What is bladder cancer?
Bladder cancer is a type of cancer that develops in the lining of the bladder. The bladder is a hollow organ in the lower abdomen that stores urine before it is expelled from the body. This type of cancer most commonly affects older adults.
What causes bladder cancer?
The exact causes of bladder cancer are not fully known, but several risk factors have been identified that increase the likelihood of developing it. Men are about three times more likely to develop bladder cancer than women. People over the age of 50 are also at higher risk. Environmental factors that can be avoided include:
- Smoking: Smokers are twice as likely to develop bladder cancer compared to non-smokers.
- Exposure to chemicals: Certain industrial chemicals used in dyes, paints, and textiles.
- Chronic bladder infections: Recurrent urinary tract infections and urinary system problems.
What are the symptoms of bladder cancer?
- Blood in the urine (most common symptom)
- Burning sensation or pain during urination
- Frequent urination
How is bladder cancer diagnosed?
Tests used to diagnose bladder cancer include:
- Urinalysis: To detect abnormal indicators in urine.
- Urine cytology: A specialized test to examine bladder cells under a microscope for cancer.
- Cystoscopy: A thin tube with a camera is inserted into the bladder to examine its lining.
- Biopsy: Taking a tissue sample from the bladder wall.
- CT scan of the abdomen and pelvis.
- Additional tests to check for cancer spread, such as bone scans, chest X-rays, and CT imaging.
How is bladder cancer treated?
1. Superficial bladder cancer:
After an initial diagnostic cystoscopy, patients usually undergo transurethral resection of bladder tumor (TURBT). In many cases, the tumor is completely removed, making this procedure potentially curative.
Sometimes, additional treatment is recommended, known as intravesical therapy, where medication is delivered directly into the bladder. The choice depends on the patient’s risk of recurrence and ability to tolerate treatment side effects.
In high-risk cases, a second TURBT may be performed before or after intravesical therapy to ensure no remaining cancer and to better stage the disease.
2. Muscle-invasive bladder cancer:
The standard treatment includes:
- Radical cystectomy (complete removal of the bladder):
- In men: removal of the bladder, urethra, prostate, seminal vesicles, lower ureters, and pelvic lymph nodes.
- In women: removal of the bladder, urethra, lower ureters, nearby vaginal tissue, uterus, and pelvic lymph nodes.
These procedures may be modified in some cases to preserve certain organs, depending on how far the cancer has spread.
Since bladder removal eliminates its function, the surgeon creates a new way for urine to exit the body (urinary diversion), which may involve the urethra, abdominal wall, or part of the intestine. The method depends on the disease stage, patient health, and personal preference.