Bladder Cancer, Bladder, Hematuria, Urinary Disorder

Description :   Bladder cancer is a common cancer of the urinary tract. Causes and risk factors, common symptoms

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What is Bladder cancer?

Bladder cancer is a cancer that arises from the cells located in your bladder. The bladder is an organ which is responsible for holding urine, which is formed by the kidney, until you urinate. It is a common cancer of the urinary tract. The most common type of bladder cancer is the transitional cell carcinoma, which arises from the transitional cells in your bladder.

The clinical course of this condition varies according to the staging and extent of the disease. If the cancer is superficial, it is less likely to progress to death. However, if the cancer involves deeper layers of the bladder wall, it can be life-threatening. The most common symptom for this condition is blood in urine and is present in around 80-90% of people.

The American Cancer Society estimated that there will be around 81,400 people who will be diagnosed with bladder cancer in 2020 and that around 17,000 others will die from the disease. Bladder cancer becomes more common with increasing age. It is rare among people aged less than 40 years. It is a condition which is more common among men compared to women. Around the world, this cancer arises in around 275,000 people per year.

The treatment for bladder cancer depends on the extent and aggressiveness of the disease.

Causes and risk factors of Bladder Cancer

Bladder cancer is caused by abnormal proliferation of cells in your bladder. It can also be due to cancer cells which have migrated from another site to the bladder. Similarly, cancer cells from the bladder cancer can travel to other organs. When this happens, the cancer is said to have metastasized.

The majority of bladder cancer cases are due to environmental exposures. The following increase your risk of having bladder cancer:

• Tobacco smoking: This is the most common cause of bladder cancer. The more cigarettes and the longer timeframe you smoke, the higher your risk. People who smoke are 2-6 times more prone to have bladder cancer compared to those who don’t smoke.
• Certain occupations: If you are exposed to diesel exhaust, petroleum products and solvents in your workplace, you have a higher risk of having bladder cancer.
• Living in urban areas: Due to the increased likelihood of exposure to carcinogens in urban areas, this make the inhabitants more prone to bladder cancer.
• Exposure to arsenic: Arsenic is an element which is found in rocks, soil, water or air as well as in man made products such as pesticides. Excessive exposure to that element increases your risk of having bladder cancer.
• Radiation to pelvis: You are at risk if you had radiation therapy to your pelvis in the past.
• Chemotherapy: Similarly, chemotherapy can put you more at risk of having bladder cancer.

Signs and symptoms of Bladder cancer

The most common symptom of bladder cancer is blood in urine. Urination is usually painless and the blood is visible to naked eye. Your urine can appear dark or cola coloured. Other signs and symptoms include:

• With advanced disease, pain on urination can arise
• Frequent urination
• Urge to urinate
• If the cancer spreads to the pelvic or other bones of the body, back pain may be present

Making a diagnosis

After taking a good history from you, your doctor will examine you to look for any other signs and symptoms. Then, your doctor will request for other tests to confirm the diagnosis. These include:

• Urine cytology: A sample of your urine is taken to be analysed under a microscope to look for the presence of cancer cells.
• Cystoscopy: In this procedure, a tube with a camera on its end is inserted through your urethra up to your bladder. This will allow visualising the inside of your bladder to look for any abnormal mass or suspicious findings. If a mass is found, a sample of it can be taken during for procedure for further analysis. In some cases, the whole mass can be taken out.
• Ultrasonography: This involves using sound waves to visualize your bladder. It can also be used to identify the presence of any complications arising in the kidneys.
• Computed tomography (CT) scan: This gives a more detailed view of the bladder, the kidneys and other surrounding structures. It is also an important step in staging the cancer. A CT urogram is a procedure in which a dye is injected in your blood. It will travel to the kidneys and bladder and thus, X-ray images are taken to view the urinary tract.

Treatment of Bladder cancer

 The treatment of bladder cancer depends on the extent (grading), aggressiveness and type of the cancer. It will also depend on the general health and age of the patient.

Surgical options include:

• Transurethral resection of bladder tumour (TURBT): This is usually done during cystoscopy. An instrument is inserted through the cystoscope to reach the bladder. Electric current is passed through the instrument to excise the cancer.
• Cystectomy: This is the removal of all or part of the bladder. If partial removal is done, only the part which has the tumour is removed. When the whole bladder is removed, this is called radical cystectomy. In some cases, surrounding structures such as the uterus, ovaries and vagina (in females) or the prostate    Read more