Bladder Cancer Overview
Bladder cancer when abnormal cells in any portion of the urinary bladder begin growing out of control until it finally forms a malignant tumor or spreads (metastasizes) to other body areas. Nearly 80,000 men and women will be diagnosed with bladder cancer this year. Many more men (four times more) than women are likely to develop bladder cancer and approximately 16,000 individuals will succumb to the horrible disease this year.
Researchers and scientists have yet to determine the clear cause of bladder cancer. However, there are specific correlations that have been made including the development of cancer and exposure to chemicals and radiation along with parasitic infections.
- Bladder Cancer Types
- Bladder Cancer Symptoms
- Survival Rate Prognosis
- Diagnosing Bladder Cancer
- Treating Bladder Cancer
Bladder Cancer Types
There are different types of cancerous cells that develop in the bladder that each requires a unique form of treatment. These include:
- Transitional Cell Carcinoma – The most common form of bladder cancer tumors can develop in the organ when abnormal cells begin to grow uncontrollably on the inside lining of the bladder. The bladder is made of transitional cells that expand and contract as the organ is filled and emptied through urination. Tumors can also form in the same type of cells that line the interior areas of the urethra and ureters.
- Squamous Cell Carcinoma – The body will often respond to an irritation or infection by developing carcinoma. Without treatment, the abnormal cells can become cancerous. Though rare in America, many individuals worldwide develop squamous cell carcinoma of the bladder in regions on the globe where schistosomiasis (parasitic infections) are more prevalent.
- Adenocarcinoma – This rare form of cancer begins when abnormal cells begin going out of control in the bladder’s mucus-secreting glands.
Some individuals develop bladder cancers and involve more than one form of an abnormal cell.
Common Bladder Cancer Symptoms
Many patients are diagnosed with bladder cancer in its early stage because of obvious symptoms including hematuria (blood found in the urine). Many individuals will not experience symptoms or pain until much later as the disease progresses. Early detection of common urinary symptoms can help minimize the damaging effects of the disease.
- Hematuria (blood found in the urine) is typically the first indicator that the individual has bladder cancer. In many cases, there are sufficient levels of blood present in the urine that it changes colors to pink, orange, and sometimes darker red. However, smaller amounts of urine might be more difficult to observe visually and require a urinalysis (urine test) during general medical physical examinations.
The common obvious visual symptoms of hematuria are not always visible each day. The individual may experience clear urine for days or weeks at a time until color changes caused by blood eventually reappear. It is important to note that any indicator of hematuria is not always indicative of bladder cancer. Blood found in the urine can be caused by noncancerous (benign) tumors, bladder/kidney stones, infection, or other nonmalignant kidney diseases.
- Bladder Habit Changes are a common symptom of individuals in the early stage of developing bladder cancer. Many of these changes will involve:
- An increase in the frequency of urinating
- A burning or painful sensation during urination
- Weak urine stream or other problem during urination
- A consistent sensation that the bladder must be emptied right away even when the organ is empty
However, many of the symptoms can be caused by other factors including bladder stones, urinary tract infections, overactive bladder, or in men, an enlarged prostate gland.
In the advancing stages of bladder cancer, the malignant cells can metastasize (spread) to other body parts and create worsening symptoms. Some of these include:
- The inability to urinate
- Constantly feeling weak or tired
- Unexpected weight loss and/or loss of appetite
- Lower back pain experienced on just one side of the body
- Pain in the body’s bones and joints
- Swollen feet
Many of the advanced stage bladder cancer symptoms can be the result of other diseases or conditions.
Survival Rate Prognosis
The long-term prognosis for individuals who have been diagnosed with bladder cancer is better than some cancers and worse than others. Statistics maintained by the American Cancer Society and the Centers for Disease Control and Prevention state that relative survival rates over five years is approximately 77 percent. This means that eight out of every 10 individuals diagnosed with bladder cancer will likely still be alive in five years.
With advancements in treatment, the 10-year relative survival rate for bladder cancer patients is approximately 70 percent and the 15-year rate of survival is 65 percent. This number rises much higher in individuals diagnosed with Stage 0 bladder cancer. Their five-year survival rate is approximately 98 percent.
Diagnosing Bladder Cancer
Many of the early signs and symptoms of beginning stage bladder cancer are detected by the individual or through laboratory tests during an annual exam or for another medical reason. Before an accurate diagnosis can be made, the doctor will typically perform a comprehensive physical examination and take a complete medical history of the patient to determine potential risk factors including genetics.
The physical examination for bladder cancer usually requires a digital rectal exam or a pelvic examination (for females). During the examination, the physician might detect a bladder tumor and determine its size, location, and whether it is metastasizing (spreading) to other portions of the bladder or another organ.
Abnormal results during a physical examination often require the urologist to perform further tests that include:
- Urine Cytology – An examination of the urine under a microscope can help reveal the presence of pre-cancer or cancer cells. In addition, the doctor may perform cytology during a cystoscopy procedure where a thin tube with a small attached video camera is inserted into the bladder through the urethra of the anesthetized patient to help detect cancers.
- Urine Culture – Urologists and doctors perform urine cultures to determine if the patient is suffering from an infection. It is during this time cancer can reveal itself after the bacteria has had a chance to grow over several days or weeks.
- Urine Tumor Marker Tests – The doctor may order a BTA stat or NMP22 Bladder Check test to see if tumor markers are present in the patient’s urine.
- Transurethral Resection of a Bladder Tumor (TURBT) – If any of the above tests identify cancer, the doctor might perform a transurethral resection of the bladder procedure to remove the tumor and a portion of the surrounding area in the bladder’s muscle. However, the bladder cancer can metastasize to other areas of the organ or urinary tract.
- Biopsy Results – Laboratory results found in a biopsy (sample of the disease area) can assist the doctor in diagnosing bladder cancer and determine if it is invasive (invading or growing into the bladder wall) or noninvasive (staying contained in the inner layers of the cells).
Treating Bladder Cancer
Doctors will often recommend various treatments for bladder carcinoma including surgery, chemotherapy, and biological therapy. The doctor may perform a urinary diversion or recommend radiation therapy or ureterostomy where the surgeon creates an abdominal only to divert the flow of urine from the bladder.
Surgical options include a ureterosigmoidostomy, cystourethrectomy, cystoprostatectomy and the surgical remover of a portion or all of the bladder.