Definition & Overview

Bladder cancer is a term that refers to a number of cancers that develop in the bladder’s epithelial lining, which is also known as the urothelium. The bladder itself is rarely involved in the development and presence of sarcoma or lymphoma, which are non-epithelial kinds of cancer that are not usually referred to as “bladder cancer.”

Transitional cell carcinoma, also known as urothelial cell cancer, is the most common kind of bladder cancer. In the United States, 77 per cent of patients diagnosed with bladder cancer have a five-year survival rate.

Bladder cancer usually begins as an uncontrolled growth of abnormal cells in the bladder lining. This cancer develops at a rapid rate, and in some cases, the cancerous cells spread from to epithelial lining to the bladder’s muscular wall. Over time, without treatment or cancer management, bladder cancer spreads to other parts of the body, such as the lymph nodes, the bowels, the kidney, the liver, and the lungs.

Many cases of bladder cancer are diagnosed early before the abnormal cells grow outside of the bladder’s epithelial lining. Seven out of ten bladder cancer patients are diagnosed with superficial bladder cancer, which does not invade the muscular wall beyond the lining. This type of bladder cancer can be treated and managed, and typically not life threatening. However, once the cancer grew into the muscular wall of the bladder and the other organs in the pelvic area, the patient might be given lower chances of surviving the condition.

Cause of Condition

The main cause of bladder cancer is the growth of cancerous cells in the epithelial lining of the bladder. There are many factors that influence the development of these abnormal cells, with smoking as one of the major influencing factors. Research shows that people who smoke cigarettes are more likely to develop bladder cancer. Approximately half of the male patients diagnosed with this cancer, as well as one-third of female patients, are cigarette smokers. The relationship between bladder cancer risk and smoking is linear, and many medical professionals recommend quitting smoking to lower the risk.

Research also shows that individuals exposed for a prolonged period to aromatic amines, chemicals found in a wide variety of products such as leather, inks, dyes, solvents, and paints have increased risk of developing the condition. In fact, around 30 per cent of bladder cancer patients have been exposed to carcinogens, such as 2-Napthylamine and benzidine, typically in their workplaces.

The risk of developing bladder cancer increases with age; many patients are diagnosed with the cancer in their 60’s or 70’s. Men are four times more likely to develop bladder cancer than women; white men lead the risk scale, with this demographic twice more likely to develop bladder cancer than men of African-American descent.

Some cancer treatments, such as a chemotherapy medication and radiation therapy to the abdominal and pelvic area, have shown to increase the chances of the growth of cancerous cells in the bladder lining. A fatty and nitrate-rich diet is also shown to increase the risks of individuals for bladder cancer, as well as a parasitical infection known as schistosomiasis.

Key Symptoms

One of the most common symptoms of bladder cancer is blood in the urine, also known as haematuria. In many cases, the blood in the urine is visible to the individual’s naked eye, occurs in episode, and usually painless. However, there are some instances when the blood in the urine is only present in small amounts, and can only be seen through a microscope. Pain when urinating often occurs because of the formation of blood clots, but is quite rare.

In many cases, patients do not feel observe symptoms, which can result to late diagnosis of the condition.

Other symptoms of bladder cancer include pain in the back or flank, frequent urination (small amounts), inability to contain urine, dysuria (painful, burning sensation while urinating), inability to urinate, pain in the pelvic bones, pain in the foot, swollen ankles, and in cases when the cancer has spread to the lungs or the bones, coughs and blood in the phlegm.

Who to See & Types of Treatments Available

If you observe the symptoms described above or feel that you are at an increased risk of bladder cancer, make an appointment with your doctor or general practitioner. Your doctor can prescribe tests and screening procedures to determine whether your bladder’s epithelial lining are showing growth of abnormal, cancerous cells. You will then be recommended to a urologist and/or a medical or radiation oncologist for treatment and management of the condition.

The treatment prescribed for bladder cancer heavily depends on the extent of the cancerous growth in the lining of the patient’s bladder. Tumours that have not entered the bladder’s muscle layer can be shaved off in a minimally invasive surgical procedure called a transurethral resection or TUR. With a TUR, an electrocautery device is attached to a resectoscope, and used to shave off the tumour and cauterize it.

In the case of recurring superficial tumours, the doctor can suggest immunotherapy, which involves delivering Bacillus Calmette-Guerin (intravesicular delivery), a vaccine originally developed for tuberculosis that effectively prevents the recurrence of tumours in the bladder’s epithelial lining. Bacillus Calmette-Guerin immunotherapy is proven by many studies as more effective than standard methods of chemotherapy.

In the event that the recurrence of tumours cannot be prevented by immunotherapy or TUR, the doctor can recommend a cystectomy, or the surgical removal of the urinary bladder. Many bladder cancer patients do not wish to undergo a cystectomy, and often opt for other kinds of treatment.

Thermotherapy, which involves the heating of the bladder wall with radio frequency, when combined with chemotherapy has shown to be effective in some cases. A combination of radiation therapy and chemotherapy can also be prescribed as a form of treatment for more invasive and serious forms of bladder cancer. Surgically removing the tumour is also a popular treatment method, but recurrence is a serious factor that should be considered during the treatment period.

References:

  • Bladder Cancer, Cancer Research UK
  • Bladder Cancer, Mount Sinai Hospital
  • SEER Stat Fact Sheets: Bladder Cancer, NCI
  • Bladder Cancer: Guideline for the Management of Nonmuscle Invasive Bladder Cancer, American Urological Association
  • Journal of the National Cancer Institute
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