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Cancer of the BladderDr Kingsley’s comments Cancer of the Bladder. More than 5000 people die every year from cancer of the bladder in the United Kingdom, with three men to every one woman. There are two causes that are generally accepted, namely tobacco smoking and exposure to particular dyes called aniline dyes, although some sufferers have never been exposed to either, to their knowledge. Occasionally cancer develops in a pouch (a diverticulum), in which urine has tended to become stagnant. A particular parasite (Schistosoma haematobium) is rarely involved. Signs and Symptoms. As with cancer of the kidney, the first sign is usually blood in the urine without any pain. Less often the first sign may be a burning pain when passing urine (cystitis) or passing urine more often than usual (urinary frequency) or a pain in the loin, possibly caused by the cancer obstructing the flow of urine from one of the tubes passing urine into the bladder from the kidneys (ureter). If the cancer has already spread locally before any of the usual early features have appeared, pain in the lower back or somewhere in the pelvis may start. A clinical examination by a doctor usually reveals very little to make him suspicious of the diagnosis. In advanced disease, however, the person may look generally ill with weight loss and occasionally, because of blockage to the flow of urine from the kidneys into the bladder, an enlarged kidney may be felt. An Explanation by Dr Kingsley Before Your Consultation about your Bladder Cancer Most consultations with doctors are fairly quick affairs, lasting perhaps five minutes, even if you are suspected of having cancer in your bladder. You may be lucky to have more time spent on you, but when you have your consultation with me, I will spend as much time as you want. There is no time limit. We will take as long as you want. Often when I see some people for the first time, they are in a state of panic. They haven’t a clue what it is all about. No one has explained anything to them. Perhaps in the past they have been admitted for an emergency operation, or they had simply been told to come into hospital on such-and-such a day when they were either operated on or started a course of chemotherapy or radiotherapy. Once in hospital some sort of explanation may have been given, and you were probably seen by a junior doctor who not only took a short history of any symptoms you had, but also examined you to look for any signs of your bladder cancer, but, by then, you were already captive and didn’t really have much choice in the matter. To be fair to doctors, they assume that their advice is the best on offer. After all, they are the experts. Virtually all doctors would treat your condition in roughly the same way, so it seldom occurs to them that you just might not want to follow their advice. In any case, most patients have been frightened by their diagnosis and want to get on with the treatment, assuming that the doctor can deal with it for them. Most people put their faith in their doctor, assuming he knows what he is doing. There is absolutely no intention on my part to tell you whether to follow your doctor’s advice of not. That is a decision you have to make. No one can make it for you, but I will help you make up your mind. The Consultation The virtual consultation with me has been planned as though you are with me in my consulting room. I will go though your history, or the history that I come across so often, explaining the parts of it that give me clues to the cause of people’s problems. The chances are that, having taken a medical history from many thousands of patients over nearly forty years of medical practice, especially in the detail that I find so valuable, it is likely that much of it will be appropriate to you. The consultation is one of the longest parts of this programme, as you would imagine, and it is full of fascinating information. Periodically I lecture to medical colleagues on the subject of ‘What a clinical history and the clinical examination can tell me’. All this information is the result of my many years of listening to patients, letting them tell their stories, believing in their observations that have often been ignored, and learning by experience. So, enjoy yourself, feel enlightened, smile, be happy and radiate confidence in what you are going to do. Be positive and forget the doom and gloom merchants. If someone has given you a poor prognosis, forget it. You no longer fit into their statistics. You are going to do something for yourself. You are now in charge. ---------------------------------------- What you do now is in your own hands. We would like you to take advantage of all the benefits of becoming a member of our Cancer Help Centre , which is free to join, so please look at the Members’ Area Overview, where you will find a summary of all that is on offer. |
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