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Bladder Cancer

Smoking is observed to be biggest risk factor for bladder cancer. Bladder cancers can be detected in early stages as they cause urine problems that will need medical attention.

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Overview

Bladder cancer develops when cells in the bladder begin to divide uncontrollably. These cancer cells grow into a tumour, which may spread to other parts of the body over time. Bladder cancer is more likely to strike men than it is to strike women.

Bladder cancer is one of the diseases that can be detected early since it causes blood in the urine as well as other urinary issues that require quick medical attention.

Smoking is the leading cause of bladder cancer, with research indicating that smokers are two to three times more likely to get the disease than non-smokers.

HCG houses the best bladder cancer specialists in India who are trained to treat bladder cancers with customised and result-oriented treatment plans that lead to positive clinical outcomes.

Types

Based on the type of cells that they originate from, bladder cancers are classified into the following types:

1. Urothelial Carcinoma: Urothelial carcinoma, also known as transitional cell carcinoma (TCC), accounts for 90% of bladder cancer cases. This type arises from the urothelial cells of the urinary tract.

2. Squamous Cell Carcinoma: Squamous cell carcinomas arise from the bladder lining and are almost always invasive.

3. Adenocarcinoma: Adenocarcinomas, which arise from the glandular cells, account for around 1% of all bladder malignancies. Almost all bladder adenocarcinomas are invasive.

4. Small-cell Carcinoma: Small-cell carcinomas are of rare occurrence and account for less than 1% of all bladder cancers. It is a neuroendocrine epithelial tumour that is poorly differentiated.

5. Sarcoma: Also called urinary sarcoma, this rare type arises from the bladder’s muscular cells.

Symptoms

Urinary bleeding is the first and most common symptom of bladder cancer. Aside from bleeding, there are a few more signs and symptoms that suggest bladder cancer development:

  • A swollen bladder (if the tumour is at the bladder neck and causing an obstruction) 
  • Pain in the sides 
  • Difficulties in passing urine
  • Burning sensation and pain while urinating
  • Frequent urination 
  • Swelling in the feet and ankles
  • Bone pain (if cancer has spread to bones or lungs)

Causes

A person’s risk of acquiring bladder cancer is increased by a number of variables. The following are some of the most important bladder cancer risk factors:

  • Cigarette Smoking: Cigarette smoking is thought to be responsible for nearly half of all bladder cancers. The risk of bladder cancer is higher among those smokers who’ve had prolonged exposure to this habit.
  • Age: The risk of developing bladder cancer increases with age. Bladder cancer affects about 90% of adults who are over the age of 55.
  • Gender: Men are more likely than women to get bladder cancer, owing to smoking and exposure to harmful chemicals.
  • Family History: Having a close relative with a history of bladder cancer may increase one’s risk of developing the disease.
  • Exposure to Harmful Chemicals: Exposure to toxic substances, such as arsenic, phenols, aniline dyes and arylamines is associated with an increased risk of bladder cancers. Individuals working in the dyeing, rubber, aluminium and leather industries, as well as truck drivers and pesticide applicators, are at a higher risk of developing bladder cancer.
  • Past Cancer Treatments: The occurrence of bladder cancer is also high among those who have received radiation therapy and chemotherapy for certain cancers in the pelvic region.
  • Chronic Infections: Bladder cancer is also predisposed by long-term chronic infections and irritation caused by stones or foreign materials.

Diagnosis

A myriad of testing methods is available for the detection and diagnosis of bladder cancer. The following are some of the most often utilised bladder cancer diagnostic methods:

a. Urinalysis: A basic urine test can confirm the presence of bleeding in the urine, prompting the doctor to recommend additional tests. Urinalysis is one of the first tests recommended by a doctor if bladder cancer is suspected.

b. Urine Cytology: Urine cytology is performed to look for any abnormal cells that could point towards tumour growth in the bladder. This is not a very effective testing method as it misses many early-stage tumours. Therefore, urine cytology is recommended along with other tests for a conclusive diagnosis.

c. Ultrasound: Bladder tumours can also be detected via ultrasound scans. It is a non-invasive method and does not need a contrast medium to be injected.

