Summary
Bladder cancer is a heterogeneous disease in molecular, histological and clinical aspects. Treatment should also be considered from different angles - surgery, intravesical chemo- or immunotherapy, radiation therapy and lifestyle changes. Intravesical treatment of superficial bladder cancer with Еpirubicin or Bacillus Calmette-Guérin (BCG) is a continuation of surgical treatment to reduce or eliminate further recurrence.
The relation between systemic autoimmune diseases that affect women in their reproductive age and the neoplasms of the lower genital tract caused by high-risk HPV strains are studied in many investigations. The studies have been focused mainly on patients with systemic lupus erythematosus exposed to glucocorticoids and immunosuppressive therapy. A higher risk of HPV infection persistence and premalignant and malignant cervical lesions formation is found among them. There are similar, though scantier data about other systemic rheumatic diseases – rheumatoid arthritis, Sjögren‘s syndrome, and systemic sclerosis. Presumably, this fact is determined by specific features of autoimmune inflammation and the impact of immunosuppressive treatment. It contributes to human papilloviruses persistence and their integration into cervical cells. HPV vaccines use in these patients have proved to be safe and effective, and is an object of special interest.
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