Nursing care for bladder

cancer

UNDER SUPERVISION:DR/NOUR RAGAB

GROUP:B6
 Prepared by

u Yathreb Bakr
u Naira samy
u Nurhan abdelnaby
u Mahmoud Alaa
u Mai abdelnaby
u Gamal abdelnasser
u Abdelrahman sabre
Objective

u At the end of the presentation students will able to :

u Identify the bladder cancer
u Dertmine the causes
u Know signs and symptoms
u Know risk factor and how to Diagnosis
u Know How to management
Out line

1. Introduction
2. Definition
3. Signs and symptoms
4. Risk factor
5. Stages
6. Diagnosis
7. Nursing care plan
Introduction

u Cancer is a disease caused when cells divide

uncontrollably and spread into surrounding tissues.
Cancer is caused by changes to DNA. Most cancer-
causing DNA changes occur in sections of DNA
called genes. These changes are also called genetic
changes.
 Definition

u What Is the Bladder? The bladder (sometimes called the urinary

bladder) is a balloon-shaped organ in your lower abdomen, near
the pelvis

u Bladder cancer is a common type of cancer that begins in the cells of the
bladder. The bladder is a hollow muscular organ in your lower abdomen
that stores urine. Bladder cancer most often begins in the cells (urothelial
cells) that line the inside of your bladder.
Pathophysiology

u Bladder cancer most often begins in the cells (urothelial cells)

that line the inside of your bladder. Urothelial cells are also
found in your kidneys and the tubes (ureters) that connect the
kidneys to the bladder. Urothelial cancer can happen in the
kidneys and ureters, too, but it's much more common in the
bladder.
Risk factors

u 1-Smoking. Smoking cigarettes, cigars or pipes may increase the risk

of bladder cancer by causing harmful chemical
u 2-Increasing age
u 3-Being male. Men are more likely to develop bladder cancer than
women are.
u 4-Exposure to certain chemicals.
u 5-Previous cancer treatment.
u 6-Chronic bladder inflammation
u 7-Personal or family history of cancer. If you've had bladder
cancer, you're more likely to get it again
Signs and symptoms

u 1--Bloodin your urine is the most common symptom of bladder cancer

blood in your urine is haematuria and it's usually painless.
u 2-Less common symptoms of bladder cancer include:a need to
urinate on a more frequent sudden urges to urinatea burning
sensation when passing urine
u 3-If bladder cancer reaches an advanced stage and has spread,
symptoms can include
u :pelvic pain
u Back pain
u weight loss
u Swelling of the leg
Stages

u There are different stages of bladder cancer:Stage 0

Stage I bladder cancerStage II bladder cancerStage
III bladder cancerStage IV bladder cancerBladder
cancer gradeRecurrent bladder cancer
Stages

u Stage 0
u The cancer is just in the inner layer of the bladder lining (stage 0a) OR there are
very early, high grade cancer cells only in the inner layer of the bladder lining
(stage 0is).
u Stage 1
u The cancer has started to grow into the connective tissue beneath the bladder
lining.
u Stage 2
u The cancer has grown through the connective tissue layer into the muscle of the
bladder wall.
Stages cont

u Stage 3
u The cancer has grown through the muscle into the fat layer and may have
spread to the prostate, womb or vagina. It might also have spread to
nearby lymph nodes.
u Stage 4
u The cancer has spread to the wall of the tummy (abdomen) or between
the hips (pelvis), to distant lymph nodes or to other parts of the body such
as the bones, lungs or liver.
Stages (cont)
Management of stages

u Stage 1,2
u Oral hydration of 2500ml/day
u (Unless contraindication for cardic or other reasons)
u Use low acid ,caffaine and alcohol free fluids
u Urinary analgesic oral agents
u Teach patient to report the location,intensity,quality,and pattern of
their pain discomfort
Management cont..

u Stage : 3,4
u Physical exam in clinical setting consider hospitalization
u Modification of therapeutic regimen.
u Administer pain relief agents urinary analgesics,narcotics ,anti
spasmodies
u Continue hydration,may require IV fluids ,monitor intake,out put
u Prepare for strile urinary catheterization
u Prepare for cystoscopy and fulguretion
Diagnosis

u Urinalysis
u CT scope
u Biopsy
u Cystoscope
Treatment

u Surgery to remove parts of the whole of the

Bladder cystocotomy to remove cancer
procedures name tranurethral reaction.
u Radiation therapy
Nursing care plan

