Bladder Cancer

Overview

Bladder cancer begins when cells in the urinary bladder (a hollow organ in the pelvis with flexible, muscular walls) start to grow uncontrollably. As more cancer cells develop, they can form a tumour and spread to other areas of the body.

Its main function is to store urine before it leaves the body. Urine is made by the kidneys and is then carried to the bladder through tubes called ureters. When you urinate, the muscles in the bladder contract, and urine is forced out of the bladder through a tube called the urethra.

The wall of the bladder has several layers, which are made up of different types of cells.

Most bladder cancers start in the innermost lining of the bladder, which is called the urothelium or transitional epithelium. As the cancer grows into or through the other layers in the bladder wall, it becomes more advanced and can be harder to treat.

Over time, the cancer might grow outside the bladder and into nearby structures. It might spread to nearby lymph nodes, or to other parts of the body.

Types of Bladder Cancer

By far, there is a most common type of Bladder Cancer:

  • Urothelial Carcinoma (also known as Transitional Cell Carcinoma): type that starts in the urothelial cells that line the inside of the bladder.

Several other types of cancer can start in the bladder, but are all much less common, such as:

  • Squamous Cell Carcinoma: type of cancer that is very invasive.
  • Adenocarcinoma: type of cancer where cells have a lot in common with gland-forming cells of Colon Cancers. Nearly all adenocarcinomas of the bladder are invasive.
  • Small Cell Carcinoma: type that start in nerve-like cells called neuroendocrine cells. These cancers often grow quickly and typically need to be treated with chemotherapy like that used for Small Cell Carcinoma of the lung.
  • Sarcoma: type of cancers that start in the muscle cells of the bladder, but they are rare.

Risk Factors

Several risk factors make a person more likely to develop bladder cancer, some of them can be controlled by having a healthy diet meanwhile other cannot be managed, for instance, the gender or the age. Risk factors in bladder cancer may include:

  • Smoking
  • Workplace exposures
  • Certain medicines or herbal supplements
  • Arsenic in drinking water
  • Not drinking enough fluids
  • Age
  • Gender
  • Chronic bladder irritation and infections
  • Personal history of bladder or other urothelial cancer
  • Bladder birth defects
  • Genetics and family history
  • Prior chemotherapy or radiation therapy

Signs and Symptoms

  • Blood in the urine
  • Changes in bladder habits or symptoms of irritation
  • Having to urinate more often than usual
  • Pain or burning during urination
  • Feeling as if you need to go right away, even when the bladder is not full
  • Having trouble urinating or having a weak urine stream
  • Being unable to urinate
  • Lower back pain on one side
  • Loss of appetite and weight loss
  • Feeling tired or weak
  • Swelling in the feet
  • Bone pain

Prognosis

Survival rates in bladder cancer is directly related to the stage where the patient is classified; being noticed a progressive drop of the chances for the patient to survive depending on how advanced the tumour is. The 5-year relative survival rate for people with stage I bladder cancer is about 88%, about 63% in stage II and more or less 50% in stage III.

Bladder cancer that has spread to other parts of the body is often hard to treat. Stage IV bladder cancer has a relative 5-year survival rate of about 15%. Still, there are often treatment options available for people with this stage of cancer.

Bladder Cancer Diagnosis

PLEASE NOTE: EARLY DIAGNOSIS IN CANCER IS VERY IMPORTANT BECAUSE CANCER THAT’S DIAGNOSED AT AN EARLY STAGE ―BEFORE IT’S HAD THE CHANCE TO GET TOO BIG OR SPREAD―, IS MORE LIKELY TO BE TREATED SUCCESSFULLY. IF THE CANCER HAS SPREAD, TREATMENT BECOMES MORE DIFFICULT, AND GENERALLY A PERSON’S CHANCES OF SURVIVING ARE MUCH LOWER.

State of the Art

With the purpose to diagnose the bladder cancer, some techniques have been developed such as cystoscopy imaging, biopsy analyse, urine cytology and imaging tests such as computerized tomography. However, some of these can be stressful or even harmful for the patient and new methods should be developed.