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Bladder Cancer - Causes, Risk Factors, Symptoms, Diagnosis, and Treatment

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Bladder Cancer - Causes, Risk Factors, Symptoms, Diagnosis, and Treatment

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Bladder cancer is cancer that occurs in the urinary bladder. Read the article to learn about its causes, risk factors, symptoms, diagnosis, and treatment.

Written by

Dr. Preetha. J

Medically reviewed by

Dr. Vaibhav Vishal

Published At September 7, 2021
Reviewed AtOctober 19, 2023

Introduction

Abnormal cells within the bladder multiply uncontrollably to become bladder cancer, a severe tumor that affects the urinary bladder. It is one of the most common malignancies in the world and can be quite harmful to health, especially for elderly people. Susceptibility is increased by elements like genetic predispositions, smoking, and chemical exposure. Early identification is crucial for effective therapy, as evidenced by signs such as hematuria and frequent urine. Numerous techniques, including cystoscopy and imaging tests, are used in diagnosis. Treatment options include immunotherapy, chemotherapy, and surgery; the selection of a treatment modality depends on the stage and characteristics of the malignancy. Because bladder cancer is a complex disease, research on the disease must continue, which emphasizes the significance of increasing public awareness, promoting preventative measures, and developing therapeutic approaches.

What Is Bladder Cancer?

Bladder cancer is cancer that develops in the urinary bladder. It is the most common type of cancer that occurs in the cells that line the inner wall of the bladder. The urinary bladder is a hollow muscular organ that stores urine in it. The cells that line the inside of the bladder are called urothelial cells. Urothelial cells can also be found in the ureters (which connect the bladder to the kidney) and kidneys. Urothelial cancer can also occur in the ureter and kidneys.

What Are The Causes of Bladder Cancer?

Bladder cancer can be caused by changes that occur in the DNA of the cells of the bladder. DNA of the cells will instruct what to do, but these DNA changes or mutations allow the cells to multiply rapidly and form a tumor. This tumor can invade and destroy the normal cells and spread throughout the body through metastasis. Smoking is a significant risk factor that causes bladder cancer.

What Are the Risk Factors For Bladder Cancer?

The known risk factors for bladder cancer include:

  • Smoking - Smoking tobacco, cigarettes, and pipes may increase the risk of bladder cancer due to the bladder's exposure to the harmful chemicals that are deposited in the urine. During smoking, the body will absorb some chemicals and excrete some in the urine. These toxic chemicals damage the lining of the bladder.

  • Increasing Age - The risk of getting bladder cancer increases with age. Though it can occur at any age, it is most commonly diagnosed in aged people.

  • Being Male - Males are more likely to develop bladder cancer than females.

  • Previous History of Cancer - People who had radiation therapy previously for cancer treatment at the pelvis level are at high risk of developing bladder cancer. And people who have anti-cancer drugs like Cyclophosphamide also have an increased risk of bladder cancer.

  • Chronic Bladder Inflammation - Repeated inflammation like cystitis, infection of the bladder, or long-term use of the urinary catheter can increase the risk of bladder cancer due to irritation factors.

  • Family History of Bladder Cancer - If bladder cancer is already present or there is a history of bladder cancer in the family, the likelihood of getting it is higher.

  • Exposure to Certain Chemicals - The kidneys play a significant role in filtering all the harmful chemicals from the blood and sending it to the bladder. Due to this, the risk of bladder cancer is increased. The chemicals associated with bladder cancer are arsenic and chemicals used in the manufacture of rubber, dyes, textiles, leather, and paint products.

  • Cowden's Disease- Multiple noncancerous tumors that typically affect the skin, mucous membranes, and internal organs are the hallmark of Cowden's disease, also known as PTEN hamartoma tumor syndrome, an uncommon genetic illness.

  • Lynch Disease - People with this syndrome are at high risk of getting bladder cancer.

What Are the Types of Bladder Cancer?

The type of cell affected in the bladder denotes which cell is involved or what cancer it is. Doctors may use this technique to determine which treatment is best. The types of bladder cancer are:

  1. Urothelial Cancer - Urothelial cancer is the most common type of bladder cancer and is also called transitional carcinoma. The carcinoma occurs in the cells that line the urinary bladder. These urothelial cells will help the bladder expand when the bladder is full and contract when the bladder is empty. One kind of bladder cancer called a papillary bladder tumor develops as finger-like extensions from the bladder's inner lining called papillae. Its aggressiveness and available treatments can vary, and cystoscopy is frequently used for diagnosis.

