[Fat Bear Science] Why are men more likely to develop bladder cancer? It turns out it’s related to this!

The bladder is a very important organ in the human body, but it is also a very fragile organ, especially for male friends. If you don’t take good care of it, you are likely to be attacked by bladder cancer.

Liu Nan, deputy director of the Urology Department of our hospital, said that in my country, the incidence of bladder cancer in men ranks seventh among all malignant tumors in the body, while that in women ranks after the tenth. However, the high incidence of bladder cancer in men is not entirely related to smoking and occupational factors, but mainly to the level of male hormones. In addition, chronic obstructive factors such as urinary retention, chronic inflammation caused by prostate hyperplasia and bladder stones can also increase the risk of bladder cancer.

Experts of this issue

Liu Nan

Liu Nan: Deputy Director of Urology Department of Chongqing Cancer Hospital, Chief Physician, Doctor of Medicine, currently a member of the Urology and Male Reproductive System Tumor Committee of the Chinese Anti-Cancer Association, a member of the Urology Physician Branch of the Chongqing Medical Association, a member of the Urology Group of the Minimally Invasive Surgery Committee of the Chongqing Medical Association, a member of the Chongqing Traditional Chinese and Western Medicine Urology Committee, and a standing member of the Urology Management Committee of the Chongqing Hospital Association. He also has a high level of attainment in minimally invasive cavity treatment of urinary system diseases and has accumulated rich experience in the diagnosis and treatment of patients with advanced renal cancer, renal pelvic cancer, prostate cancer, bladder cancer, penile cancer, etc. Clinic hours: Wednesday morning

So, how can we protect our bladder? You must know the following knowledge~

The incidence of bladder cancer in men is higher than that in women in my country

"In the past 10 years, bladder cancer has become one of the most common malignant tumors in clinical urology in my country." Liu Nan said that in my country, the incidence of bladder cancer in men ranks seventh among all malignant tumors in the body, while that in women ranks after the tenth.

In 2009, the incidence of bladder cancer in the National Cancer Registry was 6.61/100,000. By gender, the incidences were 11.41/100,000 and 3.51/100,000 for men and women, respectively. In 2009, the mortality rate of bladder cancer in the National Cancer Registry was 2.60/100,000. By gender, the incidences were 3.75/100,000 and 1.24/100,000 for men and women, respectively. This shows that the incidence of bladder cancer in men is 3.3 times that of women, and the mortality rate is twice that of women.

Smoking is the most established risk factor for disease

At present, the medical community generally believes that smoking is the most certain risk factor for bladder cancer. Studies have found that smoking can increase the risk of bladder cancer by 2 to 6 times. As the smoking time increases, the incidence of bladder cancer also increases significantly.

Another important risk factor is long-term exposure to industrial chemical products. About 20% of bladder cancer is caused by occupational factors. For example, people who work in printing and dyeing, petrochemical, leather and other manufacturing industries, or people who dye their hair for a long time and are exposed to dyes, paints, rubber and other chemical elements, are prone to "injury" to the fragile bladder.

Chronic inflammatory stimulation such as prostatic hyperplasia and stones can cause bladder cancer

However, Liu Nan believes that "the high incidence of bladder cancer in men is not entirely related to male smoking and occupational factors, but is mainly related to the level of male hormones." In addition, chronic obstructive factors such as prostate hyperplasia, as well as chronic inflammatory stimuli such as urinary retention and bladder stones, can also cause bladder cancer.

"Bladder cancer is divided into two types, one is the common urothelial carcinoma, accounting for 90%, and the other is adenocarcinoma, squamous cell carcinoma, small cell carcinoma, differentiated carcinoma, etc., accounting for 10%." Liu Nan said that diseases such as prostate hyperplasia and urethral stenosis cause chronic urinary tract obstruction, and long-term accumulation of tumorigenic substances in the bladder can easily cause bladder cancer, while local chronic long-term stimulation such as stones can cause bladder squamous cell carcinoma. Therefore, to prevent bladder cancer, male friends can start with lifestyle changes such as quitting smoking, drinking more water, and eating less meat.

The main symptom of bladder cancer is painless hematuria

"Bladder cancer is different from other cancers. Its main symptom is painless, visible hematuria throughout the entire process. As long as people have health awareness, it can be easily detected early." Liu Nan said that this is a hallmark symptom of bladder tumors and upper urinary tract tumors.

