Bladder Cancer

Definition

Bladder cancer is the growth of cancer cells that start in the bladder. The bladder stores urine until you pass it from the body. There are three main types:

• Transitional cell (urothelial) carcinoma
• Squamous cell carcinoma
• Adenocarcinoma

Causes

Cancer happens when cells in the body split without control or order. These cells go on to form a growth or tumor. These are harmful growths that can attack nearby tissues and make it hard for the bladder to work as it should. Cancer cells can also spread to other parts of the body.

It's not clear exactly what causes cancer to grow. It is likely a mix of genes and the environment.

Risk Factors

The chances of bladder cancer are higher for:

• People aged 65 to 85 years old
• Men
• Those who are White
• Smokers
• Working in certain jobs such as:
  • Rubber, leather, and textiles
  • Painting
  • Hairdressing
  • Machinery
  • Printing
  • Trucking
  • Petroleum
• Exposure to arsenic in drinking water
• Having the same problems in your family
• Problems with your genes
• Problems that cause irritation in the bladder such as repeated infections or catheter use
• Obesity
• Pioglitazone use to treat diabetes
• Radiation therapy to the pelvis

Symptoms

Problems may not appear right away. Bladder cancer may cause:

• Blood in the urine
• Urinary problems such as:
  • Passing urine more often
  • Feeling of urgency
  • Pain
  • Slow stream or having a hard time passing urine
• Lower back pain
• Weight loss, bone pain, or belly pain—found in later stages

Diagnosis

The doctor will ask about your symptoms and past health. Urine and blood tests may be done to rule out other urinary tract issues. Image tests may be done to look for tumors or other changes:

• Cystoscopy
• IV pyelogram (IVP)
• CT scan
• MRI scan
• Ultrasound

A sample of the tumor will be taken for biopsy.

The exam and your test results will help find out the stage of cancer you have. Staging guides your treatment. Bladder cancer is staged from 0 to 4. Stage 0 is cancer that has stayed in one area. Stage 4 is a cancer that has spread to other parts of the body.

Stages of Bladder Cancer

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Treatment

Talk with your doctor about the best treatment plan for you. Options are based on the stage of your cancer. You may have one or more of the following:

Surgery

Surgery will remove the tumor and nearby tissue. Options include:

• Transurethral resection—Removes cancer cells with tools placed through a scope. Any remaining cells can be burned away with another tool.
• Cystectomy can be:
  • Partial—Part of the bladder and nearby healthy tissue are removed.
  • Radical—The entire bladder and nearby lymph nodes are removed.
    • In men—The prostate may be taken out.
    • In women—The uterus, ovaries, part of the vagina, and the fallopian tubes may be taken out.

Radiation Therapy

Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. It may be:

• External—radiation is aimed at the bladder from a source outside the body
• Internal—radioactive materials placed into bladder in or near the cancer cells

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It may given by mouth, shots, or IV. The drugs enter the bloodstream and travel throughout the body.

For some, it can be given right into the bladder. This is called intravesical chemotherapy.

Biologic Therapy

Biologic therapy uses the body’s immune system to fight cancer. Substances are made by the body or in a lab. They’re placed right into the bladder to boost, direct, or restore the body’s defenses. This type is used only for shallow, low grade cancer that was taken out.

Prevention

To help lower your chances of bladder cancer:

• If you smoke or use tobacco products, talk to your doctor about ways to quit.
• Follow safe practices at work. If you are at high risk, talk to your manager about how to protect yourself.