Living with Bladder Cancer

In some patients with bladder cancer, the cancer can be completely eliminated or eliminated with treatment (chance of cure). However, anticipating the end of treatment can be both stressful and worrying. You may be relieved that you have finished the treatment, but it is impossible not to worry about the recurrence of the cancer. If you have been diagnosed with cancer, this feeling and anxiety is very common and always will be.

In some other patients, with treatment, bladder cancer may never be completely removed (no chance of cure) or may recur elsewhere in the body. There may be a need for regular treatment with chemotherapy, immunotherapy, or other treatments to try to keep the cancer under control. Learning to live with completely incurable cancer can also be very difficult and very stressful.

Life after bladder cancer means going back to some routines and also making some new choices.

Tracking and Control

Patients with bladder cancer have a very high risk of recurrence after treatment and therefore require close monitoring at regular intervals. During these checks, your doctor will ask questions about any problems you are experiencing and may request examinations, laboratory tests and imaging tests regarding cancer symptoms and/or side effects of treatment. The side effects of some treatments can last for a long time and can occur even years later. This is a good time to ask your doctor questions at checkups, and is an opportunity to share any changes or problems you notice, or any concerns you have.

Your examination and examination program will depend on the stage and grade of the cancer, what treatments you have received, and some other factors. It is recommended that you follow your doctor’s recommendations regarding the tests to be requested in the follow-ups.

Check-ups are recommended every 3 to 6 months, even for people who have no signs of cancer after treatment. At these checkups, urine tests, physical exams, imaging tests (such as X-rays, MRIs, or CT scans) and blood tests to see if the cancer has recurred or a new tumor has developed in the bladder or renal pelvis and ureters, and if your bladder has not been removed, at least Regular cystoscopy examinations will also be performed every 3 months for the first 2 years. These doctor visits and examinations will be made less frequently as time goes on and there are no new negative findings.

If your bladder has been removed and a urinary diversion has been performed (artificial bladder, ileal loop), you will be asked to be checked for signs of infection and changes in the function of your kidneys. Urine tests, blood tests and some imaging methods can be used to do this. Tests will also be done to look for signs of cancer in other parts of your urinary tract (kidney tract). Vitamin B12 levels will be checked at least once a year, as it can affect B12 absorption in patients using the gut. Your doctor will also talk to you about how well you can control your urine.

Follow-up and planning of daily life

  • 1- It is useful to have a schedule and timing for early detection tests for secondary cancer types that may be other than bladder cancer or for some screening tests you may need to investigate the effects of cancer treatment on general health in the long term.

  • 2- It is very important to get information about possible late or long-term side effects of your treatment, including what to watch out for and when to contact your doctor.

  • 3- It is useful to discuss with your doctor about the known dietary and physical activity recommendations and determine what the diet and physical activity regime will be.

  • 4- Keeping regular records of all transactions in physical or electronic media and keeping them under a file is a factor that prevents mistakes in the management and administration of the disease.

  • 5-Tests, doctor visits and treatments can be very costly, calculating and planning the cost is another aspect of this business.

  • 6-At some point in your cancer treatment, you may find yourself seeing a new doctor who is unaware of your medical history. It is important to keep copies of your medical records to give your new doctor details of your diagnosis and treatment.

Can I reduce the risk of cancer progression or recurrence?

For patients with bladder cancer, it is important to know about things that can reduce the risk of cancer growth or recurrence, such as exercise, a certain type of diet, or diet. A healthy-natural diet can reduce the risk of bladder and other cancers. However, studies to date have not found conclusive evidence that any vitamin or food supplements help prevent bladder cancer.

General recommendations for preventing progression or recurrence of bladder cancer include:

  • 1- Not smoking, It has been confirmed that smoking increases the risk of tumor recurrence and progression. Although it is still controversial whether smoking cessation of bladder cancer patients will positively affect the outcome of treatment, patients are advised to definitively quit smoking because of the overall risks associated with tobacco smoking.

  • 2-Eating naturally It is recommended to adopt healthy behaviors such as doing regular physical activity and staying at a healthy weight, but there is no publication that can be considered as evidence on this subject yet. Still, we know it can have positive effects that can lower your risk of developing bladder cancer or other cancers.

