Bladder cancer develops in the bladder, the organ that is responsible for holding urine once it has passed through the kidneys. Cancer of the bladder develops as a result of cancerous tissue that forms in the cells found in the inner lining of the bladder.
Understanding Bladder Cancer
The bladder is a rounded organ that stores urine. It is comprised of three layers of tissue and is otherwise hollow. When the cells within this tissue develop abnormally, they can experience a rapid out-of-control rate of growth and lead to the development of a mass or tumor. Tumors can be non-cancerous (benign) or cancerous (malignant). Benign tumors are typically not life threatening. They can be removed without the risk of further growth or spreading to other areas. Malignant tumors are cancerous. They can sometimes be removed but may return and can continue to grow and invade nearby tissue or other areas of the body. Malignant tumors in the bladder can be life threatening.
Types Of Bladder Cancer
Tumors within the bladder are typed according to the appearance of the cancer cells when they are carefully viewed with a microscope. When an individual is diagnosed with bladder cancer, it is important that he be checked for tumors in other areas of the urinary tract, as it is common to have more than one tumor in the surrounding locations. Though there are many rare forms of cancers, there are three main types of bladder cancer:
- Transitional Cell Carcinoma (TCC): TCC is the most commonly diagnosed form of bladder cancer and accounts for most cases. TCC begins in the cells that line the inner bladder. These tumors can grow toward the hollow inside of the bladder or they can remain on the inner lining. They are typically graded low or high in terms of how the cancer cells appear and how quickly they are presumed to grow. In addition, the tumor is labeled as wither invasive or non-invasive, a label that is determined according to whether or not the cancerous cells are likely to spread to other organs in the body.
- Squamous Cell Carcinoma: This form of bladder cancer is much less common and is typically very invasive. It often spreads quickly beyond the slim, plane cells from which it began to other areas of the bladder.
- Adenocarcinoma: This type of bladder cancer is also less common and is almost always invasive. It generally grows beyond the bladder lining and advances deeper into the inner wall of the bladder.
Symptoms Of Bladder Cancer
Bladder Cancer may produce symptoms that mimic or are associated with other types of health problems or underlying medical conditions. For this reason, it is important to report any and all suspected symptoms to your doctor right away. Symptoms associated with cancer of the bladder may include:
- Changes in the appearance of urine, including a darker color, which may indicate that blood is present in the urine.
- Blood detected in normal looking urine following a lab test.
- Increased frequency of urination.
- Increase in urgency to urinate.
- Sensation of having to urinate, without actually doing so.
- Pain during urination.
- General pain in your back and/or abdomen.
Causes Of Bladder Cancer
It has not been determined what exactly causes bladder cancer. Squamous Cell carcinoma and Adenocarcinoma are rare forms of bladder cancer, but are believed to be the result of infection and irritation. Transitional Cell Carcinoma does not have a definitive cause but there are many risk factors associated with the disease.
Although there is no one cause of bladder cancer, researchers have linked a variety of risk factors with cancer of the bladder. The most common risk factors are:
- Smoking; people who smoke are twice as likely to develop bladder cancer.
- Exposure to chemicals, toxins or radiation. When an individual is exposed to chemicals, the kidneys have to work to remove those toxins from the body. The effect of overworked kidneys trickles down to the bladder, which results in an increased risk of developing bladder cancer.
- Being a white male; white males are at the highest risk of developing bladder cancer, the reason for which is not clear.
- Family history; Individuals who have a personal or family history of the disease are at an increased risk for development of bladder cancer.
Screening and Diagnosis
If you present with any of the symptoms of bladder cancer, your doctor will likely order diagnostic tests to determine the cause of your symptoms and to determine if you in fact have bladder cancer. Typically, if there is reason to suspect cancer of the bladder your doctor will instruct you to undergo a cystoscopy. A cystoscopy is a diagnostic test that allows the doctor to take a look inside of your bladder with the use of a thin, illuminated tube, which is inserted through the urethra. If any abnormalities are detected, the doctor will remove a tiny piece of tissue for further testing. The process of collecting and testing a small sample of tissue from the bladder that is suspicious is called a biopsy. A biopsy will allow the doctor to determine if the abnormal tissue is in fact cancerous. If you have been previously diagnosed with cancer of the bladder, your doctor may order an imaging test be performed to see if the tumor has spread or invaded nearby tissue or otherwise healthy organs. Imaging tests include CT scans, and an intravenous pyelogram, which is a special x-ray procedure done to specifically scan the urinary tract for tumors or abnormalities.
Treatment for bladder cancer will be determined once the stage of the cancer is diagnosed. Treatment options include surgery, biological therapy, chemotherapy, radiation or a combination of one or more of these treatments. If the bladder cancer is non-invasive and has not spread to other areas of the body, surgery to remove the tumor may be used. If the cancer is invasive and has begun to spread, surgery to remove the cancer and surrounding tissue, including a portion of the bladder or in some cases the whole bladder, will be performed. This is known as a cystectomy. If a total cystectomy is performed, reconstructive surgery will be needed to fashion an alternative way for the body to house urine. Surgery may be used in conjunction with chemotherapy or radiation to prevent or slow any further cancer growth. Biological therapy is the use of drugs dispensed through the urethra to kick-start the immune system into attacking the cancer cells. Chemotherapy is the use of drugs to slow or kill off the cancer cells. Radiation is the use of high intensity rays, targeted to specially destroy the tumor.
A patient’s prognosis, or chance of recovery, is determined by the stage of cancer when it is detected and how well the tumor responds to treatment. When detected in the early stages, cancer of the bladder has the highest recovery rate. As the disease progresses or spreads to nearby tissue or organs, the patient’s prognosis will worsen. A patient’s age and overall health will likely play a large part in the prognosis as well. Generally, healthy individuals who are diagnosed with early stage bladder cancer have a very high rate of cure.