What is bladder cancer?

Bladder cancer is a disease in which malignant (cancer) cells form in the tissues of the bladder.

The signs and symptoms of bladder cancer include blood in the urine and painful urination.

Tests that examine the urine and the bladder are used to help diagnose bladder cancer.

The bladder is a hollow organ found in the lower abdomen, shaped like a small balloon and has a muscular wall that allows it to be enlarged or reduced to store urine by the kidneys. There are two kidneys in the body, one on each side of the spine, above the waist. Small tubules in the kidneys filter and clean the blood. They take out our waste products and then produce the urine. Urine passes from each kidney through a long tube called the ureter into the bladder. The bladder holds urine until it passes through the urethra and then out of the body.

Types of bladder cancer:-

Three types of bladder cancer begin in the cells of the lining of the bladder. These cancers are named from the type of cells that become malignant (cancerous):

Transitional cell carcinoma: Cancer that begins in cells of the innermost layer of tissue of the bladder. These cells can stretch when the bladder is full and shrink when it empties. Most bladder cancers start in transitional cells. Transitional cell carcinoma can be low-grade or high-grade:

Low-grade transitional cell carcinoma often recurs (comes back) after treatment, but rarely spreads to the muscle layer of the bladder or other parts of the body.

High-grade transitional cell carcinoma also recurs after treatment and often spreads to the muscle layer of the bladder, other parts of the body, and lymph nodes. Almost all deaths from bladder cancer are due to high-grade carcinoma.

Squamous cell carcinoma: Cancer that begins in squamous cells (thin, flat cells that line the inside of the bladder). This cancer can form after prolonged infection or irritation.

Adenocarcinoma: Cancer that begins in the glandular cells found in the lining of the bladder. The glandular cells of the bladder produce substances like mucus. This is a very rare type of bladder cancer.

Risk factor of bladder cancer:-

• Use of tobacco, especially cigarette smoking.

• Having a family history of bladder cancer.

• Having certain gene changes related to bladder cancer.

• Being exposed to paints, stains, metals, or petroleum products in the workplace.

• Previous treatment with radiation therapy to the pelvis or treatment with certain anticancer drugs, such as cyclophosphamide or ifosfamide.

• Taking Aristolochia fang chi, a Chinese herb.

• Drinking water from a well that has high levels of arsenic.

• Chlorinated drinking water.

• Having a history of bladder infections, including bladder infections caused by Schistosoma haematobium.

• Using urinary catheters for a long time.

Signs and symptoms of bladder cancer 

These are the signs and symptoms that can be caused by bladder cancer. Check with your doctor if you have any of the symptoms:-

• Blood in the urine (slightly rusty to bright red in color).

• Frequent urination

• Pain while urinating

• Lumbar pain 

Diagnosis of bladder cancer:-

Physical exam and medical history: An exam of the body to check general signs of health, including looking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and previous illnesses and treatments will also be taken.

Internal exam: An exam of the vagina or rectum. The doctor inserts lubricated, gloved fingers into the vagina and/or rectum to feel for the lumps.

Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.

Urine cytology: A laboratory test in which a urine sample is examined under a microscope to detect abnormal cells.

Cystoscopy: A procedure to look inside the bladder and urethra for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-shaped instrument with a light and lens for viewing. It may also have a tool to remove tissue samples, which are examined under a microscope for signs of cancer.

Certain factors affect the chance of recovery and treatment options:-

The stage of cancer (whether it is superficial or invasive bladder cancer and whether it has spread to other parts of the body). Bladder cancer in the early stages can often be cured.

The type of cancer cells in the bladder and what they look like under a microscope.

If there is carcinoma in situ in other parts of the bladder.

The age and general health of the patient.

If the cancer is superficial, the chances also depend on the following:

How many tumors are there?

The size of the tumors.

Whether the tumor has recurred after treatment.

Stages of Bladder Cancer:-

Stage 0 

Stage I

Stage II

Stage III

Stage IV

Stage 0:-

In stage 0, abnormal cells are found in the tissue that lines the inside of the bladder. These abnormal cells can become cancerous and spread to nearby normal tissue. Stage 0 is divided into stages 0a and 0is, depending on the type of tumor:

Stage 0a is also called noninvasive papillary carcinoma, which can be seen as long, thin growths that grow on the lining of the bladder.

Stage 0is is also called carcinoma in situ, which is a flat tumor in the tissue that lines the inside of the bladder.

Stage 1:-

The cancer has formed and spread to the connective tissue layer next to the inner lining of the bladder.

Stage II:-

 The cancer has spread to the layers of muscle tissue of the bladder.

Stage III:-

The cancer has spread from the bladder to one lymph node in the pelvis that is not near the common iliac arteries.

Stage IV:-

The cancer has spread to other parts of the body, such as the lung, bone, or liver.

How cancer spreads in the body?

Cancer can spread through tissues, the lymphatic system, and the blood.

Tissue: Cancer spreads from where it started by growing to nearby areas.

Lymphatic system: Cancer spreads from where it started by entering the lymphatic system. Cancer travels through the lymphatic vessels to other parts of the body.

Blood: Cancer spreads from where it started bypassing into the blood. Cancer travels through blood vessels to other parts of the body.

Treatment:-

The treatment include

• Surgery

• Radiation therapy

• Chemotherapy

• Immunotherapy

• Targeted therapy

Bladder Cancer Survival Rates:-

Survival rates are closely related to the stage at diagnosis. About half of bladder cancers are contracted when the disease is confined to the inner lining of the bladder. About 96% of these people will live at least 5 years, compared to people without bladder cancer. But only 5 out of 100 people whose bladder cancer was discovered after it spread to distant places, are found to be alive 5 years after diagnosis.

Living With Bladder Cancer:-

• Cancer is a life-changing experience. 

• And although there's no surefire way of preventing a recurrence, you can take steps to feel and stay healthy.

• Eating plenty of fruits, veggies, whole grains, and keeping to modest portions of lean meat is a great start.

• If you smoke, stop. Limit alcohol to one drink a day for women and up to two drinks a day for men. 

• Daily exercise and regular checkups will also support your health and give you peace of mind.

New and Experimental Treatment:-

• Several new treatments may prove useful in treating bladder cancer. 

• Photodynamic therapy, used in early-stage cancers, uses laser light to activate a chemical that kills cancer cells. 

• Some gene therapies use lab-created viruses to fight cancer. 

• Targeted therapies aim to control the growth of cancer cells.  

 Check if any of these new and experimental treatments are available to you.