Bladder Cancer (Malignant Tumor of the Urinary Bladder)

Definition

Bladder cancer is a malignancy that starts in the urinary bladder. Usually bladder cancer starts from the lining of the bladder known as the transitional cells. Bladder cancer is quite common. Treatment options for bladder cancer include chemotherapy, radiation therapy and surgery. Bladder cancer is treatable if diagnosed at an early stage although there is always chance of recurrence. If left untreated, the cancer can spread to surrounding and distant organs which may be life threatening.

Symptoms

The symptoms of bladder cancer may not be evident in the early stages.

  • Blood in urine is the most common symptom (hematuria). Bleeding can be frank (visible to naked eye) or microscopic (identified only under microscope). Color of the urine changes from normal straw color to dark yellow, cola colored or red.
  • Pain during passage of urine.
  • Inability to pass urine despite urge of urination (urinary urgency).
  • Increased frequency of urination (polyuria).
  • Lower abdominal (pelvic) and back pain.
  • Inability to hold urine (incontinence).

Other symptoms include :

  • Bone pain.
  • Anemia due to blood loss in urine, fatigue and weight loss.

Causes

Cancer is the abnormal uncontrolled growth of cells usually as a result of defective or damaged DNAl. Although like all cancers the exact cause of bladder cancer is not clear but there are strong associations between certain factors and bladder cancer like smoking, infections and certain environmental toxins.

Types

The nature of the bladder cancer depends upon the cells which become cancerous.

  • Transitional cell carcinoma is the most common type of bladder cancer. It affects the transitional cells which normally form the inner lining of the bladder.
  • Squamous cell carcinoma may arise as result of infection and persistent irritation of normal transitional cell lining of bladder thereby causing it to be replaced with squamous cells which can become cancerous in the long run. Schistosoma (type of parasite) infection can predispose to this type of cancer.
  • Adenocarcinoma is a rare type of cancer

Risk factors

Risk factors are :

  • Smoking. In studies, up to half of male bladder cancer patients and one third of female bladder cancer patients are smokers.
  • Insufficient water intake leading to infrequent urination.
  • Older people.
  • Males are generally at a greater risk.
  • Bus drivers, mechanics, rubber workers, shoe workers have increased of developing bladder cancer due to occupational exposure to certain environmental toxins namely benzidine and 2-naphthylamine.
  • Hairdressers are at greater risk because of their exposure to hair dyes.
  • Certain vegetables (carrot) can reduce the risk of bladder cancer.

Treatment

The TNM staging of the bladder cancer is one of the important factors that determines the nature of treatment. Staging is done on the basis of three things :

  • Tumor (extent of spread of the cancer within the bladder and adjacent organs).
  • Node (involvement of lymph nodes).
  • Metastasis (spread to distant organs like bone, liver and lungs).

Treatment options include :

  • Surgery :
    – For early stage options are removal of the tumor with or without portion of bladder
    – For late stage the entire bladder may be removed.
  • Immunotherapy: BCG
  • Chemotherapy are drugs given via blood vessels or inside the bladder to kill the cancer cells.
  • Radiation therapy is not so commonly used in bladder cancer.

 

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