Bladder cancer at a glance
- Bladder cancer is highly treatable and develops when cells in the bladder start to grow out of control, resulting in a cancerous tumor.
- Risk factors for this type of cancer include tobacco use, a family history of bladder cancer and exposure to certain chemicals found in dye.
- Symptoms may include blood in the urine or general disruption of urinary routines, such as needing to urinate too often or inability to urinate.
- Treatments will vary from patient to patient depending on the size and stage of the tumor, and may include surgery, chemotherapy, radiation, intravesical therapy or a combination of those.
Bladder cancer is the result of uncontrolled growth of cells in the tissue of the bladder, a small hollow organ in the pelvis region responsible for receiving and storing urine. According to the American Cancer Society, there are about 79,000 new cases of bladder cancer each year.
The disease typically affects older people, and the average diagnosis age is 73. Bladder cancer is the fourth most common cancer in men, but far less common in women, who are 3 to 4 times less likely to develop it.
The bladder consists of several layers of tissues, and where the cancer originates within those layers dictates the stage of cancer diagnosis. Bladder cancer can be detected through a urine cytology, a microscopic laboratory test of urine cells to detect pre-cancer or cancerous cells.
Bladder cancer staging depends on how far the cancer cells have spread. Early-stage cancer originates in the inner-most layers of the bladder and as the stage progresses, the cells grow to the outer edge of the bladder. In later stages, the cancer can move to other parts of the body such as the lymph nodes.
The most common form of bladder cancer by far is known as urothelial carcinoma. This type of cancer starts in the cells of the urothelial, which is the inner most layer of the bladder. Other, less common types of bladder cancer include squamous cell carcinoma (1-2 percent of all diagnoses), adenocarcinoma and small cell carcinomas (1 percent or less of bladder cancer diagnoses). A sarcoma tumor develops in the muscles of the bladder and is the rarest form of cancer of the bladder.
According to the American Cancer Society, the five-year survival rate for bladder cancer is around 77 percent. This means that of 100 people diagnosed with this type of cancer, 77 of them will still be alive five years later. Survival rates are estimates based on propagated data. But every patient’s case is different and outcomes will vary based on the individual’s unique factors.
The root cause of bladder cancer, as well as of other cancers, is unknown. Family history of this cancer does seem to increase the likelihood of getting it. There are numerous risk factors including tobacco use, chemical exposure (chemicals known as aromatic amines that are sometimes used in the dye industry), or even a parasitic infection discovered in a urine sample.
Research also suggests that people who don’t drink a lot of hydrating fluid get cancer of the bladder at a higher frequency than others. Emptying the bladder often could rinse potentially harmful chemicals out of the bladder at a faster rate. There is no way to prevent this type of cancer entirely, but minimizing the above risk factors reduces the chances.
Bladder cancer symptoms
Symptoms of this disease include blood in the urine or disrupted urinary function. Bloody urine is often the first indicator that cancer cells may be present in the bladder, but that also might mean something else is going on. So it’s important to visit a doctor as soon as possible after noticing bloody urine. Changes in the urinary functions might include the urge to urinate more often than normal and pain during that urination.
There is usually no pain in the early stages of this type of cancer. Later stage symptoms indicate that the cancer is growing and moving to other parts of the body, and may include painful urination, low back pain, swollen feet, bone pain, weight loss or loss of appetite and general fatigue.
Bladder cancer treatments
Treating cancer of the bladder will vary from patient to patient depending on the size and stage of the tumor. Treatments may include surgery, chemotherapy, radiation, intravesical therapy or a combination of two treatments.
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Surgery for this cancer is known as a transurethral resection of bladder tumor (or TURBT). This procedure is performed by placing a small tube-shaped instrument up the urethra to remove and scrape away tumor cells found in the inner lining of the bladder. A TURBT does not require a large incision across the abdomen, and the patient will not have a scar following the surgery.
If the bladder cancer is more advanced, a cystectomy surgery may be performed. During a partial cystectomy, a surgeon removes a portion of the bladder, while a radical cystectomy removes the entire bladder. If the entire bladder is removed, the patient will require a subsequent reconstructive surgery in order to implement a system to store and excrete urine. Most patients do not require a cystectomy surgery.
This form of treatment involves placing a liquid drug directly into the bladder by way of a catheter. This offers targeted treatment with little chance of damaging healthy cells. Intravesical therapy is typically reserved for early stage cases, as the liquid medicine can only be distributed within the inner lining of the bladder.
Intravesical chemotherapy includes the procedure mentioned above used with chemotherapy medicine. Another form of chemotherapy for this cancer is systemic chemotherapy. This form of chemotherapy is delivered either in pill or through an IV, both of which deliver the medicine to the blood stream to treat the cancer.
Radiation involves directing radiation waves to destroy the cancer cells. External beam radiation is the most common form of radiation used to treat this kind of cancer, and the procedure is similar to receiving an X-ray. The procedure usually requires daily sessions for weeks before treatment is complete.
Following any form of bladder cancer treatment, a physician will monitor the patient every three to six months to determine that the cancer cells have or have not returned.