Urinary bladder cancer
Bladder cancer occurs in the tissues of the bladder, which is the organ in the body that holds urine. According to the National Institutes of Health, approximately 45,000 men and 17,000 women per year are diagnosed with the disease.
Types of bladder cancer
There are three types of bladder cancer:
Transitional cell carcinoma
Transitional cell carcinoma is the most common type of bladder cancer. It begins in the transitional cells in the inner layer of the bladder. Transitional cells are cells that change shape without becoming damaged when the tissue is stretched.
Squamous cell carcinoma
Squamous cell carcinoma is a rare cancer in the United States. It begins when thin, flat squamous cells form in the bladder after a long-term infection or irritation in the bladder.
Adenocarcinoma is also a rare cancer in the United States. It begins when glandular cells form in the bladder after long-term bladder irritation and inflammation. Glandular cells are what make up the mucus-secreting glands in the body.
What are the symptoms of bladder cancer?
Many people with bladder cancer can have blood in their urine but no pain while urinating. There are a number of symptoms that might indicate bladder cancer like fatigue, weight loss, and bone tenderness, and these can indicate more advanced disease. You should pay particular attention to the following symptoms:
• blood in the urine
• painful urination
• frequent urination
• urgent urination
• urinary incontinence
• pain in the abdominal area
• pain in the lower back
What causes bladder cancer?
The exact cause of bladder cancer is unknown. It occurs when abnormal cells grow and multiply quickly and uncontrollably, and invade other tissues.
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Who is at risk for bladder cancer?
Smoking increases your risk of bladder cancer. Smoking causes half of all bladder cancers in men and women. The following factors also increase your risk of developing bladder cancer:
• exposure to cancer-causing chemicals
• chronic bladder infections
• low fluid consumption
• being male
• being white
• being older, since the majority of bladder cancers occur in people over the age of 55
• eating a high-fat diet
• having a family history of bladder cancer
• having previous treatment with a chemotherapy drug called Cytoxan
• having previous radiation therapy to treat cancer in the pelvic area
How is bladder cancer diagnosed?
Your doctor may diagnose bladder cancer using one or more of the following methods:
• a urinalysis
• an internal examination, which involves your doctor inserting gloved fingers into your vagina or rectum to feel for lumps that may indicate a cancerous growth
• a cystoscopy, which involves your doctor inserting a narrow tube that has a small camera on it through your urethra to see inside your bladder
• a biopsy in which your doctor inserts a small tool through your urethra and takes a small sample of tissue from your bladder to test for cancer
• a CT scan to view the bladder
• an intravenous pyelogram (IVP)
Your doctor can rate bladder cancer with a staging system that goes from stages 0 to 4 to identify how far the cancer has spread. The stages of bladder cancer mean the following:
• Stage 0 bladder cancer hasn’t spread past the lining of the bladder.
• Stage 1 bladder cancer has spread past the lining of the bladder, but it hasn’t reached the layer of muscle in the bladder.
• Stage 2 bladder cancer has spread to the layer of muscle in the bladder.
• Stage 3 bladder cancer has spread into the tissues that surround the bladder.
• Stage 4 bladder cancer has spread past the bladder to the neighboring areas of the body.
How is bladder cancer treated?
Your doctor will work with you to decide what treatment to provide based on the type and stage of your bladder cancer, your symptoms, and your overall health.
Treatment for stage 0 and stage 1
Treatment for stage 0 and stage 1 bladder cancer may include surgery to remove the tumor from the bladder, chemotherapy, or immunotherapy, which involves taking a medication that causes your immune system to attack the cancer cells.
Treatment for stage 2 and stage 3
Treatment for stage 2 and stage 3 bladder cancer may include:
• removal of part of the bladder in addition to chemotherapy
• removal of the whole bladder, which is a radical cystectomy, followed by surgery to create a new way for urine to exit the body
• chemotherapy, radiation therapy, or immunotherapy that can be done to shrink the tumor before surgery, to treat the cancer when surgery isn’t an option, to kill remaining cancer cells after surgery, or to prevent the cancer from recurring
Treatment for stage 4 bladder cancer
Treatment for stage 4 bladder cancer may include:
• chemotherapy without surgery to relieve symptoms and extend life
• radical cystectomy and removal of the surrounding lymph nodes, followed by a surgery to create a new way for urine to exit the body
• chemotherapy, radiation therapy, and immunotherapy after surgery to kill remaining cancer cells or to relieve symptoms and extend life
• clinical trial drugs
What is the outlook for people with bladder cancer?
Your outlook depends on a lot of variables, including the type and stage of cancer. According to the American Cancer Society, the five-year survival rates by stage are the following:
• The five-year survival rate for people with stage 0 bladder cancer is around 98 percent.
• The five-year survival rate for people with stage 1 bladder cancer is around 88 percent.
• The five-year survival rate for people with stage 2 bladder cancer is around 63 percent.
• The five-year survival rate for people with stage 3 bladder cancer is around 46 percent.
• The five-year survival rate for people with stage 4 bladder cancer is around 15 percent.
There are treatments available for all stages. Also, survival rates don’t always tell the whole story and can’t predict your future. Speak with your doctor about any questions or concerns you may have regarding your diagnosis and treatment.
Because doctors don’t yet know what causes bladder cancer, it may not be preventable in all cases. The following factors and behaviors can reduce your risk of getting bladder cancer:
• not smoking
• avoiding secondhand cigarette smoke
• avoiding other carcinogenic chemicals
• drinking plenty of water