Bladder cancer is a type of cancer that begins in the cells of the bladder, a hollow muscular organ in the lower abdomen that stores urine. The most common type of bladder cancer is urothelial carcinoma (formerly called transitional cell carcinoma), which starts in the urothelial cells that line the inside of the bladder. Other, less common types include squamous cell carcinoma and adenocarcinoma.
Bladder cancer often causes noticeable symptoms, especially in its early stages. Common signs include:
Blood in the urine (hematuria): This is the most common symptom, causing urine to appear pink, red, or brown.
Frequent urination: Feeling the need to urinate more often than usual.
Painful urination: A burning sensation or discomfort during urination.
Urgency to urinate: A sudden, strong need to urinate.
Lower back pain: Pain on one side of the lower back.
Pelvic pain: Discomfort in the pelvic area.
In advanced stages, symptoms may include weight loss, fatigue, and swelling in the feet.
Several factors can increase the risk of developing bladder cancer:
Smoking: The most significant risk factor, as harmful chemicals in tobacco smoke are excreted in urine and can damage the bladder lining.
Age: Risk increases with age, and most cases occur in people over 55.
Gender: Men are more likely to develop bladder cancer than women.
Chemical exposure: Occupational exposure to certain chemicals (e.g., in dyes, rubber, textiles, and paint) increases risk.
Chronic bladder inflammation: Repeated urinary infections or long-term use of catheters.
Family history: A family history of bladder cancer or genetic syndromes like Lynch syndrome.
Previous cancer treatment: Radiation therapy or certain chemotherapy drugs (e.g., cyclophosphamide).
Bladder cancer is typically diagnosed through a combination of tests, including:
Urine tests: To check for blood, cancer cells, or other abnormalities.
Cystoscopy: A procedure where a thin tube with a camera (cystoscope) is inserted into the bladder to examine its lining.
Imaging tests: Such as CT scans, MRIs, or ultrasounds to visualize the bladder and surrounding structures.
Biopsy: A tissue sample is taken during cystoscopy and examined under a microscope to confirm cancer.
Bladder cancer is staged based on how far it has spread:
Non-muscle-invasive bladder cancer (NMIBC): Cancer is confined to the inner lining of the bladder.
Muscle-invasive bladder cancer (MIBC): Cancer has spread into the deeper muscle layer of the bladder.
Metastatic bladder cancer: Cancer has spread to nearby lymph nodes or distant organs like the lungs, liver, or bones.
Treatment depends on the stage, type, and grade of the cancer, as well as the patient’s overall health. Options include:
Surgery:
Transurethral resection of bladder tumor (TURBT): Removal of cancerous tissue from the bladder lining.
Cystectomy: Partial or complete removal of the bladder (in advanced cases).
Immunotherapy:
BCG therapy: A vaccine injected into the bladder to stimulate the immune system to fight cancer.
Checkpoint inhibitors: Drugs like pembrolizumab or atezolizumab to help the immune system attack cancer cells.
Chemotherapy:
Drugs like cisplatin or gemcitabine, either delivered directly into the bladder (intravesical) or through the bloodstream (systemic).
Radiation therapy:
High-energy beams are used to kill cancer cells, often combined with chemotherapy.
Targeted therapy:
Drugs like erdafitinib target specific genetic mutations in cancer cells.
The prognosis for bladder cancer depends on the stage at diagnosis:
Early-stage bladder cancer (non-muscle-invasive) has a high survival rate, with regular monitoring to prevent recurrence.
Advanced bladder cancer (muscle-invasive or metastatic) is more challenging to treat and has a lower survival rate.
While bladder cancer cannot always be prevented, certain steps can reduce the risk:
Quit smoking: The most effective way to lower risk.
Limit chemical exposure: Follow safety guidelines if working with harmful chemicals.
Stay hydrated: Drinking plenty of fluids may dilute harmful substances in the urine.
Eat a healthy diet: Focus on fruits, vegetables, and whole grains.
Regular check-ups: Especially if you have a family history or other risk factors.
If you experience symptoms like blood in the urine or persistent urinary issues, consult a healthcare professional promptly for evaluation. Early detection significantly improves outcomes.
