{"id":13369,"date":"2024-08-23T00:43:59","date_gmt":"2024-08-22T22:43:59","guid":{"rendered":"https:\/\/valintermed.com\/?p=13369"},"modified":"2024-08-23T00:45:41","modified_gmt":"2024-08-22T22:45:41","slug":"rak-uroteliya","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/","title":{"rendered":"Urothelial cancer"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p>Urothelial cancer, or urothelial carcinoma, is a malignant neoplasm originating from the urothelial cells lining the bladder, ureters, and part of the urethra. This disease is characterized by a variety of clinical manifestations and can range from superficial forms that have a high chance of a favorable outcome after primary treatment, to invasive and metastatic variants. Urothelial carcinoma is the second most common cancer of the urinary system, and although it is more common in men, the proportion of women suffering from this disease is also noticeably increasing. Given the multifactorial nature of this cancer, understanding its features is critical for timely diagnosis and effective treatment.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" 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href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\" >History of the disease and interesting historical facts<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\" >Epidemiology<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\" >Genetic predisposition to this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Risk factors for the development of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Diagnosis of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Treatment<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >List of medications used to treat this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Disease monitoring<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Age-related features of the disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/urothelial-cancer\/#%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\" >Questions and Answers<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\"><\/span>History of the disease and interesting historical facts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Bladder cancer has been known since ancient times, as evidenced by inscriptions and medical treatises of ancient civilizations. In Ancient Egypt, for example, doctors made the first experiments in removing tumors and tumor formations. However, the terms and concepts associated with oncology appeared much later. In the 19th century, with the development of pathology and microscopy, more detailed studies of cells and tissues became possible. One of the first serious contributions to the understanding of bladder cancer was made by the German pathologist Gustav Roth, who in 1874 described various types of bladder tumors. In the 20th century, research focused on linking bladder cancer with exposure to carcinogens contained in tobacco smoke and some industrial chemicals, which became the basis for studying risk factors.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\"><\/span>Epidemiology<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Urothelial cancer is considered one of the most common malignant neoplasms worldwide. According to the Global Cancer Report provided by the International Agency for Research on Cancer (IARC), more than 573,000 new cases of bladder cancer were registered in 2020, with the highest prevalence in Central and Eastern Europe and North America. Statistically, men suffer from this disease three to four times more often than women. Studying the age aspect, it should be noted that the peak incidence is at 65-75 years. In recent decades, there has been a decrease in incidence rates, which is associated with both improved diagnostic methods and lifestyle changes, in particular, a decrease in smoking.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\"><\/span>Genetic predisposition to this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Genetic predisposition to urothelial cancer involves many molecular changes and microparticles. One of the key genes associated with this disease is the TP53 gene, which encodes a protein that plays an important role in cell cycle control and DNA repair. Mutations in this gene are found in more than 50% patients with the invasive form of the disease. Special attention is also paid to genes associated with metabolism, such as the 9p21 region, which can influence the development of carcinoma. Studies show that patients with hereditary syndromes, such as Li-Fraumeni syndrome, may also be predisposed to this cancer.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Risk factors for the development of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Risk factors that contribute to the development of urothelial cancer can be both physical and chemical. The main risk factors include:<\/p>\n<ul>\n<li>Smoking is considered the most significant factor, increasing the risk up to four times.<\/li>\n<li>Exposure to chemicals. This particularly applies to workers in industries that produce dyes, rubber, and other chemicals.<\/li>\n<li>Chronic inflammatory diseases. For example, cystitis and pyelonephritis can contribute to the development of tumors.<\/li>\n<li>Age: The incidence increases with age, especially after 65 years.<\/li>\n<li>Gender: Men are more susceptible to this disease than women.<\/li>\n<\/ul>\n<p>The combination of these factors significantly increases the risk, but not all people with these factors will necessarily develop urothelial cancer.