Published on Sep 07, 2021 and last reviewed on Sep 22, 2022 - 5 min read
Abstract
Bladder cancer is cancer that occurs in the urinary bladder. Read the article to know about its causes, risk factors, symptoms, diagnosis, and treatment.
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 which line the inside of the bladder are called urothelial cells. Urothelial cells can also be found in the ureters (which connects the bladder to the kidney) and kidneys. Urothelial cancer can also occur in the ureter and kidneys.
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.
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 deposits in the urine. During smoking, the body will absorb some chemicals and excretes 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 had anti-cancer drugs like Cyclophosphamide also have an increased risk of bladder cancer.
Chronic Bladder Inflammation - Repeated inflammation like cystitis and infection of the bladder or long-term use of the urinary catheter can increase the risk of bladder cancer due to the irritation factors.
Family History of Bladder Cancer - If you already had bladder cancer or any of your family members have a history of bladder cancer, you are more likely to get it.
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.
Lynch Disease - People with this syndrome are at high risk to get bladder cancer.
Workplace exposure to chemicals.
Low Fluid Consumption - People who do not consume enough fluids have more risk of getting bladder cancer.
Bladder defect from birth.
Eating a high-fat diet.
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 to be done. The types of bladder cancer are:
Urothelial Cancer - Urothelial cancer is the most common type of bladder cancer and is also called transitional carcinoma. The carcinoma occurs in the cells which line the urinary bladder. These urothelial cells will help the bladder expand when the bladder is full and contract when the bladder is empty.
Squamous Cell Carcinoma - They can be caused due to 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.
Adenocarcinoma - It is a rare type of bladder cancer, which occurs in the cells which form the mucus-secreting glands in the bladder.
Many bladder cancer patients can have blood in the 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.
Bladder cancer can be diagnosed with one or more of the following methods.
Urine analysis.
An internal examination is done using a gloved hand into the vagina or the rectum to feel for any lumps that may indicate cancerous growth.
A cystoscopy is done by inserting a narrow tube with a camera at its end inside your urethra to view the bladder.
CT scan (computed tomography) to view the bladder.
A biopsy is taken by inserting a small tube into the urethra and collecting the bladder's tissue sample to check for cancer.
X-rays.
Magnetic resonance imaging (MRI).
Positron emission tomography (PET).
Bone scan.
The treatment for bladder cancer includes:
1.Treatment for Muscle Invasive Bladder Cancer
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 you have discolored urine or blood in the urine or any signs and symptoms that worry you much, make an appointment with the doctor to get yourself checked.
There is no real way to prevent bladder cancer, but the risk of getting bladder cancer can be reduced:
Quit smoking: If you do not smoke it is good and do not start it hereafter, but if you smoke, consult with your doctor to quit smoking.
Take Precaution: If you are working with chemicals, ensure that you follow all the safety instructions to avoid exposure.
Intake of Variety of Fruits and Vegetables: Theantioxidants present in the colorful fruits and vegetables will help reduce the risk of bladder cancer.
Drink Plenty of Water.
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.
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.
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.
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.
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.
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.
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.
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.
Whether it can prevent bladder cancer completely or not, drinking plenty of water can lower one’s risk of developing bladder cancer.
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.
Bladder cancer comes with high possibilities of curability when detected in the early stages.
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.
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.
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.
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.
Drugs like Pembrolizumab (Keytruda) and Enfortumab Vedotin (Padcev) were recently approved by the FDA (Food and Drug Administration) to treat bladder cancers.
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.
Last reviewed at:
22 Sep 2022 - 5 min read
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