There are many situations in which hematuria occurs. For example, urinary tract infection can cause hematuria, but this type of infection has symptoms of frequent urination, urgency, and pain. However, hematuria caused by bladder cancer is painless. For example, a patient in the outpatient clinic will ask, "Doctor, I have blood in my urine." The doctor will ask, "Does it hurt?" "No." "Does your waist hurt?" Because kidney stones can also cause hematuria.

Bladder cancer is not only painless hematuria, but also hematuria with naked eyes throughout the process. There are many factors for microscopic hematuria, such as internal medicine diseases. Liu Nan said that although the symptoms of bladder cancer are relatively typical, some patients will think that it is due to excessive heat and fire when they find hematuria, and take some anti-inflammatory and heat-clearing drugs, thinking that drinking more water and resting will be fine. Some patients have already found bladder tumors, but they did not pay attention to them, and they came very late. This will not only cost patients more money for treatment, but also cause more pain, and it will increase the difficulty of treatment.

The 5-year survival rate of early bladder cancer patients with standardized treatment is 90%

"Generally speaking, once painless macroscopic hematuria occurs, cystoscopy can be performed to confirm the specific condition of the bladder." Liu Nan said that if a tumor is found, tissue can be taken for pathological biopsy to confirm the type of tumor. However, because cystoscopy is only performed under local anesthesia, some patients cannot tolerate it. If the bladder tumor is large, there are many blood clots, and the bladder is spasmodic, the patient will be in great pain.

Therefore, there is another clinical practice, which is to perform transurethral bladder tumor resection directly as soon as a bladder tumor is found. This has two advantages. First, because the operation is performed under general anesthesia, the tumor can be directly removed; second, the removed tumor can be pathologically examined to understand its nature and infiltration depth, and decide whether a second operation is needed, or whether a radical resection of the bladder tumor is needed. If the tumor infiltration is shallow, this transurethral resection can achieve the therapeutic effect.

"As long as early detection and standardized treatment are carried out, patients with bladder cancer can achieve long-term survival." Liu Nan said that bladder cancer can be divided into superficial layer, muscle layer, serosal layer, etc. Generally, superficial bladder cancer is treated with simple bladder tumor transurethral resection, followed by regular drug infusion and follow-up after surgery, and the 5-year survival rate can reach more than 90%, and the 10-year survival rate can reach more than 80%. However, if the patient does not have regular follow-up and drug infusion after surgery, the disease will be delayed. Because bladder cancer is very easy to recur, the 5-year recurrence rate can reach more than 40%.

Comprehensive bladder preservation treatment can also achieve complete resection

Because muscle-invasive bladder cancer and bladder squamous cell carcinoma are highly malignant and prone to distant metastasis such as lung metastasis, cystectomy is recommended. Although non-muscle-invasive bladder cancer is less likely to metastasize and only spreads locally, cystectomy is also recommended if it is high-risk, multiple, recurrent, the tumor is larger than 3 cm, and there is concurrent carcinoma in situ. This biological behavior is also equivalent to muscle-invasive bladder cancer.

So how can we prevent metastasis and improve prognosis? "Data show that it is recommended to do 2 to 3 courses of neoadjuvant chemotherapy before surgery, and then do surgery after chemotherapy, which can improve the survival rate by about 10%," said Liu Nan.

If you do not want to remove the bladder, there is currently a bladder-preserving comprehensive treatment method, which is to combine radiotherapy and chemotherapy after bladder tumor electroresection. Data show that bladder-preserving comprehensive treatment can also achieve the effect of complete resection, and the 5-year survival rate can reach 50~60%. However, the condition needs to be strictly monitored. Once the disease progresses or relapses, the bladder still needs to be removed. At present, our department has carried out bladder-preserving comprehensive treatment, and the effect is satisfactory.

5 steps to prevent bladder cancer

1. Develop good living habits, quit smoking and limit alcohol consumption.

2. Do not eat too much salty and spicy food, and do not eat food that is too hot, too cold, expired or spoiled.

3. Have a good attitude to deal with pressure, combine work and rest, and avoid overwork.

4. Strengthen physical exercise and improve physical fitness.

5. Live a regular life.

Text/ Fat Bear

Picture/ Internet

Reviewer/Liu Nan

Original article, please do not reprint without authorization

Chongqing Cancer Prevention and Treatment Science Popularization Base/Member of China Medical Self-media Alliance

Chongqing Science and Technology Commission Science Popularization Funding Project