Bladder Cancer

Overview

Bladder cancer occurs when cells grow abnormally in the bladder lining, often leading to symptoms like blood in the urine, frequent urination, and pain during urination. It has various types, including urothelial carcinoma, squamous cell carcinoma, and small cell carcinoma. However, early detection and getting prompt medical attention improve outcomes.

Treatment options that a healthcare professional may consider include surgery, chemotherapy, and radiation therapy. Also, you can adopt certain preventive measures like quitting smoking and avoiding harmful chemicals to reduce risk. Ensure regular medical checkups for managing bladder cancer effectively.

What is Bladder Cancer?

The bladder is the organ in your body that is responsible for holding your urine. Bladder cancer refers to the condition where cells grow and multiply abnormally in the bladder, leading to their spread to nearby organs. Symptoms include blood in urine, pain during urination, and frequent urination.

Once you notice these signs, you should immediately consult a doctor. Remember, it is easier for healthcare professionals to treat bladder cancer at their early stage. Also, you must keep following up with your doctor after the treatment as about 75% of the time they come back even when completely cured in the first instance.

Types of Bladder Cancer

Different types of cancer cells can grow in your blender, and the location where it begins determines the bladder cancer type.

Usually, healthcare providers classify bladder cancer as:

Non-muscle-invasive: It refers to the type of bladder cancer where the cancer has spread into the deeper layers of the cells but not into the muscle.

Noninvasive: Here, bladder cancer develops in the form of tumours near the surface of the bladder or in a small section of the tissue.

Muscle-invasive: In this type, bladder cancer has already spread into the muscle of the bladder and even into its fatty layer or to the adjoining organs.

Other common types of bladder cancer that people are diagnosed with include:

Urothelial Carcinoma

Urothelial cells line the inner surface of the bladder. It expands with your bladder being full and contacts when your bladder is empty. The abnormal growth of these types of cells causes cancer referred to as urothelial carcinoma or transitional cell carcinoma (TCC).

These cells also line the inside walls of the kidney, uterus, and urethra, indicating that the cancer can spread to those places as well. Individuals suffering from bladder cancer can also have tumours in these places. Hence, one must get screened for them as well.

Squamous Cell Carcinoma

Also known as epidermoid carcinoma, it is a group of cancerous cells or masses that occur in squamous cells. These are thin, flat cells that line the inside wall of your bladder. This cancer type occurs with chronic irritation of the bladder, such as an infection or prolonged use of a urinary catheter.

Small Cell Carcinoma

Small cell carcinoma of the bladder is aggressive and rare and accounts for less than 1% of all bladder cancer cases. These fast-growing abnormal cells grow in neuroendocrine cells and require to be treated using chemotherapy.

Sarcoma

This rare cancer type starts in the structural tissues, muscles, fat or nerves in the bladder. Also known as soft tissue sarcoma, these cancer cells can spread to the other parts or cells of the body like the urothelial cells (metastasis).

Adenocarcinoma

It starts in cells that form mucus-secreting glands in the bladder. It is an unusual malignancy of the bladder that may primarily form in the bladder itself, or secondarily from other body parts. Early diagnosis and treatment can help manage the risk factors of this cancer type.

Papillary Bladder Cancer

It is a non-muscle invasive bladder cancer that appears with small growths, structured like mushrooms. These cell masses spread beyond the bladder lining, requiring a surgeon to remove them. This cancer type has a chance of coming back, even after it is cured the first time.

Carcinoma in Situ (CIS)

The areas affected by this cancer type are flat, and they grow out of the bladder wall. The malignant cells grow and spread rapidly, and are also called high-grade. Compared to other types of muscle-invasive bladder cancer, this type is likely to come back.

High Grade T1 Tumours

They are early cancerous cells that start spreading from the bladder lining into a layer below that, called the lamina propria. While these tumours are early cancers, they can spread rapidly.

Symptoms of Bladder Cancer

Symptoms of cancer in the bladder may include the following:

• Lower back pain on one side
• Swelling experienced in the feet
• Experience pain during urination
• Hematuria (blood in urine, causing the urine to appear bright or cola red)
• Frequent urge to urinate
• Bone pain
• Bladder infection

Causes of Bladder Cancer

Researchers are not able to identify why the cells in the bladder mutate and become cancerous cells. However, the following may be the common causes of bladder cancer:

• Exposure to radiation
• Persistent infection in the bladder
• Chain smoking
• Chemotherapy
• Continuous use of catheter
• Exposure to chemicals used in dyes, textiles, rubber and paint

Risk Factors of Bladder Cancer

Here are some factors that may increase the risk of developing bladder cancer in individuals:

Age: The risk of developing bladder cancer increases as one age. While the disease can develop at any age, individuals older than 55 are commonly diagnosed with cancer of the bladder.

