Bladder Cancer

What Is Bladder Cancer?

Bladder cancer begins when cells in the urinary bladder start to grow uncontrollably. As more cancer cells develop, they can form a tumor and spread to other areas of the body.

The bladder is a hollow organ in the pelvis with flexible, muscular walls. Its main function is to store urine before it leaves the body. Urine is made by the kidneys and is then carried to the bladder through tubes called ureters. When you urinate, the muscles in the bladder contract, and urine is forced out of the bladder through a tube called the urethra.

Bladder Cancer: Types & Stages

Several types of cancer can start in the bladder

Urothelial carcinoma (transitional cell carcinoma)

Urothelial carcinoma, also known as transitional cell carcinoma (TCC), is by far the most common type of bladder cancer. In fact, if you are told you have bladder cancer it is almost certain to be a urothelial carcinoma. These cancers start in the urothelial cells that line the inside of the bladder.

Urothelial cells also line other parts of the urinary tract, such as the part of the kidney that connects to the ureter (called the renal pelvis), the ureters, and the urethra. Patients with bladder cancer sometimes have other tumors in these places, so the entire urinary tract needs to be checked for tumors.

Invasive versus non­invasive bladder cancer

Bladder cancers are often described based on how far they have invaded into the wall of the bladder:

  • Non-­invasive cancers are still in the inner layer of cells (the transitional epithelium) but have not grown into the deeper layers.
  • Invasive cancers have grown into deeper layers of the bladder wall. These cancers are more likely to spread and are harder to treat.

A bladder cancer can also be described as superficial or non­muscle invasive. These terms include both non­invasive tumors as well as any invasive tumors that have not grown into the main muscle layer of the bladder.

Papillary versus flat cancer

Bladder cancers are also divided into 2 subtypes, papillary and flat, based on how they grow (see image above).

  • Papillary carcinomasgrow in slender, finger­like projections from the inner surface of the bladder toward the hollow center. Papillary tumors often grow toward the center of the bladder without growing into the deeper bladder layers. These tumors are called non­invasive papillary cancers. Very low­grade (slow growing), non­invasive papillary cancer is sometimes called papillary urothelial neoplasm of low­malignant potential (PUNLMP) and tends to have a very good outcome.
  • Flat carcinomasdo not grow toward the hollow part of the bladder at all. If a flat tumor is only in the inner layer of bladder cells, it is known as a non­invasive flat carcinoma or a flat carcinoma in situ (CIS).

If either a papillary or flat tumor grows into deeper layers of the bladder, it is called an invasive urothelial (or transitional cell) carcinoma.

Bladder Cancer: Detection & Treatment Options

Screening for bladder cancer

Screening is the use of tests or exams to look for a disease in people who have no symptoms. At this time, no major professional organizations recommend routine screening of the general public for bladder cancer.

This is because no screening test has been shown to lower the risk of dying from bladder cancer in people who are at average risk.

Some doctors may recommend bladder cancer screening for people at very high risk, such as:

  • People who hadbladder cancer before
  • People who had certain birth defectsof the bladder
  • People exposed to certain chemicals at work

While no screening tests are recommended for people at average risk, bladder cancer can often be found early because it causes blood in the urine or other urinary symptoms. Many of these symptoms often have less serious causes, but it’s important to have them checked by a doctor right away so the cause can be found and treated, if needed. If the symptoms are from bladder cancer, finding it early offers the best chance for successful treatment.

Bladder cancer treatment

If you’ve been diagnosed with bladder cancer, your cancer care team will discuss your treatment options with you. It’s important that you think carefully about your choices. You will want to weigh the benefits of each treatment option against the possible risks and side effects

Which treatments are used for bladder cancer?

Depending on the stage of the cancer and other factors, treatment options for people with bladder cancer can include:

  • Surgery
  • Intravesical therapy
  • Chemotherapy
  • Radiation therapy
  • Immunotherapy

Sometimes, the best option might include more than one of type of treatment. Surgery, alone or with other treatments, is part of the treatment for most bladder cancers. Surgery can often remove early­stage bladder tumors. But a major concern in people with early­stage bladder cancer is that new cancers often form in other parts of the bladder over time. Removing the entire bladder (known as a radical cystectomy) is one way to avoid this, but it can have major side effects. If the entire bladder is not removed, other treatments may be given to try to reduce the risk of new cancers. Whether or not other treatments are given, close follow­up is needed to look for signs of new cancers in the bladder.

Bladder Cancer: FAQs

Seek medical help: The most important thing you can do if you suspect you may have bladder cancer is to see a physician, preferably a urologist as soon as possible. Most bladder cancers can be treated effectively with early detection. If you are found to have bladder cancer – do not lose hope! Today, there are more than one­half million bladder cancer survivors in the U.S. alone

Answer :

Bladder cancer is the nation’s sixth most common form of cancer with more than 73,000 new cases and about 15,000
deaths each year. Even though it is very common, it is one from of cancer that most people know very little about. Bladder cancer, also referred to as urothelial carcinoma, begins when the cells in the lining of the bladder start to grow out of control. It may also occur anywhere in the urethra, renal pelvis and ureters.

Answer :

The most common symptom is blood in the urine. Other symptoms include irritation when urinating, urgency, and frequency of urination. These are also common symptoms of a urinary tract infection. If you have any of these symptoms, go see your doctor.

Answer :

The exact causes remain unknown, but smoking has been found to be the greatest risk factor for bladder cancer, with smokers getting bladder cancer twice as often as people who don’t smoke. Other risk factors include exposure to carcinogens in the environment. Workers in the rubber, chemical and leather industries are at risk, as are hairdressers, machinists, metal workers, painters, textile workers and firefighters.

Answer :

There are many tests your doctor can use including ultrasounds, CT scans, and MRI scansto detect irregularities in the bladder wall, which would suggest a possible cancer. The urologist will also perform a cystoscopy by looking inside the bladder with a long thin camera to visually examine your bladder and remove samples of any suspicious areas for biopsy. Urine cytology can be performed to detect cancer cells in urine. Other tests use urine­based markers to detect cells or substances in a urine sample that are relatively specific to bladder cancer.

Bladder Preservation Therapy –Although bladder removal, with or without chemotherapy, is the treatment usually offered for muscle­invasive bladder cancer, for some patients it might be possible to use high­dose external beam radiation therapy in combination with chemotherapy. This allows the patient to keep their bladder, and still leaves the possibility of removing the bladder later if tumors recur

Answer :

There are many bladder cancer support groups across the United States. Visit www.bcan.org to find one near you. There is also an online support community available to survivors, caregivers and loved ones 24 hours a day. It is free to join and more than 5,000 members have posted thousands of different discussions supporting each other in battling bladder cancer. There are also general cancer support groups through hospitals and the Cancer Support Community.

Answer :

Seek medical help: The most important thing you can do if you suspect you may have bladder cancer is to see a physician, preferably a urologist as soon as possible. Most bladder cancers can be treated effectively with early detection. If you are found to have bladder cancer – do not lose hope! Today, there are more than one­half million bladder cancer survivors in the U.S. alone