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Diagnosis of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Diagnosis of urothelial cancer involves a comprehensive approach that includes anamnesis, physical examination, and a number of special studies. The main symptoms to look out for include:<\/p>\n<ul>\n<li>Hematuria (blood in urine).<\/li>\n<li>Pain when urinating.<\/li>\n<li>Frequent urge to urinate.<\/li>\n<li>Pain in the lumbar region.<\/li>\n<\/ul>\n<p>Laboratory tests are primarily aimed at detecting cancer cells in the urine. Radiological examinations such as computed tomography (CT) and magnetic resonance imaging (MRI) play an important role in assessing the extent of the disease. Cystoscopy, which allows visual inspection of the inner surface of the bladder and the taking of tissue samples for biopsy, is a key diagnostic step. An important component is also differential diagnosis, which requires excluding infectious diseases, bladder stones, or other benign neoplasms.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment of urothelial cancer largely depends on the stage of the disease, its characteristics and the general condition of the patient. The main treatment areas include:<\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<ul>\n<li>Surgical treatment: This may include transurethral resection of the tumor (TURBT) for superficial carcinomas, and radical cystectomy for invasive forms.<\/li>\n<li>Pharmacological treatment. This includes the use of chemotherapy, both adjuvant and neoadjuvant. The most commonly used drugs are cisplatin and gemcitabine.<\/li>\n<li>Immunotherapy. It is increasingly used, especially in cases where standard treatments are ineffective.<\/li>\n<li>Radiation therapy. Can be used both for palliative treatment and for the treatment of certain types of tumors.<\/li>\n<\/ul>\n<p>Combination treatment is often the most effective, and the regimen is determined individually for each patient by a specialist.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>List of medications used to treat this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The following drugs are used in the treatment of urothelial cancer:<\/p>\n<ul>\n<li>Cisplatin.<\/li>\n<li>Gemcitabine.<\/li>\n<li>Docetaxel.<\/li>\n<li>Pemetrexed.<\/li>\n<li>Atezolizumab (immunomodulator).<\/li>\n<li>nivolumab (immunomodulator).<\/li>\n<\/ul>\n<p>Each of these drugs can be used depending on the stage of the disease and the general condition of the patient.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Disease monitoring<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Monitoring of patients with urothelial cancer involves regular examinations to detect possible recurrence. Monitoring steps typically include:<\/p>\n<ul>\n<li>Regular cystoscopies to monitor the condition of the bladder.<\/li>\n<li>Laboratory tests to measure levels of cancer markers.<\/li>\n<li>Monitoring the patient&#039;s general health.<\/li>\n<\/ul>\n<p>The prognosis of the disease depends on many factors, including the stage at diagnosis and the response to treatment. Complications may include the development of metastases and relapses.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Age-related features of the disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Urothelial cancer manifests itself differently depending on the age group. In older patients, the disease is often diagnosed at a later stage due to the absence of typical symptoms or their ignoring. In younger patients, the disease is often less aggressive, but high-risk groups such as smokers may experience more serious forms. In children, urothelial cancer is extremely rare, but may be associated with hereditary factors or concomitant diseases such as syndromes of infectious origin.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\"><\/span>Questions and Answers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><strong>What are the main symptoms of urothelial cancer?<\/strong> The main symptoms include hematuria, painful urination, frequent urination, and pain in the lumbar region.<\/li>\n<li><strong>What are the key risk factors for developing urothelial cancer?<\/strong> Key risk factors include smoking, chemical exposure, chronic infections and age.<\/li>\n<li><strong>How is urothelial cancer diagnosed?<\/strong> Bladder cancer is diagnosed using cystoscopy, mammography, and laboratory and imaging tests.<\/li>\n<li><strong>What are the main treatments for urothelial cancer?<\/strong> The main treatment methods include surgery, chemotherapy, immune therapy and radiation therapy.<\/li>\n<li><strong>What is the prognosis for patients with urothelial cancer?<\/strong> The prognosis depends on the stage of the disease at the time of diagnosis, but modern treatment methods significantly improve the chances of recovery.<\/li>\n<\/ul>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Urothelial cancer, or urothelial carcinoma, is a malignant neoplasm that originates from the urothelial cells lining the bladder, ureters, and part of the urethra.<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[298],"tags":[],"class_list":["post-13369","post","type-post","status-publish","format-standard","hentry","category-medlibrary"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13369","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=13369"}],"version-history":[{"count":2,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13369\/revisions"}],"predecessor-version":[{"id":13550,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13369\/revisions\/13550"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=13369"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=13369"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=13369"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}