History of Cancer Treatment: The risk of bladder cancer increases for an individual who has previously taken anticancer drugs. Additionally, patients who received radiation treatments in the pelvic area are at high risk of bladder cancer.

Exposure to Chemicals: Chemical exposure, including arsenic or the ones used in rubber, leather, dyes and textiles, increases the cancer risk. The kidney filters these harmful chemicals from the bloodstream and moves them into the bladder, raising the risk for abnormal cells to grow in your bladder.

Family History of Cancer: If your family members, including parents, siblings or child, have a history of bladder cancer, you are at a risk of developing it. Moreover, a family history of Lynch syndrome increases the risk of Cancer cell growth in the urinary system, ovaries, uterus, and colon.

Chronic Bladder Infections: Inflammation caused by long-term use of urinary catheters or repeated unity infections increases the risk of developing abnormal squamous cells in the bladder. Squamous cell carcinoma is linked to bladder inflammation or infections caused by schistosomiasis.

Complications of Bladder Cancer

Bladder cancer can spread to other parts of the body including bones, liver and lungs. Following are the other complications that the disease may cause:

• Anemia
• Urethral stricture
• Swelling of the ureters
• Depression
• Sexual dysfunction in women
• Erectile dysfunction in men
• Urinary inconsistency
• Pelvic pain
• Fatigue
• Infertility in both men and women

Diagnosis of Bladder Cancer

Here are some of the diagnostic tests that a healthcare provider may recommend:

Cytology: Study of bladder cells under a microscope to identify signs of cancer.

Urinalysis: An individual's urine is tested to examine an infection in the bladder.

Cystoscopy: A pencil-sized lighted tube is used to examine the inside of the bladder and urethra. Then, a fluorescent dye and special blue light are used to view cancer.

Transurethral Resection of Bladder Tumour (TURBT): Removes bladder tumours before the tumour invades the bladder’s muscle wall.

Magnetic Resonance Imaging (MRI) Test: A magnet, computer and radio waves are used to capture detailed bladder images.

Bone Scan: Bones are scanned to check for signs of bladder cancerous cells that have spread to the bones.

Treatment for Bladder Cancer

Following are some of the treatment options that a healthcare professional may consider to manage the risk factors of the disease:

• Surgery
• Radiation therapy
• Transurethral resection with fulguration
• Partial cystectomy
• Immunotherapy
• Chemotherapy
• Radiation therapy
• Radical cystectomy with urinary division

Targeted therapy including enfortumab vedotin, erdafitinib, ramucirumab and sacituzumab govitecan-hziy

Preventive Measures for Bladder Cancer

Following are some of the measures that can help prevent the complications of bladder cancer:

• Drink enough fluids including water throughout the day
• Quit smoking including cigars, pipes and cigarettes
• Consume a healthy diet rich in fruits and vegetables
• Limit exposure to harmful chemicals at the workplace and follow safety protocols
• Avoid consuming water that has a high percentage of arsenic

Myths and Facts Related to Bladder Cancer

Following are some of the popular myths and facts related to bladder cancer:

Myth 1: Bladder cancer cannot be treated

Fact: The disease can be treated and its complications can be managed with early diagnosis. Treatment options include radiation, immunotherapy, chemotherapy and surgery, depending on the aggressiveness and stage of cancer.

Myth 2: Only older people develop cancer in the bladder

Fact: While smoking habits and age increase the risk factor of developing this disease, it can affect individuals of any age. People who do not smoke or are younger can also be at risk of bladder cancer due to exposure to harmful chemicals or chronic bladder infection.

Myth 3: Bladder cancer always causes death

Fact: Treating the disease can become challenging if diagnosed at an advanced stage. However, getting screened early and receiving immediate medical attention can lead to increased survival rates, enabling people to live a happy life.

Myth 4: Blood in urine indicates bladder cancer

Fact: Blood in urine can be a symptom of bladder cancer, but it may be due to an underlying issue such as kidney stones or urinary tract infections. Consult a doctor to confirm the cause.

Myth 5: A man is more vulnerable to developing bladder cancer

Fact: While most individuals diagnosed with this cancer type are men, it can affect anyone regardless of gender. A woman who is working in the manufacturing industry of paints, textiles or dyes may develop the disease, or a woman who has received prior cancer treatment.