  2. Squamous Cell Carcinoma - They can be caused by chronic irritation of the bladder, such as an infection or long-term use of a urinary catheter. Squamous cell carcinoma is a rare form of bladder cancer.

  3. Adenocarcinoma - It is a rare type of bladder cancer that occurs in the cells that form the mucus-secreting glands in the bladder.

What Are the Symptoms of Bladder Cancer?

Many bladder cancer patients can have blood in their urine but no pain while urinating. Other symptoms, like weight loss, fatigue, and bone tenderness, may indicate the disease's advanced stage.

  • Blood clots or blood in the urine.

  • Burning sensation or pain during urination.

  • Frequent urination.

  • Urinary urgency.

  • Urinary incontinence.

  • Lower back pain on one side of the body.

  • Pain in the abdominal area.

How to Diagnose Bladder Cancer?

Bladder cancer can be diagnosed with one or more of the following methods.

  1. Urine analysis.

  2. An internal examination is done using a gloved hand to feel for any lumps that may indicate cancerous growth.

  3. A cystoscopy is performed by inserting a narrow tube with a camera at its end into the urethra to view the bladder.

  4. CT scan (computed tomography) to view the bladder.

  5. A biopsy is taken by inserting a small tube into the urethra and collecting the bladder's tissue sample to check for cancer.

  6. Intravenous pyelogram.

  7. X-rays.

  8. Magnetic resonance imaging (MRI).

  9. Positron emission tomography (PET).

  10. Bone scan.

What Is the Treatment for Bladder Cancer?

The treatment for bladder cancer includes:

1. Treatment for Muscle Invasive Bladder Cancer

  • Chemotherapy.

  • Cystectomy.

  • Immunotherapy.

  • Targeted therapy.

  • Radiation therapy.

2. Treatment for Nonmuscle-Invasive Bladder Cancer

  • Intravesical drug therapy.

  • Transurethral resection of the bladder tumor.

  • Cystoscopy.

3. Surgery to Remove the Tumor In Bladder Cancer:

  • Neobladder reconstruction.

  • Ileal conduit.

  • Continent urinary reservoir.

  • Transurethral resection of the bladder tumor.

  • Cystoscopy.

When to See a Doctor for Bladder Cancer?

When there is discolored urine or blood in the urine, or any concerning signs and symptoms, schedule an appointment with a doctor for a checkup.

How to Prevent Bladder Cancer?

There is no real way to prevent bladder cancer, but the risk of getting bladder cancer can be reduced:

  • Quit Smoking: Not smoking is a healthy choice; refrain from starting in the future. If smoking is a habit, consult a doctor to quit.

  • Take Precaution: When working with chemicals, make sure to adhere to all safety instructions to prevent exposure.

  • Intake of Variety of Fruits and Vegetables: The antioxidants present in colorful fruits and vegetables will help reduce the risk of bladder cancer.

  • Drink Plenty of Water.

Conclusion

Bladder cancer is a serious health concern that calls for ongoing study, education, and preventative actions. Regular screenings are important since early detection is still necessary for an improved prognosis. Treatment approaches that have advanced, including targeted treatments and immunotherapy, provide promise for better results. Promoting prompt intervention requires public education on symptoms and risk factors. To address the complex nature of bladder cancer and eventually lessen its impact on people and society, cooperation between medical professionals, researchers, and the community is essential.

Frequently Asked Questions

1.

Which Initial Sign or Symptom Does Bladder Cancer Exhibit?

A person with bladder cancer might notice blood in their urine as an initial symptom. The urine color also changes to orange, pink, or dark red due to blood, and blood in urine need not appear with every urination. Though it is a sign that is common to other less serious conditions, it is also one of the initial signs of bladder cancer.

2.

What Are the Presenting Symptoms of Bladder Cancer?

A person with bladder cancer can exhibit the following symptoms. But it need not necessarily be bladder cancer all the time. Other conditions like urinary tract infection, stones in the bladder, enlarged prostate also share these symptoms.
- Blood in the urine.
- Weak urine stream.
- Urinary incontinence.
- Increased urinary frequency.
- Frequently getting up at night to urinate.
- Pain during urination.
- Burning sensation during urination.
- One-sided lower back pain.
- Appetite and weight loss.
- Tiredness.

