Symptoms control for patients with superficial bladder cancers before and after TURBT and intravesical epirubicin instillation

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Date: January-February 2017
From: Urologic Nursing(Vol. 37, Issue 1)
Publisher: Jannetti Publications, Inc.
Document Type: Report
Length: 2,564 words
Lexile Measure: 1390L

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Bladder cancer is one of the most common cancers among urologic cancers. Intravesical instillation following transurethral resection of bladder tumor (TURBT) is used as a treatment of bladder cancer. According to results of this study, before and after intravesical instillations following TURBT have no effect on symptom outcomes of patients with superficial bladder cancer.

Key Words: Bladder cancer, transurethral resection of bladder tumor (TURBT), intravesical instillation, nursing care, symptom assessment.


Bladder cancer is the ninth most common cancer, with 430,000 new cases diagnosed annually according to the Globocan 2012 report of The International Agency for Research on Cancer (Ferlay et al., 2013). Specifically for men, bladder cancer is the sixth most common cancer, with 330,000 new cases diagnosed annually (Ferlay et al., 2013). For women, bladder cancer is the 19th most common cancer, with 99,000 new cases diagnosed each year (Ferlay et al., 2013). Belgium, Lebanon, Malta, Turkey, Hungary, Denmark, and Norway each report high incidences of this disease (Ferlay et al., 2013).

Several factors, including age, sex, diet, and exposures to aromatic amines, polycyclic aromatic hydrocarbons, cyclophosphamide, chlornaphazine, and radiation have been linked to an increased risk of developing bladder cancer (Piyathilake, 2016). Tobacco smoking has been identified as the most major risk factor (Babjuk et al., 2011), and genetic factors are the other important risk factor in the development of bladder cancer (Babjuk et al., 2013).

The most common symptoms of bladder cancer are microscopic and macroscopic painless hematuria; other symptoms include frequency, urgency, and dysuria (Burke, Mohn-Brown, & Eby, 2011). Superficial bladder cancer comprises 70% of bladder cancers (Isharwal & Konety, 2015). According to the Tumor, Node, Metastasis (TNM) classification, non-invasive papillary carcinoma (Ta), mucosa-limited carcinoma in situ (Tis), and tumors growing inside the subepithelial connective tissue (Tl) are among superficial bladder cancers (Babjuk et al., 2013; Sobin, Gospodariwicz, & Wittekind, 2009). Ta, T1, and Tis lesions comprise 70%, 20%, and 10% of superficial bladder cancers, respectively (Isharwal & Konety, 2015.

The most commonly used and prioritized treatment of superficial bladder cancers is transurethral resection of bladder tumor (TURBT) and a concomitant intravesical instillation immediately after (Babjuk et al., 2015). Bacillus Calmette-Guerin (BCG), mitomycin C, epirubicin, and doxorubicin are chemotherapy agents used for intravesical instillation (Shelley, Mason, & Kynaston, 2010). Bacillus Calmette-Guerin therapy is effective at preventing tumor recurrence, but it is recommended for patients with intermediate and high-risk tumors due to high risk of toxicity (Oddens et al., 2014). An immediate intravesical instillation of a chemotherapeutic agent, such as mitomycin-C or epirubicin, following TURBT is also effective at preventing tumor recurrence in patients with low-risk tumors (Babjuk et al., 2015; Shelley et al., 2010).

Anecdotal data from the study site identified patients reporting adverse effects, such as pain, tiredness, and drowsiness, after TURBT with an intravesical instillation. Symptoms may be increased to due to the present malignant process and the local or systemic side effects of an intravesical instillation of a chemotherapeutic agent. The purpose of this study was to compare the symptoms of patients before...

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Gale Document Number: GALE|A491087291