Actor and model Paulo Zulu, 59, has shared on his Instagram some testimonials about how he has faced bladder cancer and what he has learned about the need to lead a healthy life and perform routine exams. He said he had already undergone a surgical procedure to remove a cancerous tumor in the bladder two years ago and, in February of this year, he had to undergo a new surgery.
The disease is the second most common type of cancer of the urinary system in Brazil, second only to prostate cancer, and has a higher incidence in men, according to Inca (National Cancer Institute). Those who have had bladder cancer once are more likely to develop the disease again, as was the case with Zulu.
“Unfortunately, 30% to 40% of patients already discover the disease in the advanced stage”, says urologist Bruno Benigno, from the Oncology and Urology Center at Hospital Alemão Oswaldo Cruz. When discovered early, the chances of cure are higher, around 80% to 90%.
What can cause bladder cancer and how to prevent it?
The disease, according to Alex Meller, urologist at Hospital Israelita Albert Einstein and professor at Unifesp (Federal University of São Paulo), is multifactorial, but the main risk factor is smoking.
“People who work in the chemical industry, with paints or solvents, and those who have recurrent urinary tract infections are also at greater risk”, says Meller. “Who has been exposed to petroleum derivatives for over 20 years and who has already undergone radiotherapy sessions as well”, adds Benigno.
Another risk group are patients who use a probe or who have had severe inflammatory processes in the bladder or urinary system, says Meller. People over 55 years of age and/or with cases of cancer in the family, especially bladder cancer, are also more likely to develop the disease.
To prevent bladder cancer, it’s important to get regular checkups and eliminate risk factors in general. Early diagnosis, as with all other types of cancer, is essential to increase the chances of cure.
Image tests, such as ultrasound and tomography, or urine tests, when blood is present, may indicate the possible existence of the disease. From then on, it is recommended that a bladder endoscopy with biopsy be performed to confirm whether it is indeed cancer and what type of tumor.
symptoms and treatment
According to Benigno, the main symptoms of bladder cancer are bleeding in the urine and pain when urinating. However, in many cases, the patient is asymptomatic, hence the importance of performing tests regularly.
There are different types of bladder cancer and the evaluation of the best treatment must be done on a case-by-case basis by a specialist doctor. However, in a simplified way, in general there are two cases: the advanced ones, in which the tumor has completely invaded the bladder, and the initial ones, in which it is located in the wall of the organ.
“If you detect the disease at the most superficial stage, a more localized treatment is usually done, with a bladder scraping to eliminate the tumor and then we apply a vaccine to the bladder that prevents the tumor from returning”, says Meller. “In some cases, chemotherapy can also be used inside the bladder”, says Benigno.
The cure rate in such cases is 80% to 90% and the patient only needs to follow up later to prevent the disease from returning. The indicated vaccine is BCG, which is available through the SUS (Single Health System), but there was a shortage last year.
When the tumor invades the bladder, it is necessary to remove the organ completely. “You can reconstruct the bladder with a reservoir made from the wall of the intestine or with the installation of a bag that stays in the patient’s abdomen”, explains Benigno. In this case, the cure rate drops to 50%.
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