Cancer of bladder

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bladder cancer, its incidence, etiology, clinical manifestations, diagnosis, medical nand nursing management are included in this ppt.

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Cancer of bladder

  1. 1. Mrs. Shaina Sharma R.N, MSc. N
  2. 2. Rapid, uncontrolled growth of abnormal cells in the bladder Begins in the lining of the bladder & Invasive bladder spread through the lining into the cancer : spread to muscular wall of the lymph nodes, other bladder. organs in the pelvis or other organs (liver and lungs)
  3. 3. INCIDENCE • In India bladder cancer is the fifth most common cancer In men according to Delhi based registry with age adjusted incidence rate of 5.8/100,000 • Incidence is much lower in females 1.5 cases/100,000 • Male to female ratio= 8.6:1
  4. 4. High urinary pH High cholesterol intake Pelvic radiation therapy Cancers arising from prostrate, c olon & rectum
  5. 5. In the Western world, tobacco use is the single most important cause of bladder cancer, accounting for an estimated 40-70% of all cases. Smokers' risks of bladder cancer are 2-3 times higher compared to nonsmokers
  6. 6. CLASSIFICATION 90% of bladder cancers are transitional cell carcinoma. The other 10% are squamous cell carcinoma, adenocarcinoma, sarcoma, small cell carcinoma,
  7. 7. STAGES OF BLADDER CANCER
  8. 8. Stage CIS: Flat cancer limited to the innermost lining of the bladder. It is high grade. Stage T1: Cancer penetrated into the submucosal tissue. Stage T2: Cancer penetrated the muscular bladder wall. Stage T3: Cancer penetrated through muscular bladder wall into the surrounding fat. Stage T4: Cancer penetrated into the adjacent structures (prostate, uterus, or vagina). Regional lymph nodes not involved yet. Stage T1-4N1-2M1-2: Cancer spread out of abdomen/pelvic wall to lymph nodes or distant organs like liver, lungs, or bones.
  9. 9. Hematuria Urinary tract infection
  10. 10. • Pain with metastasis • Any change in voiding/urine
  11. 11. PHYSICAL EXAMINATION URINALYSIS URINE CYTOLOGY CYSTOSCOPY
  12. 12. CT SCAN PYELOGRAPH Y BIOPSY ULTRA SOUND
  13. 13. Stop smoking Avoid exposure to industrial chemicals Avoid exposure to arsenic Eat healthy food Adequate fluid intake
  14. 14. MANAGEMENT Depends on:- Grade of tumor Stage of tumor Multicentricity
  15. 15. SURGICAL MANAGEMENT Transuretheral resection Cystectomy
  16. 16. Intra venous Intra vesical Topical
  17. 17. Intra-vesical BCG effective in: Superficial transitional cell carcinoma Carcinoma in situ Decreasing tumor progression
  18. 18. Radiation treatment can be used: As part of the treatment for early stage bladder cancer, after limited surgery As the main treatment for people with early stage cancers who can’t have surgery As part of the treatment for advanced bladder cancers To help prevent or treat symptoms caused by advanced bladder cancers
  19. 19. •Transurethral resection •Chemotherapy •Radiotherapy Trimodality therapy
  20. 20. Treating hematuria Hydrostatic therapy Instillation of formalin, phenol or silver nitrate
  21. 21. Other modalities of treatment….. Photodynamic therapy (PDT) Targeted therapies Gene therapy
  22. 22. COMPLICATIONS Regional metastasis through pelvis Metastasis to liver, lungs and bone
  23. 23. NURSING ASSESSMENT HEMATURIA RISK FACTORS IRRITATIVE VOIDING SYNDROME FATIGUE WEIGHT LOSS
  24. 24. ASSESSMENT CONT…… SIGNS OF METASTASIS FEELINGS ABOUT IMPOTENCE COPING ABILITY KNOWLEDGE OF DISEASE
  25. 25. NURSING DIAGNOSIS Impaired urinary elimination related to hematuria and transuretheral surgery Acute pain related to irritative voiding symptoms and catheter related discomfort Anxiety related to diagnosis of cancer
  26. 26. NURSING CARE/NURSING INTERVENTIONS Maintaining urinary elimination after TUS Controlling pain Relieving anxiety
  27. 27. PATIENT TEACHING Advise the patient about:- • Irritative voiding symptoms & Intermittent hematuria after TUR • Follow up schedule • Yearly cystoscopy

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