Table of Contents
What is Bladder Cancer?
Bladder cancer is a familiar type of cancer that begins in the cells of the bladder. The bladder is an organ that holds urine before it exits the body.
The bladder plays a significantly vital role in the totality of our health. It operates as a reservoir for urine in our bodies. Bladder cancer treatment can include with surgery, chemotherapy, intravesical chemotherapy, immunotherapy or radiation therapy.
What is Bladder & How Does it Operate?
When the kidneys filter waste from the blood, urine is built that enters the bladder through two tubes called ureters, the bladder then permits the storage of urine for a period of time before being discharged in urination through another tube called urethra.
The bladder can be considered as a muscular balloon; a flattened structure when there is no urine (immediately after an individual urinates) but can be filled up to a litre with urine. Usually, when the bladder is filled with urine of about half a litre, we sense the urge to urinate.
The muscular structure of the bladder also helps further pelvic muscles to push the urine out when released. The bladder is located in the lower abdomen (belly) deep in the pelvis, just outside the pubic symphysis.
Bladder Cancer
Bladder cancer refers to several kinds of malignant growth of the urinary bladder. It is a condition in which abnormal cells multiply without control in the bladder. The greatest risk element for bladder cancer is a genetic predisposition (a genetic effect that affects the phenotype of an organism but which can be altered by the environmental conditions); it can also be linked with smoking and occupational orientation to aniline-based dyes (such as a textile factory), as well as with petrol and other chemicals.
Causes
Bladder cancer initiates when cells in the bladder develop changes (mutations) in their DNA. A cell’s DNA retains instructions that tell the cell what to do. The changes tell the cell to reproduce rapidly and to go on living when healthy cells would die. The abnormal cells form a tumor that can intrude and destroy normal body tissue. In time, the abnormal cells can split away and spread (metastasize) through the body.
Types of Bladder Cancer
There are various types of bladder cancer. The bladder cancer cell type can be transitional cell carcinoma, squamous cell carcinoma or adenocarcinoma—each named for the kinds of cells that line the wall of the bladder where cancer develops.
Most bladder cancers (more than 90 per cent) start from the transitional cells, which inhabit the innermost lining of the bladder wall. The cancers, which initiate in these cells lining the bladder can, in some examples, invade the deeper layers of the bladder (called the lamina propria), the thick muscle coating of the bladder, or through the bladder wall into the fatty tissues that encircle the bladder.
Squamous cells are light flat cells that line the urethra and can begin in the bladder after long bouts of bladder inflammation or irritation. Squamous cell carcinoma can be about 5 percent of bladder cancers.
Adenocarcinoma is a very infrequent type of bladder cancer that initiates in glandular (secretory) cells in the lining of the bladder. Only 1 per cent to 2 per cent of these bladder cancers are adenocarcinoma.
Bladder Cancer Signs & Symptoms
The most typical warning sign of bladder cancer is the presence of blood in the urine, the colour can be faintly rusty to deep red hanging on the amount of blood present.
Other signs & symptoms include pain during urination, frequent urination, or feeling the condition to urinate without results. However, these signs and symptoms are not exact to bladder cancer, but may also be induced by non-cancerous diseases such as prostate infections and cystitis. When symptoms do appear, see the doctor right away as any illness should be diagnosed and treated as early as possible.
What are the treatments for bladder cancer?
The treatment of bladder cancer depends on how deep the tumor intrudes into the bladder wall.
There are four kinds of treatment for patients with bladder cancer. These include:
- Surgery
- Chemotherapy
- Intravesical chemotherapy or immunotherapy for superficial (External) cancers
- Radiation therapy
Sometimes, hybrids of these treatments will be used
Surgical options
Surgery is a standard treatment option for bladder cancer. The kind of surgery selected will depend on the stage of the cancer.
Transurethral resection of the bladder is used most frequently for early-stage conditions (Ta, T1, or CIS). It is accomplished under general or spinal anaesthesia.
In this process, a superior telescope called a resectoscope is inserted through the urethra into the bladder. The tumor is then trimmed out with the resectoscope, using a wire loop, and the raw surface of the bladder is then fulgurated (eliminated with an electric current).
Partial cystectomy is the removal of a division of the bladder. At times, it is utilised for a single tumor that invades the bladder wall in only one part of the bladder. This type of surgery maintains most of the bladder.
Chemotherapy or radiation therapy is usually used in combination. Only a minority of patients will authorise for this bladder-sparing process.
Radical cystectomy is the entire removal of the bladder. It is utilised for more extensive cancers and those that have spread beyond the bladder (or several early tumors over a large part of the bladder).
This surgery is usually done using a robot, which pulls the bladder and any other surrounding organs. In men, it is the prostate and seminal vesicles (cysts). In women, the ovaries, uterus and a portion of the vagina may be extracted along with the bladder.
Because the bladder is extracted, a process called a urinary diversion must be done so that urine can exit the body. A pouch made of the intestine may be made inside the body, or a leak-proof bag worn outside the body may be used to collect urine. The procedure normally requires a hospital stay of five to six days, give or take a few either way.
Chemotherapy
Chemotherapy guides the use of any of a group of drugs whose main effect is either to kill or delay the reproduction of rapidly multiplying cells. Cancer cells absorb chemotherapy drugs quicker than normal cells do (but all cells are revealed to the chemotherapy drug).
Chemotherapy medicines are delivered intravenously (through a vein) or can be delivered intravesically (straight into the bladder through a catheter threaded through the ureter), depending on the stage of bladder cancer.
