherapy (e.g., cyclophosphamide)
诊断方法
- Urinalysis and urine cytology
- Cystoscopy with biopsy (gold standard)
- CT urogram or MRI for staging
- Transurethral resection of bladder tumor (TURBT)
治疗方案
- TURBT + intravesical therapy (e.g., BCG) for non-muscle invasive disease
- Radical cystectomy with or without urinary diversion for muscle-invasive disease
- Chemotherapy (e.g., cisplatin-based regimens)
- Immunotherapy (e.g., checkpoint inhibitors)
- Bladder-preserving trimodal therapy (select cases)
预后情况
- Non-muscle invasive: high recurrence but low progression
- Muscle-invasive: prognosis depends on stage and treatment
- 5-year survival:
- Localized: ~70%
- Regional: ~35%
- Distant: ~6%
与此类癌症共处
- Long-term cystoscopic surveillance
- Lifestyle changes (e.g., smoking cessation)
- Managing urinary reconstruction or ostomy (if applicable)
- Psychological support and survivorship care
预防与筛查
- Stop smoking
- Reduce chemical exposures
- Monitor for hematuria in high-risk groups
- No routine screening unless high-risk occupation/history
FAQs
Q: Is bladder cancer curable?
A：Yes, especially in early-stage disease; lifelong surveillance is key.
Q: Can it come back?
A：Yes. It has a high recurrence rate even in low-grade disease.
Q: Do I need my bladder removed?
A：Only in muscle-invasive or recurrent aggressive cases.
相关资源
- Bladder Cancer Advocacy Network (BCAN)
- American Urological Association
- ClinicalTrials.gov
