7- Bladder Cancer
Bladder Cancer is a type of cancer that begins in your bladder — a balloon-shaped organ in your pelvic area that stores urine. Bladder cancer begins most often in the cells that line the inside of the bladder. Bladder cancer typically affects older adults, though it can occur at any age.
The great majority of bladder cancers are diagnosed at an early stage — when bladder cancer is highly treatable. However, even early-stage bladder cancer is likely to recur. For this reason, bladder cancer survivors often undergo follow-up tests to look for bladder cancer recurrence for years after treatment.
Symptoms of Bladder Cancer
Bladder cancer signs and symptoms may include:• Blood in urine (hematuria) — urine may appear dark yellow, bright red or cola colored. Or urine may appear normal, but blood may be detected in a microscopic examination of the urine.
• Frequent urination.
• Painful urination.
• Back pain.
• Pelvic pain.
When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you, such as blood in your urine. Causes
It's not always clear what causes bladder cancer. Bladder cancer has been linked to smoking, a parasitic infection, radiation and chemical exposure. Bladder cancer develops when cells in the bladder begin to grow abnormally. Rather than grow and divide in an orderly way, these cells develop mutations that cause them to grow out of control and not die. These abnormal cells form a tumor.Types of bladder cancer
Different types of cells in your bladder can become cancerous. The type of bladder cell where cancer begins determines the type of bladder cancer. Your bladder cancer type determines which treatments may work best for you.Types of bladder cancer include:
• Transitional cell carcinoma. Transitional cell carcinoma occurs in the cells that line the inside of your bladder. Transitional cells expand when your bladder is full and contract when your bladder is empty. These same cells line the inside of your ureters and your urethra, and tumors can form in those places as well. Transitional cell carcinoma is the most common type of bladder cancer in the United States.
• Squamous cell carcinoma. Squamous cells appear in your bladder in response to infection and irritation. Over time they can become cancerous. Squamous cell bladder cancer is rare in the United States. It's more common in parts of the world where a certain parasitic infection (schistosomiasis) is a prevalent cause of bladder infections.
• Adenocarcinoma. Adenocarcinoma begins in cells that make up mucus-secreting glands in the bladder. Adenocarcinoma of the bladder is rare in the United States.
Some bladder cancers include more than one type of cell
Risk factors
Factors that may increase your risk of bladder cancer include:• Smoking. Smoking cigarettes, cigars or pipes may increase your risk of bladder cancer by causing harmful chemicals to accumulate in your urine. When you smoke, your body processes the chemicals in the smoke and excretes some of them in your urine. These harmful chemicals may damage the lining of your bladder, which can increase your risk of cancer.
• Increasing age. Your risk of bladder cancer increases as you age. Bladder cancer can occur at any age, but it's rarely found in people younger than 40.
• Being white. Whites have a greater risk of bladder cancer than do people of other races.
• Being a man. Men are more likely to develop bladder cancer than women are.
• Exposure to certain chemicals.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 your risk of bladder cancer. Chemicals linked to bladder cancer risk include arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products.
• Previous cancer treatment. Treatment with the anti-cancer drug cyclophosphamide (Cytoxan) increases your risk of bladder cancer. People who received radiation treatments aimed at the pelvis for a previous cancer may have an elevated risk of developing bladder cancer.
• Taking a certain diabetes medication. People who take the diabetes medication pioglitazone (Actos) for more than a year may have an increased risk of bladder cancer. Other diabetes medications contain pioglitazone, including pioglitazone and metformin (Actoplus Met) and pioglitazone and glimepiride (Duetact).
• Chronic bladder inflammation. Chronic or repeated urinary infections or inflammations (cystitis), such as may happen with long-term use of a urinary catheter, may increase your risk of a squamous cell bladder cancer. In some areas of the world, squamous cell carcinoma is linked to chronic bladder inflammation caused by the parasitic infection known as schistosomiasis.
• Personal or family history of cancer. If you've had bladder cancer, you're more likely to get it again. If one or more of your immediate relatives have a history of bladder cancer, you may have an increased risk of the disease, although it's rare for bladder cancer to run in families. A family history of hereditary nonpolyposis colorectal cancer, also called Lynch syndrome, can increase your risk of cancer in your urinary system, as well as in your colon, uterus, ovaries and other organs.
Complications
Bladder cancer often recurs. Because of this, bladder cancer survivors often undergo follow-up testing for years after successful treatment. What tests you'll undergo and how often will depend on your type of bladder cancer and your treatment, among other factors.Ask your doctor to create a follow-up plan for you. In general, doctors recommend a test to examine the inside of your urethra and bladder (cystoscopy) every three to six months for the first few years after bladder cancer treatment. Then you may undergo cystoscopy every year. Your doctor may recommend other tests at various intervals as well.
People with aggressive cancers may undergo more frequent screening. Those with less aggressive cancers may undergo screening tests less often.
Tests and diagnosis
- Female cystoscopy
- Male cystoscopyDiagnosing bladder cancer
Tests and procedures used to diagnose bladder cancer may include:• Cystoscopy. During cystoscopy, your doctor inserts a narrow tube (cystoscope) through your urethra. The cystoscope has a lens and fiber-optic lighting system, allowing your doctor to see the inside of your urethra and bladder. You usually receive a local anesthetic during cystoscopy to help make you comfortable.
• Biopsy. During cystoscopy, your doctor may pass a special tool through the scope and into your bladder in order to collect a cell sample (biopsy) for testing. This procedure is sometimes called transurethral resection (TUR). TUR can also be used to treat bladder cancer. TUR is usually performed under general anesthesia.
• Urine cytology. A sample of your urine is analyzed under a microscope to check for cancer cells in a procedure called urine cytology.
• Imaging tests. Imaging tests allow your doctor to examine the structures of your urinary tract. Tests to highlight the urinary tract sometimes use a dye, which is injected into a vein before the procedure. An intravenous pyelogram is a type of X-ray imaging test that uses a dye to highlight your kidneys, ureters and bladder. A computerized tomography (CT) scan is a type of X-ray test that allows your doctor to better see your urinary tract and the surrounding tissues.
Staging bladder cancer
Once it's confirmed that you have bladder cancer, your doctor may order additional tests to determine the extent (stage) of the cancer. Staging tests may include:• CT scan.
• Magnetic resonance imaging (MRI).
• Bone scan.
• Chest X-ray.
Bladder cancer stages
The stages of bladder cancer are:• Stage I. Cancer at this stage occurs in the bladder's inner lining but hasn't invaded the muscular bladder wall.
• Stage II. At this stage, cancer has invaded the bladder wall but is still confined to the bladder.
• Stage III. The cancer cells have spread through the bladder wall to surrounding tissue. They may also have spread to the prostate in men or the uterus or vagina in women.
• Stage IV. By this stage, cancer cells may have spread to the lymph nodes and other organs, such as your lungs, bones or liver.
