Cancer, Bladder


Acknowledgement

I wish to thank Dr. Andrew Dziewit for his work on this chapter in an earlier edition of this book.

Risk

  • Primary risk factor is smoking; smokers are more than twice as likely to get bladder cancer compared with nonsmokers.

  • Incidence: males 37 per 100,000; females 9 per 100,000.

  • No associated increased risk with alcohol or caffeine consumption.

  • Median age of diagnosis: 73 y.

  • Greater for Caucasian than for African Americans.

  • Quitting smoking decreases risk over time (baseline in 5–8 y).

  • Incidence on a decline since 1999.

Perioperative Risks

  • Risks vary based on surgical procedure and coexisting disease

  • Chemotherapy: Pulm fibrosis and renal and cardiac dysfunction

  • Fatty infiltration of liver in those with poor nutritional status

  • Protein-calorie malnutrition resulting from cancer, metabolism, anorexia, anemia, hypoalbuminemia and dehydration

Overview

  • Transitional cell cancer generally a systemic disease at time of Dx; 60% of patients will die of metastatic complications.

  • Pts are typically elderly with long Hx of smoking, thereby promoting concurrent diseases: COPD, lung CA, atherosclerosis, angina, CAD, CHF, and Htn.

  • Chemotherapy/radiation therapy may be used preop, thus complicating periop period.

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