d. CT scan/MRI: A CT scan or MRI provides comprehensive information on the tumour growth and may find tiny tumours in the bladder that an ultrasound might have missed.

e. Cystoscopy: This is one of the crucial diagnostic methods recommended for bladder cancer. During this procedure, a thin tube-like optical tool that is equipped with a camera and light source is introduced into the bladder through the urethra. The interior surface of the bladder is made visible on a video monitor. Those small tumours that go undetected during other tests are easily detected when a cystoscopy is performed.

f. Biopsy: The biopsy sample may be collected during the cystoscopy. The biopsy sample is further examined under the microscope for the presence of abnormal cells. A biopsy can help specialists in obtaining a definitive diagnosis of bladder cancer.

At HCG, our bladder cancer specialists strive to deliver the best bladder cancer treatment in India via superior quality diagnostic support and innovative treatment approaches.

Treatment

Bladder cancer can be treated in many ways. However, treatment decisions are made depending on a number of parameters, including the stage, grade and exact location of the tumour along with the overall health condition of the patient.

a. Surgery: Surgery removes the tumour along with a small portion of the healthy tissues surrounding it, called the margin. There are several surgical approaches that specialists use to manage bladder cancer:

    • 1. Transurethral Resection of Bladder Tumour (TURBT): During this non-invasive procedure, the surgeon runs an electric wire loop into the bladder through the cystoscope. The electric current passed through the wire slices or burns the tumour. A high-energy laser may also be used. Following this treatment, the residual cancer cells are destroyed with a one-time injection of cancer-killing medication given to the bladder.

2. Cystectomy: This surgery may remove the bladder completely (radical cystectomy) or partially (partial cystectomy). The bladder, prostate, and seminal vesicles are removed in men, whereas the bladder, uterus, ovaries, and a portion of the vaginal wall are removed in women.

Urine diversion, or a new method for urine to be expelled from the body, is required once the bladder is fully removed. Neobladder reconstruction may be considered in these cases. During the procedure, the urethra is connected to a reservoir made from a piece of the patient’s intestine. This neobladder is nearly identical to the original bladder in terms of functionality.

b. Chemotherapy: Chemotherapy employs potent drugs to kill cancer cells. Bladder cancer is treated with a combination of two or more chemo drugs. Chemotherapy can be given intravenously to eliminate any leftover cancer cells, or directly into the bladder to treat superficial bladder cancer, which arises from the lining of the bladder.

c. Radiation Therapy: Radiation therapy kills cancer cells by using intense energy beams, such as X-rays and protons. For better results, radiation therapy is used in conjunction with chemotherapy or surgery.

Frequently Asked Questions

1. Is bladder cancer treatable?

Yes, bladder cancer is one of the few cancers that can be detected in the early stages when it is more easily treatable. There are multiple treatment approaches to treat and manage early to advanced-stage bladder cancers with positive clinical outcomes.

2. Can I live a normal life after bladder cancer?

It is not uncommon for survivors to worry about not being able to return to their normal life after their bladder cancer treatment.

Bladder cancers can be challenging, yet, returning to routine activities and continuing to have a normal life is possible. However, the survivors need to keep up their follow-up appointments with their doctors and follow their expert team’s recommendations.

3. Does quitting smoking reduce bladder cancer risk?

Smoking is one of the biggest risk factors for bladder cancer, and it increases one’s risk of getting bladder cancer risk by three times.

Therefore yes, quitting smoking can reduce one’s bladder cancer risk.

4. If I am diagnosed with bladder cancer, will the doctor remove my bladder?

No, removing the bladder is not the only treatment option for bladder cancer. Treatment planning is made based on multiple factors such as the stage and grade of the tumour, its size, exact location and the patient’s overall condition.

In the early stages, only the tumour and a small portion of the healthy tissues surrounding it are removed. The surgery may be followed by chemotherapy to reduce the risk of recurrence.

In advanced stages, bladder removal may be recommended in order to improve the survival rates for the patients. The removal may be followed by neobladder reconstruction, wherein a part of the patient’s intestine is excised to build a reservoir and it is attached to the urethra. Neobladder functions in a similar way to your original bladder.

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