Bladder Cancer
Bladder cancer is a form of cancer that affects the bladder's cells and tissues. The bladder is the hollow muscular structure that holds urine in the lower abdomen. Cancer of the bladder thus starts in the cells lining the inner bladder (urothelial cells). The kidneys and the ureter tubes that join the kidneys to the bladder also contain urothelial cells.
The majority of bladder cancers are detected early on, while they are curable. However, early-stage bladder tumors might recur after effective treatment. As a result, persons with bladder cancer may require follow-up testing over the years following treatment to check for recurrence.
Types of Bladder Cancer
Various types of bladder cells have the potential to become malignant. Therefore, the type of bladder cell from which cancer develops determines the kind of bladder cancer. This information enables the doctors and urologists to identify the treatment that is most likely to be effective.
The following are the common types of bladder cancer;
- Urothelial carcinoma
Initially known as transitional cell carcinoma, urothelial carcinoma is the most common form of bladder cancer. It develops within the cells lining the inside of the bladder. When the bladder gets full, urothelial cells enlarge and contract when empty. The inner of the ureters and urethra are also lined with similar cells, and malignancies can occur there as well.
- Squamous cell carcinoma
Persistent irritation of the bladder, such as from an infection or long-term urinary catheter use, is linked to squamous cell carcinoma. Squamous cell bladder cancer is uncommon. However, it's more prevalent in places of the world where schistosomiasis, a parasitic infection, is the major bladder infections cause.
- Adenocarcinoma
This is another rare form of bladder cancer. It starts with the formation of glandular cells in the bladder as a result of continuing bladder inflammation and irritation. The mucus-secreting glands inside the body comprise the glandular cells.
Signs and Symptoms of Bladder Cancer
Blood can be present in the urine of most persons with bladder cancer. However, they do not experience any pain when urinating. Weight loss, fatigue, and bone tenderness are some of the bladder cancer early signs. They can also signify more advanced disorders.
In addition, pay special attention to signs and symptoms of bladder cancer such as;
- Pain when urinating
- Blood in the urine
- Frequent urge to urinate
- Urinary incontinence
- Pain around the abdominal region and lower back
Causes of Bladder Cancer
The actual cause of bladder cancer is not known. However, medical professionals believe that bladder cancer develops if the DNA of cells within the bladder changes (mutates). The DNA of a cell carries instructions that instruct it on what to do.
The mutations thus instruct the cell to divide quickly and continue to live even if the healthy cells die. The aberrant cells eventually result in a tumor, which can infiltrate and destroy healthy tissue. Also, these abnormal cells might break free and metastasize or spread in the body over time.
Risk Factors of Bladder Cancer
The following bladder cancer risk factors can increase the chances of developing the condition;
- Smoking: Cigarettes smoking, cigars, or even pipes can raise the risk of getting bladder cancer. This is because it causes hazardous chemicals to build in the urine. Whenever you smoke, the chemicals present in the smoke are processed by the body, while some are excreted in the urine. These dangerous substances can damage the bladder lining, increasing your cancer risk.
- Getting older: As you become older, your chances of developing bladder cancer increase. Although bladder cancer can strike anyone at any age, the majority of those diagnosed are over the age of 55.
- Exposure to cancer-causing chemicals: The kidneys are responsible for filtering dangerous chemicals out of the bloodstream and transporting them to the bladder. As a result, exposure to some chemicals may raise the chance of bladder cancer.
- Male gender: Bladder cancer is more common in men than it is in women.
- Previous treatment for cancer: The anti-cancer medication cyclophosphamide raises the risk of developing bladder cancer. Individuals who have had pelvic radiation treatments for a previous malignancy are more likely to get bladder cancer.
- Family or personal history of malignancy: You're more likely to develop bladder cancer again if you have already had it before. Also, if a close member like a parent, child, or sibling has a history of the condition, your chances increase.
- Chronic bladder irritation and inflammation: Recurrent, chronic urinary infections and inflammations (cystitis), like those caused by urinary catheter usage for an extended period, may raise the risk of developing squamous cell bladder cancer.
