Urinary Bladder Cancer
What is Urinary Bladder Cancer?
Urinary bladder cancer is a type of cancer that begins in the cells of the bladder, the hollow organ in the lower abdomen that stores urine. The most common type of bladder cancer is transitional cell carcinoma, which starts in the cells that line the inside of the bladder.
Types of Bladder Cancer
Transitional Cell Carcinoma (TCC):
Also known as urothelial carcinoma, it is the most common type of bladder cancer.
Arises in the urothelial cells lining the inside of the bladder.
Squamous Cell Carcinoma:
Develops in the thin, flat cells lining the bladder.
Often associated with chronic irritation and inflammation.
Adenocarcinoma:
Starts in the glandular (secretory) cells of the bladder.
Rare and typically associated with chronic bladder inflammation.
Risk Factors
Smoking: The leading risk factor, as chemicals in tobacco smoke can accumulate in the urine and damage the bladder lining.
Chemical Exposure: Occupational exposure to certain chemicals, such as those used in the dye, rubber, leather, and textile industries.
Chronic Bladder Inflammation: Long-term bladder irritation or infections, such as those caused by urinary catheters or infections.
Age: Risk increases with age, especially after age 55.
Gender: More common in men than women.
Race: More common in Caucasians than in other races.
Previous Cancer Treatments: History of radiation therapy to the pelvis or treatment with certain anti-cancer drugs.
Family History: Having a family history of bladder cancer.
Symptoms
Blood in the urine (hematuria), which may make the urine appear bright red or cola-colored.
Frequent urination.
Painful urination.
Urgent need to urinate.
Pelvic pain.
Back pain.
Diagnosis
Urinalysis: Testing urine for the presence of blood and abnormal cells.
Cystoscopy: A procedure in which a thin tube with a camera is inserted into the bladder through the urethra to examine the bladder.
Biopsy: During a cystoscopy, tissue samples may be taken for microscopic examination to confirm the presence of cancer cells.
Imaging Tests: CT scans, MRI, and ultrasound can help determine the extent of cancer.
Staging
Staging determines the extent of cancer spread and guides treatment decisions:
Stage 0: Cancer is only in the bladder's inner lining (carcinoma in situ).
Stage I: Cancer has spread to the layer of tissue under the bladder lining but not to the muscle layer.
Stage II: Cancer has spread to the muscle layer of the bladder.
Stage III: Cancer has spread to the outer layer of the bladder and possibly to surrounding tissues.
Stage IV: Cancer has spread to lymph nodes or distant organs.
Treatment Options
The choice of treatment depends on the stage and grade of cancer, the patient’s overall health, and personal preferences.
Surgical Treatments:
Transurethral Resection of Bladder Tumor (TURBT): Removal of tumors from the bladder lining using a cystoscope.
Cystectomy: Removal of part or all of the bladder.
Partial Cystectomy: Only part of the bladder is removed.
Radical Cystectomy: Removal of the entire bladder, nearby lymph nodes, and possibly parts of nearby organs.
Intravesical Therapy:
BCG Therapy: Bacillus Calmette-Guérin (BCG) is a type of immunotherapy delivered directly into the bladder.
Intravesical Chemotherapy: Chemotherapy drugs are placed directly into the bladder.
Systemic Chemotherapy:
Used to kill cancer cells throughout the body.
Often used before or after surgery to reduce the risk of recurrence.
Radiation Therapy:
High-energy radiation is used to kill cancer cells.
Can be combined with chemotherapy (chemoradiation).
Immunotherapy:
Uses the body’s immune system to fight cancer.
Examples include checkpoint inhibitors like pembrolizumab.
Targeted Therapy:
Drugs that target specific molecules involved in cancer cell growth.
Examples include FGFR inhibitors for patients with specific genetic mutations.
Side Effects of Treatment
Surgical Side Effects: Risks of infection, bleeding, and changes in urinary and sexual function.
Chemotherapy Side Effects: Nausea, vomiting, hair loss, fatigue, and increased risk of infection.
Radiation Side Effects: Skin irritation, fatigue, and bladder irritation.
Follow-Up Care
Regular follow-up exams and tests are crucial to monitor for cancer recurrence.
Management of side effects and support for quality of life.
Lifestyle changes and support systems to help with recovery and prevention of recurrence.
Conclusion
Urinary bladder cancer is a serious condition that requires a comprehensive approach for diagnosis, staging, and treatment. Early detection and tailored treatment strategies can significantly improve outcomes.
Dr. Saurabh Mishra and his team are dedicated to providing personalized care and support for patients with bladder cancer, utilizing the latest advancements in urological oncology.