Bladder Cancer

Causes

Cancer happens when cells in the body split without control or order. These cells form a growth or tumor. These harmful growths 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 is not clear exactly what causes cancer to grow. It is likely a mix of genes and the environment.

Risk Factors

Bladder cancer is more common in men. It is also more common in people over 55 years old and those who are White. Other things that may raise the risk are:

• Smoking and exposure to others' smoking
• Working in certain jobs such as:
  • Rubber, leather, and textiles
  • Painting
  • Hairdressing
  • Machinery
  • Printing
  • Trucking
  • Petroleum
• Exposure to arsenic in drinking water
• A family history of bladder cancer
• Certain gene problems
• Problems that cause irritation in the bladder such as repeated infections or catheter use
• Obesity
• Certain medicines or treatments, such as:
• Pioglitazone to treat diabetes
• Radiation therapy to the pelvis

Symptoms

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

• Blood in the urine
• Urinary problems such as:
  • Passing urine (pee) more often
  • An urgent need to pass urine
  • 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 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 and test with a biopsy.

The exam and test results help find the stage of cancer. 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

Treatment depends on the stage of the bladder cancer and the person's health and age. Several treatments may be used.

Surgery is often used to remove the tumor and nearby tissue. Options include:

• Transurethral resection (TURBT)—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.

Chemotherapy (chemo) uses drugs to kill cancer cells. It may be given by mouth, shots, or IV. For some, it can be put into the bladder. This is called intravesical chemotherapy. Chemo may be given:

• Before surgery to shrink a tumor
• After surgery—to kill any cancer cells that may remain
• To help radiation work better
• For bladder cancers that have spread to distant parts of the body

Radiation therapy may be used alone or with chemo. It uses x-rays or particles 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

Radiation therapy may be used after surgery, or for those who cannot have surgery. It may also be used to treat symptoms from advanced cancer.

Other treatments may be:

• Immunotherapy—drugs that help the body fight cancer. They may be given by IV or placed in the bladder as a liquid.
• Targeted therapy—drugs that target the cancer cells. They are taken by mouth.

Prevention

To help lower the risk of bladder cancer:

• If you smoke, quit. Stay away from others when they are smoking.
• Follow safe practices when working with chemicals.