Bladder Cancer Diagnosis
Urologists can use the following tests and procedures to diagnose bladder cancer;
Cystoscopy (examining the inside of the bladder with a scope): This procedure involves inserting a thin, narrow tube (cystoscope) into the urethra. The cystoscope contains a lens that enables the doctor to check the urethra and bladder for symptoms of cancer.
Biopsy (taking a tissue sample for more testing): The doctor can insert tiny equipment through the urethra into the bladder to obtain a small cell sample for further testing.
Urine cytology (evaluation of the urine sample): Urine cytology is a procedure that examines a sample of the urine under a microscope to look for malignant cells.
Imaging exams: The doctor can examine the urinary system structures using imaging tests like a retrograde pyelogram or a computerized tomography (CT) urogram.
In addition, the physician can recommend more tests after finding out that you have bladder cancer. The purpose of these tests is to check if cancer has metastasized to the lymph nodes or other body parts.
Examples of these tests are chest x-rays, magnetic resonance imaging (MRI), bone scan, positron emission tomography (PET), and CT scan.
Bladder Cancer Grading
The doctor can use a staging system that ranges from 0 to 4 stages to determine the extent to which cancer has spread. The following are the stages of bladder cancer:
- Stage 0: Cancer has not progressed beyond the bladder's lining.
- Stage 1: Here, bladder cancer has progressed beyond the bladder lining but not to the bladder's muscle layer.
- Stage 2: Bladder cancer has metastasized to the bladder's muscle layer.
- Stage 3: The bladder cancer has spread to the surrounding tissues.
- Stage 4: Bladder cancer has gone beyond the bladder to other parts of the body.
Bladder Cancer Treatment
Bladder cancer treatment options are determined by various factors such as;
- The type of cancer
- The grade and stage of the condition
- Your overall health
- Treatment preferences
Generally, bladder cancer is curable and the treatment options can include;
Chemotherapy:
Chemotherapy uses medications to destroy or slow down the reproduction of quickly growing cells. Chemotherapy drugs are absorbed faster by the cancerous cells, unlike normal cells, even though all cells get exposed to the drug.
Depending on the cancer stage, chemotherapy medications are given intravenously (via a vein) or intravesically (straight into the bladder via a catheter threaded through the ureter).
Intravesical therapy:
Doctors can use this treatment to address bladder malignancies during their early stages. The procedure involves injecting a liquid drug directly into the bladder using a catheter. Normally, they will have to select between immunotherapy and chemotherapy. With immunotherapy, the cancerous cells are attacked by the body's immune system. Intravesical chemotherapy entails injecting cancer-fighting drugs into the bladder using a catheter.
Radiation therapy:
By hitting the cancer cells using high-energy x-rays or other forms of radiation, radiation treatment can destroy their DNA. It could be used instead of surgery or in conjunction with chemotherapy or surgery. The provider can administer radiation therapy externally or internally.
Immunotherapy:
The immune system attacks the cancerous cells in this treatment. It aids the body's immune system in recognizing malignant cells as threats and launching a more effective attack against them. This can cause the tumors to shrink or cease growing.
Surgical Treatment for Bladder Cancer
The following are some options for bladder cancer surgery:
Transurethral resection of a bladder tumor (TURBT): Doctors use this procedure to detect bladder cancer and eliminate tumors restricted to the bladder's inner layers and are not muscle-invasive.
Cystectomy: A cystectomy is a procedure that involves removing a section or the entire bladder. The surgeon can only remove the part of the bladder that has a single malignant tumor during a partial cystectomy. On the other hand, a radical cystectomy entails removing the whole bladder and the nearby lymph nodes.
Reconstruction of the neobladder: The surgeon will have to make a new path for the urine to exit the body following a radical cystectomy (urinary diversion). Neobladder reconstruction is one alternative for urine diversion.
Conclusion
Bladder cancer occurs when the abnormal cells in the bladder cells develop out of control. Usually, a tumor develops with time. It has the potential to spread to adjacent lymph nodes and organs. It can also spread to other areas of the body in extreme circumstances.
Blood in the urine is the most prevalent symptom of bladder cancer, and it is typically painless. Therefore, if you see blood in your urine, even if it only occurs occasionally, you should see your doctor so that the cause may be determined.