  • 3- Food supplements: So far, no dietary supplement (including vitamins, minerals, and herbal products) has been shown to clearly help reduce the risk of bladder cancer progression or recurrence. This doesn’t mean that no supplements will help, but it’s important to know that none of them have been proven to do so. It is recommended that you do not allow food supplements and complementary medicine products to harm you, and that you stay away from products that will hinder or hinder your current treatment. Although there are limitations to the use of such dietary supplements, proof of efficacy and safety is not required before being sold. So if you’re considering taking any type of nutritional supplement, talk to your healthcare team. They can help you decide which ones you can safely use while avoiding those that may be harmful.

What would it be like to return to daily life and routines after bladder cancer?

For patients with urostomy: If you have had a radical cystectomy and are carrying a urostomy bag on the abdominal wall, you may even worry about daily activities at first. You may need to change some of your daily routines due to changes in the way you urinate. Other sexual issues can also be cause for concern, and it’s perfectly normal to have worries and concerns as you get used to such a big change. Adhering the urostomy bag in the right direction, fitting it correctly, and emptying it before sex reduces the possibility of urine leakage. It may be important to choose sexual positions that prevent your partner’s weight from rubbing against the pouch. To assist patients with urostomies, healthcare professionals specially trained can teach you to care for a urostomy and help you cope with the changes it brings. You can also get help about programs that offer information and support in your area, and some associations.

Sexuality: In radical cystectomy, prostate and seminal vesicles are also removed along with the bladder, and these changes affect your sex life deeply. These structures form the semen, removing them means a man will no longer ejaculate. In other words, there is a dry orgasm, semen is not possible. Due to nerve damage during surgery, erection abilities are negatively affected in many male patients. This erection problem may improve somewhat over time in some patients. The younger the patient, the more likely he is to regain the ability to have a full erection. This issue should be discussed with the healthcare team before surgery. New surgical techniques are claimed to bring some improvements to reduce the likelihood of erection problems.

Sexual effects of radical cystectomy in women: This surgery removes the uterus, ovaries, and usually the ⅓ upper/front part of the vagina. This can often make sex very uncomfortable for women. Reconstructing the vagina may require a related intervention (vaginal reconstruction). Whether you’re reconstructed or not, there are many ways to make sex more comfortable. During radical cystectomy, if the nerve bundles that run on either side of the vagina are damaged, it can affect the ability to orgasm. In cases where the entire urinary tract (urethra) along with the bladder must be removed, blood flow to the clitoris may be affected, which may affect sexual arousal.

Emotional support: It’s normal to feel a little depressed, anxious, or anxious when bladder cancer is a part of your life. Some people are affected more than others. However, patients can seek help and support from friends and family, some religious groups, some support groups and associations, more professional counselors, or other people if they wish.

Secondary Cancers After Bladder Cancer

Patients with bladder cancer can get another type of cancer, a secondary cancer. Patients diagnosed with bladder cancer are at a higher risk of developing some other secondary cancer types than the normal population. These are called secondary cancers. Many of these cancers have been clearly associated with smoking, a major risk factor for bladder cancer.

Other than bladder cancer, the types of cancer you can get are:

  • Secondary bladder cancer of another type (a different type from the primary cancer)

  • Renal pelvis / ureter cancer (ureter, tubes connecting the kidney to the bladder; the part where the kidney is connected is called the renal pelvis), the risk is quite high (4-7%)

  • pancreatic cancer

  • Larynx cancer (larynx)

  • Esophageal cancer

  • Lung cancer (most common, accounting for ¼ of secondary cancers that develop in patients with bladder cancer)

  • Vaginal cancer

  • Prostate cancer

  • kidney cancer

  • rectal cancer

  • Skin cancer (excluding basal and squamous cell skin cancers)

  • acute myeloid leukemia (AML)

Most experts do not recommend any routine screening test to screen for secondary cancers unless you have symptoms.

Can I reduce my risk of developing a second cancer?

There are steps you can take to reduce your risk and stay as healthy as possible. One of the most important things you can do is stop using any type of tobacco and stay away from tobacco smoke. Smoking increases the risk of many secondary cancers seen after bladder cancer, as well as many other cancers.

Bladder cancer survivors should also:

  • Absolutely quit smoking

  • Reach and maintain a healthy weight

  • Be physically active and limit the time you spend sitting or lying down.

  • Eat foods rich in fruits, vegetables and whole grains or, conversely, limit red and processed meats, sugary drinks and highly processed foods and plan a healthy diet that avoids them.

  • It is best not to drink alcohol. If you drink, limit the amount of it as much as possible.

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