The bladder is the part of our urinary tract responsible to store our urine until we are ready to let it out. When the cells in the inside lining of the bladder begin to proliferate incessantly and abnormally, it leads to bladder cancer. Though people of any age may get bladder cancer, old people are more vulnerable to the bladder cancer. The average age at which this cancer is diagnosed is 73 years and men are 5 times more likely to have a bladder cancer than women.
To better cope with the disease, one must have a better understanding of the symptoms he/she is experiencing, bladder cancer causes, diagnosis and its treatment options. Before jumping to further details, let’s have a look at the types of the bladder cancer.
Types of Bladder Cancer
Sometimes, more than one type of cells may be involved in bladder cancer. Depending on which bladder cells become cancerous, there are following different types of bladder cancer:
- Transitional cell carcinoma affects the transitional cells which are found in the lining of the urinary bladder, also known as urothelial and the cancer is also called urothelial cancer. These are functional when bladder contracts and relaxes. They all join together when there is no urine in the bladder and they stretch out into a single layer when the bladder is full of urine. Transitional cell carcinoma appears when these cells come in contact with the waste products such as toxic chemicals in urine.
- Squamous cell bladder is usually caused by an infection such as schistosomiasis and irritation in a bladder.
- Adenocarcinoma is a tumor in the mucus-secreting glands of the urinary bladder.
Bladder Cancer Causes and Risk Factors
Tumor in the bladder develops when cells in the organ start to grow abnormally and due to mutations, these cells grow out of control, not die and accumulate to form a clump or tumor. The causes of the abnormally growth and mutations of cells are not completely known. Following factors are linked to causing mutation of the bladder cells and causing them to grow in an uncontrolled fashion and not die, thus, forming a tumor.
Different Bladder Cancer Causes:
- Harmful chemicals in smoking may damage the bladder lining: During smoking, these harmful chemicals accumulate in the urine which may damage the bladder lining increasing the risk of bladder cancer
- Advancing age: Though this cancer can occur at any age, it is commonly found in people older than 40
- Exposure to chemicals such as those used in textiles, rubber, leather and paints: Our kidney is responsible for filtering chemicals from our blood and transferring them into the bladder. Due to this function of the kidney, exposure to chemicals increases the risk of having bladder cancer
- Diet: Regular diet comprises large portions of fried meat and animal fats are one of the main risk factors for developing the cancer of the bladder. Not including enough water intake in your daily routine also increases the chances of this cancer along with other serious conditions like liver damage or stones in kidney
- Radiation treatment in pelvic area for cancer treatment
- Medicines for the treatment of diabetes such as pioglitazone
- Inflammation of bladder such as cystitis, UTIs, schistosomiasis
- Family history of cancer
Bladder Cancer Signs and Symptoms
In this type of cancer, the majority of symptoms are related to urination and often severe symptoms do not show in the early stages. Therefore even at the appearance of slightest signs, you should see your primary care doctor right away. Also, you may consider getting screening tests if you fall under the category of risk factors of cancer.
Signs and Symptoms indicating that you might have Bladder Cancer
- Blood in urine (haematuria)
- Frequent urge to urinate
- Pain and burning sensation during urinating
- Pain in the back, abdominal area and pelvic area
When to see a Doctor?
These are general symptoms and not very specific, meaning they might be linked with various other conditions that have nothing to do with cancer. If there is a blood in the urine, that’s an alarming sign and you should see your doctor immediately. Blood in the urine may also indicate Urinary Tract Infection, benign tumors or kidney/bladder stones. For other symptoms as well, it is important to be assessed by your primary care doctor. The sooner this cancer is diagnosed, the more high chances of its successful treatment.
Bladder Cancer Diagnosis
Like all other cancers, if detected early, bladder cancer has high chances of successful treatment. By diagnosing, other conditions can also be found that are causing symptoms and can be serious.
- Medical interview & physical examinations: You will be asked about your medical history, symptoms you are facing, your lifestyle to evaluate the risk of your bladder cancer. The doctor might also physically test your rectum or vagina for lumps that might be tumor or reason for blood in urine.
- Urinalysis: In this, a sample of urine is collected to check any abnormalities like blood, sugar or protein. If any of these abnormalities are found, then they will be further tested for more definitive tests.
- Urine cytology: In this test, a sample of urine is tested under a microscope to look for cells that make the inner lining of the bladder.
