Why does bladder cancer recur?

Patients who have undergone bladder cancer surgery should go to the hospital for regular checkups. Regular checkups are generally done every three months. If there is no recurrence after one year, the checkup period can be appropriately extended. Like all cancers, the most worrying issue for bladder cancer patients after surgery is postoperative recurrence and metastasis. Most patients who undergo bladder preservation surgery will relapse within two years. Let's learn about the knowledge of bladder cancer recurrence.

The most common sites of recurrence of bladder cancer after surgery are: local lymph nodes in the near area, and lungs, liver, bones, etc. in the distant area.

Patients who have undergone bladder cancer surgery should undergo regular checkups even if they do not have any adverse symptoms. The checkups include:

1. Cystoscopy is mainly suitable for patients who retain their bladder. Since the recurrence of bladder cancer may also occur in the renal pelvis, ureter, and urethra, a negative cystoscopy cannot completely rule out the possibility of bladder cancer recurrence.

2. Urine exfoliative cytology is simple and easy to perform. It is not expensive and does not cause any pain. It can be used as the main means of regular review.

3. X-ray examination. Mainly chest X-ray. It can detect whether there is metastasis in the lungs.

4. Blood tests for carcinoembryonic antigen (CEA) and other tumor markers can help determine whether bladder cancer has distant recurrence or metastasis. 5. B-ultrasound examination of the liver and local lymph nodes can reveal liver metastasis. If local lymph nodes are metastatic or adjacent tissues are invaded, the patient may have discomfort or pain in the lower abdomen. For patients who retain their bladder, signs of recurrence include hematuria, frequent urination, painful urination, and even difficulty urinating or urine retention. The above symptoms may also occur due to urinary tract infections, urinary stones and other diseases. Therefore, discomfort or hematuria after surgery does not necessarily mean that bladder cancer has recurred. Only after further examination can it be confirmed whether bladder cancer has locally recurred or metastasized.

To prevent recurrence, patients should go to the hospital for regular checkups after bladder cancer surgery. Patients who retain their bladders can receive BCG or other drugs instilled into the bladder cavity after surgery to prevent recurrence. Before instilling BCG into the bladder, the urine should be emptied first. You cannot urinate for two hours after instillation, and change your body position every 15 minutes during this period. Six BCG instillations constitute a course of treatment, and then once a month for two years. Its adverse reactions include frequent urination, painful urination, and low fever. A small number of patients may develop tuberculous cystitis and need to receive anti-tuberculosis treatment if necessary. Interleukin-2 and chemotherapy drugs can also be used for bladder instillation, and specific use should be in accordance with the doctor's instructions. Whether patients with complete cystectomy need systemic treatment to prevent recurrence should be determined by the doctor based on the specific situation.

If bladder cancer recurs after surgery, patients should not be negative or resist and should accept re-treatment, as there is still a possibility of cure. For patients who retain their bladder, surgical treatment is still the main treatment for bladder cancer recurrence. The principle is the same as that of initial treatment, that is, the tumor is limited to the mucosa or submucosa, and only local resection or electrocautery is performed. This operation can be performed repeatedly. Since most patients have undergone BCG infusion before, other drugs should generally be used for infusion after re-surgery, such as mitomycin, doxorubicin (adriamycin), etc.; if the tumor invades the local muscle layer, partial cystectomy can be considered; if the tumor is large, full cystectomy should be used. Advanced patients or patients who cannot undergo surgery due to other conditions. Laser treatment can be used to relieve bladder cancer symptoms and control bleeding. Of course, radiotherapy can also be considered for patients with pain and dysuria caused by metastasis to local pelvic lymph nodes or organs adjacent to the bladder.

The above is some of the knowledge we have prepared for you today about why bladder cancer recurs. We hope it will be helpful to you. If you have any other needs, you can also consult our online consulting experts. We are always here to answer your questions.

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