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Bladder Cancer

Definition:
Bladder cancer is a disease in which cancer cells grow in the bladder. The bladder, which is located in the lower abdomen, is a hollow organ with flexible muscular walls. Its primary function is to store urine until a person is ready to urinate.

Cancer occurs when cells in the body (in this case, bladder cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue, called a growth or tumor, forms. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor does not invade or spread.

There are three main types of cancer that affect the bladder. They are named for the type of cell that becomes cancerous:

  • Transitional cell (urothelial) carcinoma – accounts for more than 90% of bladder cancers
  • Squamous cell carcinoma – accounts for about 4% of bladder cancers
  • Adenocarcinoma – accounts for about 1-2% of bladder cancers
Causes:
The cause of bladder cancer is unknown. However, several risk factors have been identified.

Risk Factors:
A risk factor is something that increases your chances of getting a disease or condition.

The following factors increase your chances of developing bladder cancer:

  • Smoking
  • Increasing age: the majority of people with bladder cancer are between 65 and 85 years old
  • Occupation: due to occupational exposures to certain substances. Occupations at risk include:
    • Rubber, leather, and textile workers
    • Painters
    • Hairdressers
    • Machinists
    • Printers
    • Truck drivers
  • Race: White
  • Sex: Male
  • Chronic bladder inflammation or infection (e.g., Schistosomiasis, an infection caused by a parasitic worm)
  • Personal or family history of bladder cancer
  • Chemotherapeutic drugs: cyclophosphamide and ifosfamide
  • Exposure to arsenic
  • Radiation treatment of the pelvis
  • Bladder birth defects

Symptoms:
Symptoms include:

  • Blood in the urine (hematuria)
  • Frequent urination, or feeling the need to urinate without being able to
  • Painful urination
  • Lower back pain
Diagnosis:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. During the exam, your doctor will feel the abdomen and pelvis for abnormalities. The physical exam may include a rectal or vaginal exam.

Tests include:

Urine cytology: a sample of urine is examined under a microscope to look for cancerous or precancerous cells

Urine culture: a sample of urine is cultured to look for signs of infection (i.e., bacteria)

Cystoscopy: a procedure in which a doctor looks into the bladder through the urethra using a cytoscope (a slender tube with a lens and light)

Intravenous pyelogram (IVP): x-rays of the bladder, kidneys, and ureters taken after dye is injected into the bloodstream

CT scan: a type of x-ray that uses a computer to make pictures of the inside of the bladder and surrounding structures

Magnetic resonance imaging (MRI) scan: a test that uses magnetic waves to make pictures of the inside of the bladder and surrounding structures

Ultrasound:a test that uses sound waves to examine the bladder

Biopsy: removal of a sample of bladder tissue to test for cancer cells

Treatment:
Once bladder cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what parts of the body. Treatments for bladder cancer depend on the stage of the cancer. The stages of bladder cancer are as follows:
  • Stage 0: cancer cells are found only on the surface of the inner lining of the bladder
  • Stage 1: cancer cells are found deep in the inner lining of the bladder
  • Stage 2: cancer cells have spread to the muscle of the bladder
  • Stage 3: cancer cells have spread through the muscular wall of the bladder to the layer of tissue surrounding the bladder and possibly to the reproductive organs
  • Stage 4: cancer cells extend to the wall of the abdomen or to the wall of the pelvis and possibly to one or more lymph nodes or other parts of the body
Prevention:
The following steps can reduce your risk of getting bladder cancer:
  • Don't smoke or use tobacco products. If you do, quit.
  • Avoid or minimize occupational exposure to certain chemicals; follow good work safety practices
  • Drink plenty of liquids
  • Eat a diet rich in fruits and vegetables
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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