- Cystoscopy: Similar as endoscopy, a camera is attached to the catheter, narrow long tube to look for any abnormalities inside the bladder.
- Fluorescence cystoscopy: In this, a light-activated drug is placed inside the bladder with the help of a catheter. When these drugs are picked up by the cancer cells, they become fluorescent and identified by the blue light emitting from the tube.
Above tests are conducted to diagnose the possibility of cancer. Following are the tests should be done after the cancer is suspected:
- CT Scan: Unlike X-rays, this imaging test gives a three-dimensional image of your bladders and your urinary tract. This is used to look for any clumps, tumors or abnormalities in the area.
- Retrograde Pyelogram: In this procedure, a dye is injected in the ureter through the cystoscope to fill the ureter and the kidney. During filling, an X-ray is taken to find out which areas are not filling with the dye. These unfilled areas are known as filling defects and can be determined as tumors.
- MRI: Magnetic resonance imaging gives the result same as fluorescence cystoscopy, but done in individuals who are allergic to this fluoro imaging.
- Biopsy: In this procedure, tiny samples of bladder lining tissues are taken for the diagnosis of cancer.
If a tumor is found in any of the above tests, then other tests are performed to find out whether a cancer has spread to other parts of the body. These tests include ultrasound, chest x-ray, bone scan and CT scan. Check out bladder cancer treatment cost.
Bladder Cancer Stages
Once all the diagnostic tests are completed, doctors carry out further testing, known as staging to determine the extent of the disease. Staging helps to find out how far the tumor has spread from the bladder, whether it has affected other main organ of the body and whether the tumor has spread to lymph nodes as well.
There are four stages of bladder cancer as mentioned below:
- Stage I – When the cancer is only present in inner lining of the bladder
- Stage II – When the cancerous cells have invaded the muscular wall of the bladder but have not spread beyond.
- Stage III – When the cancer cells have spread to the tissues surrounding the bladder wall, maybe in uterus and vagina in women, and prostate in men.
- Stage IV – When the cancer cells have spread to other organs such as lymph nodes, lungs, bones or liver
Depending on the stages of cancer, doctors decide on the best treatment plan suitable for the patient.
Bladder Cancer Treatment
If a tumor is found out or suspected in your bladder, then your primary care doctor will refer you to the urologist who specializes in the disorders and diseases of urinary tract and kidneys. Your urologist after examining your reports and the stage of cancer, considering your medical history and current conditions will suggest you the best treatment plan and discuss with you its pros and cons. The treatment of the bladder cancer mainly depends on your current condition and the stage of cancer. Various other physicians may be included in the decision-making process like a medical oncologist and a radiation oncologist in case a radiation-based treatment is involved.
Standard therapies for the treatment of the cancer are:
- Surgery to remove a tumor, a small portion of the bladder or entire bladder. This is used to get rid of cancerous cells in the treated area only
- Chemotherapy using chemotherapeutic drugs to kill cancer cells anywhere in the body. This may be used before and after surgical procedures
- Radiotherapy using high-energy radiation to destroy the cancer cells in the treated area only or sometimes the radiation may be extended to adjacent area in the pelvic region
- Immunotherapy involves stimulating the immune system of the body to fight against cancerous cells
When is Follow-up Required?
After the completion of the treatment, a series of other tests will be conducted to determine the success rate of the treatment. In case, tests show the few remains of cancer cells, then your urologist will recommend further treatment. Otherwise, you will be asked for follow-up visits which will include few tests to determine the recurrence of cancer.
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Prognosis of Bladder Cancer
The recurrence and the result of the treatment vary person to person depending on the stage of cancer at the time of diagnosis. Almost 90% of patients treated for superficial bladder cancer have a chance to survive 5 years after the treatment. Patients whose cancer has spread to other organs have a lifetime of 12-18 months after the treatment. Recurrence rate is higher in those diagnosed with advanced stage cancer but if the recurrence is low-grade superficial cancer then it is rarely dangerous unless it does not come into the light in time and has a chance to become invasive cancer.
The survivors are advised to undergo continuous follow-up and screening every 3-5 months. The screening is done using Cystoscopy to check the insides of urethra and bladder of a patient. You don’t have to live with the fear of recurrence of bladder cancer but learn how to cope with the situation by going for regular check-ups without delays, take good care of yourself by making small lifestyle changes, and stay in touch with others who are also in similar situation