Bladder cancer is one of the most common cancers. Bladder cancer mostly affects men more than it affects women. Also, older adults are mostly at risk. However, it can affect anyone at any age.
Bladder cancer mostly starts in the cells (urothelial cells) that line the inside of your bladder which is the hollow, muscular organ in your lower abdomen that stores urine. It is mostly common in the bladder, even though this same type of cancer can occur in other parts of the urinary tract drainage system.
Bladder Cancer Symptoms
- Painful urination
- Blood in urine (hematuria)
- Pelvic pain
- Back pain
- Frequent urination.
However, these symptoms may not always be caused by bladder cancer. If you have hematuria, your urine may appear bright red or cola colored. Sometimes, urine may not appear any different, but blood in urine may be detected during a microscopic assessment of the urine.
Bladder cancer occurs when cells in the bladder begin to grow abnormally. Rather than grow and divide in an orderly manner, these cells develop mutations that cause them to grow out of proportion and thrive instead of dying. These abnormal cells later form a tumor.
Causes of bladder cancer include:
- Smoking and other tobacco use
- Exposure to chemicals
- Past radiation exposure
- Chronic irritation of the lining of the bladder
- Parasitic infections, especially in people who are from or have traveled to certain areas outside the United States
Types of bladder cancer
Different types of cells in your bladder can become cancerous. The type of bladder cell where cancer starts determines the type of bladder cancer.
Types of bladder cancer include:
- Urothelial carcinoma:This type of bladder cancer is also called transitional cell carcinoma. It occurs in the cells that line the inside of the bladder. Urothelial cells expand when your bladder is full and contract when your bladder is empty. These same cells line the inside of the ureters and the urethra, and tumors can form in those places as well. Urothelial carcinoma is the most common type of bladder cancer in the United States.
- Squamous cell carcinoma:Squamous cell carcinoma is linked with chronic irritation of the bladder, for instance from an infection or from long-term use of a urinary catheter. This type is more common in parts of the world where a certain parasitic infection (schistosomiasis) is a common cause of bladder infections.
- Adenocarcinoma: Adenocarcinoma begins in cells that make up mucus-secreting glands in the bladder.
Factors that may increase bladder cancer risk include:
- Being white:White people have a greater risk of bladder cancer than do people of other races.
- Smoking:Smoking cigarettes, cigars or pipes may increase the risk of bladder cancer by causing harmful chemicals to accumulate in the urine.
- Increasing age:Bladder cancer risk increases as you age.
- Being a man:Men are more likely to develop bladder cancer than women.
- Exposure to certain chemicals:Chemicals used in the manufacture of leather, rubber, dyes, paint products, and leather have been linked to bladder cancer. Your kidneys play a key role in filtering harmful chemicals from your bloodstream and moving them into your bladder. Because of this, it’s thought that being around certain chemicals may increase the risk of bladder cancer.
- Previous cancer treatment:Treatment with the anti-cancer drug cyclophosphamide increases the risk of bladder cancer. People who received radiation treatments aimed at the pelvis for a previous cancer are at an increased risk.
- Chronic bladder inflammation:Chronic or repeated urinary infections or inflammations (cystitis), such as might happen with long-term use of a urinary catheter, may increase the risk of a squamous cell bladder cancer.
- Personal or family history of cancer:If you’ve had bladder cancer, you’re more likely to get it again. If your parent, sibling or child has a history of bladder cancer, you may have an increased risk of the disease.
Prevention of bladder cancer
Although there’s no guaranteed way to prevent bladder cancer, you can take steps to help reduce your risk. For instance:
- Avoid smoking:Not smoking means that cancer-causing chemicals in smoke can’t accumulate in your bladder. If you don’t smoke, don’t start. If you smoke, talk to your doctor about a plan to help you stop. You can join support groups, take medications and other methods to help you quit.
- Take caution around chemicals:If you work with chemicals, follow all safety instructions to avoid exposure.
- Choose a variety of fruits and vegetables: The antioxidants in fruits and vegetables may help reduce your risk of cancer.
Diagnosing bladder cancer
Tests and procedures used to diagnose bladder cancer may include:
- A small narrow tube called a cystoscope is being our doctor inserts a small, narrow tube (cystoscope) through the urethra. The cystoscope has a lens that permits your doctor to see the inside of your urethra and bladder, to examine these structures for signs of disease.
- During cystoscopy, your doctor may pass a special tool through the scope and into your bladder to collect a cell sample (biopsy) for testing. This procedure is sometimes called transurethral resection of bladder tumor (TURBT). TURBT can also be used to treat bladder cancer.
- Urine cytology.In this procedure, a sample of your urine is examined under a microscope to check for cancer cells.
- Imaging tests.Imaging tests, such as computerized tomography (CT) urogram or retrograde pyelogram, allows your doctor to examine the structures of your urinary tract. A CT urogram procedure is when a contrast dye injected into a vein in your hand eventually flows into your kidneys, ureters and bladder. X-ray images taken during the test provide a detailed view of your urinary tract and help your doctor identify any areas that might be cancer.
Determining the extent of the cancer
After confirming that you have bladder cancer, your doctor may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body. Tests may include:
- CT scan
- Magnetic resonance imaging (MRI)
- Bone scan
- Chest X-ray
Your doctor uses information from these procedures to assign your cancer a stage. The stages of bladder cancer are indicated by Roman numerals ranging from 0 to IV. The lowest stages indicate a cancer that’s confined to the inner layers of the bladder and that hasn’t grown to affect the muscular bladder wall. The highest stage — stage IV — indicates cancer has spread to lymph nodes or organs in distant areas of the body.
Bladder cancer treatment
Bladder cancer treatment may include:
- Surgery: This is performedto remove cancerous tissue
- Chemotherapy in the bladder (intravesical chemotherapy): This is doneto treat tumors that are confined to the lining of the bladder but have a high risk of return or progression to a higher stage
- Reconstruction,to create a new way for urine to exit the body after bladder removal
- Chemotherapy for the whole body (systemic chemotherapy),to increase the chance for a cure in a person having surgery to remove the bladder, or as a primary treatment in cases where surgery isn’t an option
- Radiation therapy,to destroy cancer cells, often as a primary treatment in cases where surgery isn’t an option or isn’t desired
- Immunotherapy,to trigger the body’s immune system to fight cancer cells, either in the bladder or throughout the body
A combination of treatment approaches may be recommended by your doctor and members of your care team.