Bladder Cancer

A typical form of cancer that starts in the bladder's cells is bladder cancer. Your lower abdomen has a hollow muscular structure called the bladder that stores pee.

The cells (urothelial cells) that line the lining of your bladder are where bladder cancer most frequently develops. Your ureters, which link your kidneys to your bladder, as well as your kidneys themselves contain urothelial cells. Although it can occur in the kidneys and ureters as well, bladder urothelial carcinoma is significantly more prevalent.

The majority of bladder cancer cases are discovered in their early stages when they are quite curable. However, even early-stage bladder tumors might recur following a curative regimen. Because of this, bladder cancer patients frequently require follow-up exams for years following treatment to check for bladder cancer that returns.

Bladder Cancer: Types

Your bladder contains a variety of cell types, some of which are malignant. The kind of bladder cancer depends on the type of bladder cell where the disease first develops. These details help doctors decide which therapy could be most effective for you.

The following bladder cancer subtypes −

• Urothelial cancer. The cells that line the inside of the bladder can develop urothelial carcinoma, formerly known as transitional cell carcinoma. When your bladder is full, urothelial cells enlarge; when empty, they contract. The lining of the ureters and the urethra is made up of the same cells, and cancer can develop there as well. The most prevalent kind of bladder cancer is urothelial carcinoma.

• Carcinoma of the squamous cell. Chronic irritation of the bladder, such as that caused by an infection or by prolonged use of a urinary catheter, is linked to squamous cell carcinoma. In the US, squamous cell bladder cancer is uncommon. It occurs more frequently in regions of the world where schistosomiasis, a particular parasitic illness, is a frequent cause of bladder infections.

• Adenocarcinoma. The cells that make up the bladder's mucus-secreting glands are where adenocarcinoma develops. Bladder adenocarcinoma is quite uncommon.

Multiple cell types can be present in certain bladder tumors.

Bladder Cancer: Causes

When bladder cells experience DNA alterations (mutations), bladder cancer starts to spread. The DNA of a cell carries instructions that direct the cell's actions. The adjustments instruct the cell to proliferate quickly and to continue to exist when healthy cells would.

A tumor created by the aberrant cells can penetrate and obliterate healthy bodily tissue. The aberrant cells have the potential to separate over time and spread (metastasize) throughout the body.

Bladder Cancer: Symptoms

The major symptoms include −

• Hematuria (blood in the urine) can make the urine seem bright red or cola-colored, yet there are situations when the pee appears normal and blood is found on a lab test.

• Frequent urinating

• Unpleasant urination

• Backache

Bladder Cancer: Risk Factors

The major risk factors include −

• Smoking. Smoking cigarettes, cigars, or pipes can raise your risk of bladder cancer by causing your urine to get accumulated with dangerous chemicals. Your body breaks down the chemicals in cigarette smoke and excretes some of them in urine. Your bladder's lining might get harmed by these dangerous substances, raising your chance of developing cancer.

• Advancing years. The risk of bladder cancer rises with age. While bladder cancer can strike anybody at any age, most cases occur in those over the age of 55.

• Being a man. Bladder cancer is more common in males than in women.

Bladder Cancer: Diagnosis

To diagnose bladder cancer, your doctor may suggest the following tests −

• Examining the inside of your bladder with a scope (cystoscopy). Your doctor passes a tiny, thin tube called a cystoscope into your urethra to perform a cystoscopy. Your doctor can use the cystoscope's lens to view your urethra and bladder and check these organs for illness symptoms. Both a hospital and a doctor's office are options for cystoscopy procedures.

• Removing a tissue sample for analysis (biopsy). Your doctor may perform a cystoscopy and insert a specialized instrument into your bladder to take a cell sample (biopsy) for analysis. Occasionally, this process is referred to as transurethral resection of bladder tumor (TURBT). Bladder cancer can also be treated by TURBT.

• Looking at a urine sample (urine cytology). Urine cytology is a process where a sample of your urine is examined under a microscope to look for cancer cells.

• Imaging exams. Imaging procedures, such as computed tomography (CT) urogram or retrograde pyelogram, allow your doctor to study the anatomy of your urinary system.

Testing could involve −

• An MRI

• Imaging with magnetic resonance (MRI)

• CT with positron emission (PET)

• Scan of the bone

• A chest X-ray

Grade of Bladder Cancer

Based on how the cancer cells look under a microscope, bladder malignancies are further divided into several types. The grade of bladder cancer is described as this, and your doctor may use the terms "low grade" or "high grade" to describe it −

• Bladder cancer of a low grade. These cancer cells resemble normal cells more in terms of structure and appearance (well differentiated). Compared to high-grade tumors, low-grade tumors often develop more slowly and are less likely to breach the bladder's muscular wall.

• Advanced bladder cancer. This form of cancer has cells that appear aberrant and have no relation to tissues that appear to be normal (poorly differentiated). A high-grade tumor has the propensity to develop more quickly than a low-grade tumor and may be more likely to invade other tissues and organs, including the muscular wall of the bladder.

Bladder Cancer: Treatment

The kind, grade, and stage of the disease, as well as your general health and treatment preferences, are taken into consideration when determining the best course of therapy for bladder cancer.

The kind, grade, and stage of the disease, as well as your general health and treatment preferences, are taken into consideration when determining the best course of therapy for bladder cancer.

• Surgery, to remove the malignant cells

• Intravesical chemotherapy is used to treat bladder cancers that are limited to the lining of the bladder but are at a high risk of returning or progressing to a more advanced stage.

• When surgery to remove the bladder is not a possibility, systemic chemotherapy may be used as the primary treatment to enhance the patient's chance of recovery.

• When surgery is not an option or is not wanted, radiation therapy is frequently used as the primary treatment to eradicate cancer cells.

• Immunotherapy, which activates the body's defenses against cancer cells in the bladder or elsewhere in the body

• When other therapies have failed, targeted therapy may be used to treat advanced cancer.

Bladder Cancer: Prevention

One can take the following preventive measures to avoid the chances of getting bladder cancer −

• Avoid smoking. Stop smoking if you haven't already. If you smoke, discuss a strategy with your doctor to help you quit. You may be able to quit using support groups, medicine, and other strategies.

• Be cautious when around chemicals. Follow all safety recommendations if you operate with chemicals to prevent exposure.

• Eat a variety of fruits and vegetables. Pick a diet high in a diversity of fruit and vegetable colors. Antioxidants found in fruits and vegetables may lower your chance of developing cancer.

Conclusion

Our understanding of the biology of the illness has increased because of improvements in bladder cancer detection and treatment. The number of newly diagnosed advanced cases will decrease as a result of increased social awareness of risk factors, reduced work exposure, and attentive illness diagnosis.

Radical cystectomies will become less common as a result of high-quality transurethral procedures combined with adjuvant medications that are more effective and less morbid. The management of bladder cancer will need ongoing collaboration across a range of medical specialties to provide a successful outcome.