Some common chemotherapy medications that are used for the treatment of bladder cancer include:
- Methotrexate
- Vinblastine
- Doxorubicin
- Cyclophosphamide
- Paclitaxel
- Carboplatin
- Cisplatin
- Ifosfamide
- Gemcitabine
- Many of these medications are used in combinations.
Side effects can appear with chemotherapy, and their harshness depends on the precise medication used and the ability of the patient to tolerate the drugs. Typical side effects from chemotherapy include:
- Nausea and vomiting
- Loss of appetite
- Hair loss
- Tiredness from anaemia
- Vulnerability to infections
- Ulcers or sores in the mouth
Chemotherapy can be given alone but is usually used with surgery or radiation therapy.
Intravesical therapy
For treatment of Bladder cancer, there can be used intravesical (into the bladder through a tube inserted into the urethra) immunotherapy or chemotherapy.
Immunotherapy guides to using of the body’s own immune system to attack the cancer cells. A vaccine called Bacillus Calmette-Guérin (BCG) is typically used for this purpose in the intravesical treatment of stages Ta, T1, or carcinoma in situ (limited to the innermost lining) bladder cancers. In the process, a solution containing BCG is possessed in the bladder for a few hours before being drained.
Intravesical BCG is normally given once a week for six weeks, but periodically long-term maintenance therapy is needed. Bladder irritation, pain or burning during urination, and low-grade fever and chills are probable side effects of intravesical BCG.
Intravesical chemotherapy with mitomycin C is another therapy option. Because the chemotherapy is given straight into the bladder, other cells in the body aren’t exposed to the chemotherapy, which decreases the chances of side effects from the chemotherapy. It’s also usually given as a single dose after a tumor has been removed via cystoscopy.
Radiation therapy
Radiation therapy sabotages the DNA of cancer cells by bombarding them with high-energy X-rays or other kinds of radiation. It may be a choice of surgery or used in a hybrid with surgery or chemotherapy. Radiation therapy can be given externally or internally depending on the situation.
In external radiation therapy, a radiation source is a machine outside the body that executes a focused beam of radiation at the tumor. With better imaging technologies in use today, computer-guided radiation produced from several angles minimizes radiation exposure to surrounding tissues and organs, limiting injury to these tissues. Fatigue, swelling of soft tissues and skin irritation are expected side effects of external radiation.
Internal radiation therapy is not usually used for bladder cancer. In this type of therapy, a radioactive pellet is inserted into the bladder through the urethra or an incision in the more downward abdomen. Internal radiation needs a hospital stay during the course of treatment, which can be several days, after which the pellet is released.
Risk Factors of Bladder Cancer
Factors that may raise bladder cancer risk include:
Smoking
Smoking cigarettes, cigars or pipes may raise the risk of bladder cancer by provoking harmful chemicals to accumulate in the urine. When you smoke, your body processes the chemicals in the smoke and discharges some of them in your urine. These harmful chemicals may harm the lining of your bladder, which can raise your risk of cancer.
Increasing age
Bladder cancer risk rises as you age. Though it can appear at any age, most individuals diagnosed with bladder cancer are older than 55.
Being male
Men are more probable to develop bladder cancer than women. Disclosure of specific chemicals. Your kidneys play a key role in purifying harmful chemicals from your bloodstream and moving them into your bladder. Because of this, it’s thought that being around specific chemicals may increase the risk of bladder cancer. Chemicals linked to bladder cancer risk include arsenic and chemicals utilised in the manufacture of dyes, rubber, leather, textiles and paint products.
Earlier cancer treatment
Treatment with the anti-cancer medicine cyclophosphamide raises the risk of bladder cancer. Individuals who received radiation treatments aimed at the pelvis for earlier cancer have a higher risk of developing bladder cancer.
Chronic bladder inflammation
Chronic or duplicated urinary infections or inflammations (cystitis), such as might occur with long-term use of a urinary catheter, may raise the risk of squamous cell bladder cancer. In some regions of the world, squamous cell carcinoma is related to chronic bladder inflammation induced by the parasitic infection known as schistosomiasis.
Personal or family history of cancer
If you’ve had bladder cancer, you’re more possible to get it again. If one of your blood relatives — a parent, sibling or child — has a history of bladder cancer, you may have a raised risk of the condition, although it’s infrequent for bladder cancer to run in families. A family record of Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC), can raise the risk of cancer in the urinary system, as well as in the colon, uterus, ovaries and other organs.
Prevention of Bladder Cancer
Although there’s no assured way to prevent bladder cancer, you can take steps to help reduce your risk. For example:
Don’t smoke
If you don’t smoke, don’t initiate. If you smoke, talk to your doctor about a strategy to help you stop. Support groups, medications and other techniques may help you quit.
Take caution around chemicals
If you work with chemicals, follow all security instructions to avoid exposure.
Choose a sort of fruits and vegetables
Choose a diet rich in a type of colourful fruits and vegetables. The antioxidants in fruits and vegetables may help lower your risk of cancer.
Conclusion
Bladder cancer is the fourth most typical cancer in men and the eighth-most typical cancer in women. More than fifty thousand cases are diagnosed every year in the United States, with over twelve thousand deaths. According to available data, 549,393 new cases of bladder cancer were observed worldwide in 2018.
According to the contemporary reports of the National Cancer Registry Programme (NCRP), the general incidence rate of urinary bladder cancer is 2.25% (per 100,000 annually): 3.67% among males and 0.83% for females in India.