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

1. Mrs. Shaina Sharma
R.N, MSc. N

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. 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

5. High
urinary pH
High
cholesterol
intake
Pelvic
radiation
therapy
Cancers
arising
from
prostrate, c
olon &
rectum

6. 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

7. CLASSIFICATION
90% of bladder cancers are transitional cell
carcinoma. The other 10% are squamous cell
carcinoma, adenocarcinoma, sarcoma, small
cell carcinoma,

8. STAGES OF BLADDER
CANCER

9. 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.

10. Hematuria
Urinary tract infection

12. • Pain with
metastasis
• Any change in
voiding/urine

13. PHYSICAL
EXAMINATION
URINALYSIS
URINE
CYTOLOGY
CYSTOSCOPY

14. CT
SCAN
PYELOGRAPH
Y
BIOPSY
ULTRA
SOUND

15. Stop smoking
Avoid exposure to industrial chemicals
Avoid exposure to arsenic
Eat healthy food
Adequate fluid intake

16. MANAGEMENT
Depends on:-
Grade of
tumor
Stage of tumor
Multicentricity

17. SURGICAL
MANAGEMENT
Transuretheral
resection
Cystectomy

18. Intra
venous
Intra
vesical
Topical

19. Intra-vesical BCG effective
in:
Superficial
transitional cell
carcinoma
Carcinoma in situ
Decreasing tumor
progression

20. 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

21. •Transurethral resection
•Chemotherapy
•Radiotherapy
Trimodality
therapy

22. Treating hematuria
Hydrostatic
therapy
Instillation of
formalin, phenol
or silver nitrate

23. Other modalities of treatment…..
Photodynamic
therapy (PDT)
Targeted
therapies
Gene therapy

24. COMPLICATIONS
Regional
metastasis
through
pelvis
Metastasis
to liver, lungs
and bone

25. NURSING ASSESSMENT
HEMATURIA
RISK
FACTORS
IRRITATIVE
VOIDING
SYNDROME
FATIGUE
WEIGHT
LOSS

26. ASSESSMENT CONT……
SIGNS OF
METASTASIS
FEELINGS
ABOUT
IMPOTENCE
COPING
ABILITY
KNOWLEDGE OF
DISEASE

27. 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

28. NURSING CARE/NURSING
INTERVENTIONS
Maintaining
urinary
elimination
after TUS
Controlling pain
Relieving
anxiety

29. PATIENT TEACHING
Advise
the
patient
about:-
• Irritative voiding symptoms
& Intermittent hematuria
after TUR
• Follow up schedule
• Yearly cystoscopy