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TITLE:

CHALLENGES IN THE MANAGEMENT OF BLADDER TUMOUR

AUTHORS:

Hassan Mumtaz, Mumtaz Ahmad, Ayesha Zafar, Tehreem Fatima, Shamim Mumtaz.

ABSTRACT:

Bladder cancer is a relatively common type of CA that most often arises in urothelilal cells lining inside of bladder. Most bladder cancers can be detected at an early stage, where treatments might be highly effective, however early stage CA may recur even after successful treatment, therefore follow up is mandatory. We present a 65 years old Female Presented on 22 June 2020 with Gross and painless hematuria since 4 days. An Ultrasound abdomen & pelvis was done revealing soft tissue mass, measuring 19x25x32 mm, directed inwards, arising from the left-posterior aspect of urinary bladder. A Cystoscopy/TURBT was done showing a solitary, papillary growth, more than 3 cm in size arising just above and lateral to the left ureteric orifice. Cold cup biopsy was taken from the base of the tumor during TURBT, which showed Papillary Urothelial Carcinoma, high grade pTa stage. There was a poor patient compliance as she was unwilling to undergo a repeat cystoscopy, so only a intravesical mitomycin could be given for 6 weeks. Repeat TURBT is gaining widespread importance in evaluating the recurrence of bladder tumor. The primary reason for the recurrence is noncompliance of patients and an inability to follow-up after initial TURBT. There needs to be a strong doctor-patient relationship, responsible information sharing, mutual trust and a clear understanding of options in case of a recurrence for the disease to be properly managed. With appropriate doctor training and research upon the various modalities of treatment for BCA, the disease prognosis may be significantly improved.

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