3.

What Symptoms Does a Person With Late-Stage Bladder Cancer Show?

A person with later or advanced stages of bladder cancer experiences,
- Tiredness.
- Difficulty to urinate.
- Pain in bones.
- One-sided lower back pain.
- Swelling of the feet.

4.

Is Bladder Cancer a Fast-Growing and Fast-Spreading One?

Low-grade bladder cancer variants tend to grow and spread at a slower rate compared to the high-grade ones that grow and spread fast.

5.

Where Can the Initial Spread of Bladder Cancer Be Expected?

Bladder cancer grows from within the bladder wall and spreads outside, and affects the nearby lymph nodes. They spread further and affect the abdominal or reproductive organs. In case of distant spread, they can affect the lungs, liver, or bones initially.

6.

Can One Have Bladder Cancer and Not Know It?

Bladder cancer causes infrequent but recurrent blood in the urine as an initial sign. This helps people with bladder cancer to get it detected early. But most people tend to ignore this condition and lead a normal life until they happen to experience accompanying symptoms like lower back pain, swollen feet, urinary problems, etc., and seek medical assistance.

7.

Which Organ System Does Bladder Cancer Affect?

Apart from the bladder, the cancer of the bladder can spread locally to affect nearby organs like the kidney, prostate, uterus, and vagina. If it spreads to distant body parts, it usually affects the liver, lungs, and bones.

8.

Can Blood Tests Determine the Presence of Bladder Cancer?

Blood tests as such do not lead to a definitive diagnosis of bladder cancers. Still, abnormal blood parameters do raise a question regarding the presence of an underlying serious health condition in an individual.

9.

Can Bladder Cancer Be Prevented by Drinking Water?

Whether it can prevent bladder cancer completely or not, drinking plenty of water can lower one’s risk of developing bladder cancer.

10.

Does Bladder Cancer Lead To Death?

Developing bladder cancer itself does not put one’s life to an end soon after its detection. Several other factors like stage and type of cancer contribute to life expectancy. Bladder cancer is very much treatable when detected in the early stage. According to the American Society of Clinical Oncology (ASCO), the estimated five-year survival rate for people with bladder cancer is 77%, and it increases to 96% if detected early.

11.

How Possible Is It to Cure Bladder Cancer?

Bladder cancer comes with high possibilities of curability when detected in the early stages.

12.

Which Treatment Method Successfully Treats Bladder Cancer?

Transurethral resection of bladder tumor, burning the tumor base with laser (fulguration), and intravesical therapy effectively treat the initial stage of bladder cancer. Based on the cancer stage and type, partial or complete removal of the bladder followed by or following chemotherapy, radiotherapy, targeted therapy, and immunotherapy are the available treatment methods.

13.

Can Surgery Cure Bladder Cancer?

Surgery can very well treat bladder cancer if bladder cancer is detected in the earlier stages and treated along with other non-invasive treatment methodologies.

14.

How Long Does Bladder Cancer Surgery Take To Finish?

It takes about 4 to 8 hours for bladder removal surgery and about 40 minutes (in case of only tumor removal) for excising the tumor alone through transurethral resection.

15.

What Side Effects Does Bladder Cancer Surgery Cause?

Though these side effects do not occur with every bladder cancer surgery, possible side effects of bladder cancer surgery include,
Infection.
- Nerve damage in the pelvis region.
- Loss of sexual sensations and orgasm.
- Loss of stamina.
- Erectile dysfunction.
- Risk of injury to nearby organs.
- Bleeding.

16.

What Is the Latest Treatment for Bladder Cancer?

Drugs like Pembrolizumab (Keytruda) and Enfortumab Vedotin (Padcev) were recently approved by the FDA (Food and Drug Administration) to treat bladder cancers.

17.

What Can People Expect After a Bladder Cancer Surgery?

During a bladder cancer surgery, based on the spread of cancer, nearby organs like the prostate and part of the urethra in men and ovaries, uterus, fallopian tube, and part of the vagina in women might be removed along with the bladder. An alternative pathway or technique might also be created for urination post-surgery in a complete bladder resection.
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Dr. Vaibhav Vishal
Dr. Vaibhav Vishal

Urology

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