Bladder cancer is cancer that forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas (cancer that begins in cells
that normally make up the inner lining of the bladder). Other types include
squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma
(cancer that begins in cells that make and release mucus and other fluids).
The cells that form squamous cell carcinoma and adenocarcinoma develop in
the inner lining of the bladder as a result of chronic irritation and inflammation.
The bladder is a hollow organ in the lower abdomen.
It stores urine, the liquid waste produced
by the kidneys. Urine passes from each kidney
into the bladder through a tube called a ureter.
An outer layer of muscle surrounds the inner lining of the bladder. When
the bladder is full, the muscles in the bladder wall can tighten to allow
urination. Urine leaves the bladder through another tube, the urethra.
Who is at risk from bladder cancer?
No one knows the exact causes of bladder cancer. However, it is clear that
this disease is not contagious. No one can "catch" cancer from another person.
People who get bladder cancer are more likely than other people to have
certain risk factors. A risk factor is something that increases a person's
chance of developing the disease.
Still, most people with known risk factors do not get bladder cancer, and
many who do get this disease have none of these factors. Doctors can seldom
explain why one person gets this cancer and another does not.
Studies have found the following risk factors for bladder cancer:
Chlorine is added to water to make
it safe to drink. It kills deadly bacteria. However, chlorine by-products
sometimes can form in chlorinated water. Researchers have been studying
chlorine by-products for more than 25 years. So far, there is no proof that
chlorinated water causes bladder cancer in people. Studies continue to look
at this question.
- Age. The chance of getting bladder cancer goes up as people
get older. People under 40 rarely get this disease.
- Tobacco. The use of tobacco is a major risk factor. Cigarette
smokers are two to three times more likely than nonsmokers to get bladder
cancer. Pipe and cigar smokers are also at increased risk.
- Occupation. Some workers have a higher risk of getting bladder
cancer because of carcinogens in the workplace. Workers in the rubber,
chemical, and leather industries are at risk. So are hairdressers, machinists,
metal workers, printers, painters, textile workers, and truck drivers.
- Infections. Being infected with certain parasites increases
the risk of bladder cancer. These parasites are common in tropical areas
but not in the United States.
- Treatment with cyclophosphamide or arsenic. These drugs are
used to treat cancer and some other conditions. They raise the risk
of bladder cancer.
- Race. Whites get bladder cancer twice as often as African Americans
and Hispanics. The lowest rates are among Asians.
- Being a man. Men are two to three times more likely than women
to get bladder cancer.
- Family history. People with family members who have bladder
cancer are more likely to get the disease. Researchers are studying
changes in certain genes that may increase the risk of bladder cancer.
- Personal history of bladder cancer. People who have had bladder
cancer have an increased chance of getting the disease again.
Some studies have found that saccharin, an artificial sweetener,
causes bladder cancer in animals. However, research does not show that saccharin
causes cancer in people.
People who think they may be at risk for bladder cancer should discuss this
concern with their doctor. The doctor may suggest ways to reduce the risk
and can plan an appropriate schedule for checkups.
What are the signs and symptoms of bladder cancer?
Common symptoms of bladder cancer include:
These symptoms are not sure signs of bladder cancer. Infections, benign
tumors, bladder stones, or other problems also can cause these symptoms.
Anyone with these symptoms should see a doctor so that the doctor can diagnose
and treat any problem as early as possible. People with symptoms like these
may see their family doctor or a urologist, a doctor who specializes in
diseases of the urinary system.
- Blood in the urine (making the urine slightly rusty to deep red),
- Pain during urination, and
- Frequent urination, or feeling the need to urinate without results.
is bladder cancer diagnosed?
If a patient has symptoms that suggest bladder cancer, the doctor may check
general signs of health and may order lab tests. The person may have one
or more of the following procedures:
The doctor can remove samples of tissue with the cystoscope. A pathologist
then examines the tissue under a microscope. The removal of tissue to look
for cancer cells is called a biopsy. In many
cases, a biopsy is the only sure way to tell whether cancer is present.
For a small number of patients, the doctor removes the entire cancerous
area during the biopsy. For these patients, bladder cancer is diagnosed
and treated in a single procedure.
- Physical exam. The doctor feels the abdomen and pelvis for tumors. The physical exam
may include a rectal or vaginal exam.
- Urine tests. The laboratory checks the urine for blood, cancer
cells, and other signs of disease.
- Intravenous pyelogram. The doctor injects dye into a blood
vessel. The dye collects in the urine, making the bladder show up on X-rays.
- Cystoscopy. The doctor uses a thin, lighted tube (cystoscope)
to look directly into the bladder. The doctor inserts the cystoscope
into the bladder through the urethra to examine the lining of the bladder.
The patient may need anesthesia for
A patient who needs a biopsy may want to ask the doctor some of the following
- Why do I need to have a biopsy?
- How long will it take? Will I be awake? Will it hurt?
- How soon will I know the results?
- Are there any risks? What are the chances of infection or bleeding
after the biopsy?
If I do have cancer, who will talk with me about treatment? When?
Staging the disease
If bladder cancer is diagnosed, the doctor needs to know the stage, or extent,
of the disease to plan the best treatment. Staging is a careful attempt
to find out whether the cancer has invaded the bladder wall, whether the
disease has spread, and if so, to what parts of the body.
The doctor may determine the stage of bladder cancer at the time of diagnosis,
or may need to give the patient more tests. Such tests may include imaging
tests – CT scan, magnetic resonance imaging (MRI), sonogram, intravenous pyelogram, bone
scan, or chest X-ray. Sometimes
staging is not complete until the patient has surgery.
These are the main features of each stage of the disease:
- Stage 0. The cancer cells are found only on the surface of the inner
lining of the bladder. The doctor may call this superficial cancer or
carcinoma in situ.
- Stage I. The cancer cells are found deep in the inner lining of the
bladder. They have not spread to the muscle of the bladder.
- Stage II. The cancer cells have spread to the muscle of the bladder.
- Stage III. The cancer cells have spread through the muscular wall
of the bladder to the layer of tissue surrounding the bladder. The cancer
cells may have spread to the prostate (in men) or to the uterus or vagina (in women).
- Stage IV. The cancer extends to the wall of the abdomen or to the wall of the pelvis. The cancer
cells may have spread to lymph nodes and other parts of the body far away from the bladder, such as the lungs.
How is bladder cancer treated?
Read about how bladder cancer
Source: National Cancer Institute