Bladder Cancer

• Bladder cancer primarily originates in the urothelial cells lining the bladder and is more prevalent in older individuals.
• Common indicators include blood in the urine, frequent urination, and discomfort during urination.
• Smoking and occupational exposure to certain chemicals are significant risk factors contributing to the development of bladder cancer.
• Treatment approaches vary widely, encompassing surgical removal, chemotherapy, and radiation therapy, tailored to the cancer’s stage and type.
• Early diagnosis and intervention are critical for improving prognosis and achieving successful outcomes.

What is Bladder Cancer?

To understand what is Bladder Cancer, it’s important to know that it typically starts in the urothelial cells that line the inside of the bladder. These cells are also found in the kidneys and ureters, meaning cancer can occur in those areas too. The most common type is urothelial carcinoma (also known as transitional cell carcinoma), accounting for about 90% of all bladder cancers. According to the World Health Organization (WHO), bladder cancer is among the ten most common cancers globally, with an estimated 573,000 new cases and 212,000 deaths worldwide in 2020, highlighting its significant global health impact.

Symptoms and Causes of Bladder Cancer

Recognizing the signs and understanding the factors that contribute to bladder cancer is vital for early diagnosis and prevention. Symptoms can often be subtle or mimic less serious conditions, making awareness crucial.

Common Bladder Cancer Symptoms

The most common bladder cancer symptoms often involve changes in urinary habits. While these symptoms do not always indicate cancer, they warrant medical evaluation:

• Hematuria: Blood in the urine, which may be visible (gross hematuria) or only detectable under a microscope (microscopic hematuria). This is often painless and can be intermittent.
• Frequent Urination: Needing to urinate more often than usual.
• Painful Urination (Dysuria): Discomfort or burning sensation during urination.
• Urgency: A sudden, strong need to urinate, even when the bladder is not full.
• Back or Pelvic Pain: In more advanced stages, cancer can spread and cause pain in the lower back or pelvic region.

Key Risk Factors and Causes

Several factors increase the risk of developing bladder cancer. Understanding these causes of bladder cancer can help in prevention and early risk assessment:

• Smoking: This is the most significant risk factor, as harmful chemicals from tobacco smoke are processed by the kidneys and accumulate in the urine, damaging bladder lining cells.
• Exposure to Certain Chemicals: Workers in industries involving dyes, rubber, leather, textiles, and paint may be exposed to aromatic amines, which are carcinogens.
• Age: The risk of bladder cancer increases significantly with age, with most diagnoses occurring in people over 55.
• Chronic Bladder Inflammation: Persistent irritation from recurrent urinary tract infections, bladder stones, or long-term catheter use can increase risk.
• Previous Cancer Treatment: Radiation therapy to the pelvis or certain chemotherapy drugs (like cyclophosphamide) can increase the risk of developing bladder cancer years later.
• Family History: A personal or family history of bladder cancer can indicate a higher genetic predisposition.

Bladder Cancer Treatment Options

The approach to treating bladder cancer is highly individualized, depending on the stage and grade of the cancer, the patient’s overall health, and personal preferences. A multidisciplinary team typically devises the most effective strategy.

Surgical Approaches

Surgery is a primary component of many bladder cancer treatment options. For early-stage, non-muscle-invasive bladder cancer, a transurethral resection of bladder tumor (TURBT) is often performed to remove the tumor through the urethra. For more advanced or muscle-invasive cancer, a cystectomy may be necessary. This involves removing part (partial cystectomy) or all (radical cystectomy) of the bladder. If the entire bladder is removed, a new way to store and pass urine must be created, such as an ileal conduit or a neobladder.

Medical Therapies

Medical therapies play a crucial role, often in conjunction with surgery. Intravesical therapy involves administering drugs directly into the bladder via a catheter, commonly used for early-stage cancers to prevent recurrence. This includes Bacillus Calmette-Guérin (BCG) immunotherapy or chemotherapy drugs like mitomycin. For more advanced or metastatic bladder cancer, systemic chemotherapy, immunotherapy (using checkpoint inhibitors), or targeted therapy may be used to kill cancer cells throughout the body or block specific pathways that help cancer grow.

Radiation and Other Treatments

Radiation therapy uses high-energy rays to destroy cancer cells. It can be used alone, often in combination with chemotherapy, as an alternative to surgery for muscle-invasive bladder cancer, or for palliative care to relieve symptoms. While these are the primary medical interventions, it’s important to note that any mention of alternative or complementary therapies is supportive only and does not replace conventional medical treatment. Always consult with a healthcare professional regarding the most appropriate treatment plan.