Bladder Cancer

The bladder is located in the lower abdomen, and collects and stores urine produced by the kidneys and is where urine is temporarily stored until it is discharged from the body.The bladder’s wall is multi-layered, and cancer most often occurs first in the innermost lining and spreads outward to the external walls.

Most bladder cancers are one of three types:

• Urothelial carcinoma — Occurs when the cells that line the inner wall of the bladder undergo changes that lead to the uncontrolled cell growth.
• Squamous cell carcinoma — Originates from the thin, flat cells that can form as a result of bladder inflammation or irritation that has taken place over an extended period of time.
• Adenocarcinoma — Form from the cells that make up glands, which produce and release fluids such as mucus.

Treatment choices may depend on which type of bladder cancer the patient has.

Risk Factors

• Age — The likelihood of getting bladder cancer increases with age.
• Gender — Males develop bladder cancer two to three times more often than females, according to the National Cancer Institute.
• Occupation — Exposure to certain chemicals
• Smoking or tobacco use
• Medical treatment with arsenic or cyclophosphamide
• Personal history of bladder cancer
• Family history

Signs of Bladder Cancer

People who have bladder cancer may notice a combination of the following signs:

• Painful urination
• Blood in the urine
• Frequent urination
• Back or abdominal pain
• Loss of appetite and weight loss

Detection and Diagnosis

Patients who notice signs of bladder cancer should see a physician as quickly as possible because the earlier bladder cancer is diagnosed, the easier it is to treat effectively. Physicians may examine a patient's abdomen and pelvis for lumps or swelling and may also conduct a rectal or vaginal exam. A urinalysis and urine culture will examine a sample of the patient’s urine for infection or blood. Urine cytology checks for cancer cells from what has been “washed” from the bladder.

A CT scan is completed during which dye is injected into the bloodstream and images are taken of the bladder and abdominal pelvic organs, including the kidneys and bladder.

During a cystoscopy the physician will insert a long thin camera, called a cystoscope, into the bladder through the urethra to be able to look closely at the bladder lining. If there is anything that appears abnormal, a sample may be removed using the cystoscope. An examination of the biopsy sample under a microscope may diagnose cancer.

Additional studies, such as X-rays, CAT scans and magnetic resonance imaging (MRI) may be needed to detect cancerous growth by taking internal pictures of the body.

Treatment Options

Surgery is the most common form of treatment for all types and stages of bladder cancer. Superficial, noninvasive tumors can be removed in a cystoscopic procedure, while some tumors may require partial bladder removal (partial cystectomy).

Cancers that invade the bladder muscle, and superficial cancers that extend over much of the bladder may require removal of the bladder (radical cystectomy), surrounding lymph nodes and cancerous structures.

• Immunotherapy is often used with patients who have non-muscle invasive disease to decrease recurrence of tumors and their progression to muscle invasive disease.
• Chemotherapy is the use of powerful drugs to kill cancer. It is usually given before surgery or radiation therapy.
• Radiation therapy is an alternative for people unable to undergo surgery. High-energy radiation rays can reduce tumors and kill cancer cells