The primary level of care for bladder cancer involves the initial
assessment, and referral processes. At this level, the focus is on
identifying potential bladder cancer symptoms and risk factors,
1. Health Promotion and Education:
- Promote awareness: Educate the general population and at-risk
individuals about the signs, symptoms, and risk factors associated with
bladder cancer.
- Healthy lifestyle promotion: Encourage healthy habits such as
smoking , maintaining a balanced diet, staying physically active, and
reducing exposure to occupational or environmental carcinogens.
 Nursing care plan (cont)

u Risk Assessment and Identification:

2.

u - Assess risk factors: Identify individuals with risk

factors for bladder cancer, including a history of
smoking, exposure to certain chemicals (such as
those used in the dye industry), frequent urinary
tract infections, or a family history of bladder
cancer.
 Nursing care plan (cont)

u The second level of care for bladder cancer involves specialized evaluation, treatment,
and ongoing management of the disease

1-Treatment planning: Based on the stage, grade, and individual factors,

develop a personalized treatment plan. The treatment options for bladder
cancer may include surgery, radiation therapy, chemotherapy,
immunotherapy,
Nursing care plan (cont)

2.Surgical Interventions:
- Radical cystectomy: In cases of more advanced bladder cancer, the surgical
removal of the entire bladder (radical cystectomy) may be recommended. This
procedure may also involve the removal of nearby lymph nodes and, in some cases,
the creation of a new way for urine elimination (urinary diversion).

u 3. Radiation Therapy:
u - External beam radiation therapy: This treatment involves the use of high-energy X-rays or other
radiation sources to target and kill cancer cells.
u - Brachytherapy: In some cases, radioactive materials may be placed inside the bladder (intravesical
brachytherapy) to deliver radiation directly to the cancer cells.
Nursing care plan (cont)

4.Systemic Therapy:
- Chemotherapy: Drugs may be administered orally or
intravenously to kill cancer cells throughout the body.
Chemotherapy can be used before surgery, after surgery (or in
cases of advanced or metastatic bladder cancer.

u 5. Follow-up:
u - Regular monitoring: After initial treatment, individuals with bladder
cancer require regular follow-up visits to monitor for any recurrence or
progression of the disease.
Nursing care plan (cont)

u The tertiary level of care for bladder cancer involves advanced treatment
options and specialized care for individuals with complex cases or advanced
stages of the disease.

u 1.Treatment Planning:
u -, including urologists, medical oncologists, radiation oncologists, pathologists,
radiologists, and other specialists, reviews the individual's case to develop a
comprehensive treatment plan.
Nursing care plan (Cont)

u 2- Immunotherapy: Utilize advanced immune checkpoint inhibitors or other

immunotherapies that enhance the immune system's ability to recognize and
attack cancer cells.
u 3 - Psychological support: Offer counseling, psychosocial support, and resources
to address emotional and psychological needs of patients and their families
during the treatment process.

u 4. Rehabilitation and Survivorship Programs:

u - Physical therapy: Provide specialized physical therapy services to help
individuals regain strength, mobility, and urinary function after surgery or other
treatments.
Nursing Care Plan (Cont)

u 1-Determine if the client has a 1 piece or 2 piece ostomy pouch.

u Gather your suppliesA new pouchA pouch clip or VelcroS
cissorsClean towels or paper towel Stoma powderStoma paste or a
ring sealSkin wipesA measuring card and pen
u 2-Wash your hands with soap and water
u 3-Remove the pouch
u 4-Put the old ostomy pouch in a plastic bag and put it in the trash.
Nursing Care Plan (Cont)

u 5-Clean the skin around the stoma with warm soap and water. And
dry the skin.
u 6-Check the stoma and skin around the stoma to make sure there
are no problems
u .7-Measure the stoma using the stoma measuring card and a pen,
u 8-Place the new pouch:
u 9-Attach any pouch clips or place the Velcro if needed.
u 10-Wash your hands again, following proper infection control
standards.
Nursing care plan (Cont)

u Care of Artificial bladder

u He bathes every day in the summer and twice in the
winter, even if we can't change his clothesHe goes to
the bathroom every two hours, and at least he runs
the water next to him to do training for bladder