Things to know about bladder cancer

Bladder cancer is cancer that begins in the cells of the urinary bladder. The urinary bladder is a hollow muscular organ in the lower abdomen that is responsible for the storage of urine filtered by the kidneys. The disease is caused when deoxyribonucleic acid (DNA) in the cells of the bladder mutates or changes. These changes often result in uncontrolled cell growth or cancer.
Bladder cancer is a common urologic cancer that has the highest recurrence rate of any malignancy. Bladder cancer is less common in women than in men, but women often face a worse prognosis. Women have a higher chance of being diagnosed only when they have an advanced stage of bladder cancer. Hence, women tend to have a worse prognosis compared to men. The chances of cure are good in bladder cancer if diagnosed early.
What are the types of bladder cancer?
Different types of cells in the bladder can become cancerous. The type of cell where cancer begins determines the type of bladder cancer. Three types of bladder cancer are:
- Urothelial carcinoma: Urothelial carcinoma, previously called transitional cell carcinoma, is the most common type of bladder cancer that occurs in the cells that line the inside of the bladder.
- Squamous cell carcinoma: Squamous cell carcinoma is associated with chronic irritation of the bladder caused by an infection or long-term use of a urinary catheter. Squamous cell bladder cancer is more common in parts of the world where the parasitic infection, schistosomiasis, is a common cause of bladder infections.
- Adenocarcinoma: Adenocarcinoma begins in cells that make up mucus-secreting glands in the bladder. Adenocarcinoma of the bladder is rare.
What are the five stages of bladder cancer?
Doctors assign the stage of bladder cancer by combining the T, N, and M classifications.
- Tumor (T): The size and location of the tumor.
- Node (N): The tumor spread to the lymph nodes.
- Metastasis (M): Determines cancer spread to other parts of the body.
The five stages of bladder cancer indicate the following.
- Stage 0 bladder cancer hasn’t spread past the lining of the bladder.
- Stage I bladder cancer has spread past the lining of the bladder, but it hasn’t reached the layer of muscle in the bladder.
- Stage II bladder cancer has spread to the layer of muscle in the bladder.
- Stage III bladder cancer has spread into the tissues that surround the bladder.
- Stage IV bladder cancer has spread past the bladder to the neighboring areas of the body.

SLIDESHOW
Signs of Prostate Cancer: Symptoms, PSA Test, Treatments See SlideshowWhat are the signs and symptoms of bladder cancer?
Many people with bladder cancer first may have blood in their urine without pain while urinating. Most often, bladder cancer is diagnosed after a person finds blood in the urine. Several symptoms might indicate bladder cancer, such as fatigue, weight loss, and bone tenderness. These can indicate more advanced diseases. The common bladder cancer symptoms include
- Blood or blood clots in the urine
- Pain or burning sensation during urination
- Frequent urination
- Feeling the need to urinate many times throughout the night
- Feeling the need to urinate but not being able to pass urine
- Lower back pain on one side of the body
- Pelvic pain
- Reduced appetite
- Lethargy
- Weight loss
In the advanced stages, cancer spreads to other parts of the body causing symptoms to the site such as bone pain, difficulty breathing, weakness, nausea, or vomiting.
What are the risk factors for bladder cancer?
Smoking cigarettes, cigars, or pipes cause harmful chemicals to accumulate in the urine. These harmful chemicals may damage the lining of the bladder, increasing the risk of developing cancer. Other risk factors include
- Exposure to cancer-causing chemicals, especially the industrial solvents
- Chronic bladder infections
- Low fluid consumption
- Male gender
- In old age, the majority of bladder cancers occur in people older than 55 years of age
- High-fat diet
- Family history of bladder cancer
- Previous treatment with a chemotherapy drug called Cytoxan
- Previous radiation therapy to treat cancer in the pelvic area
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How is bladder cancer treated?
The doctor will work with the patient to decide what treatment to provide based on the symptoms, type, and stage of the bladder cancer, and the patient’s overall health. In general, the main treatment options for bladder cancer are
- Surgery: Surgery is done to remove cancer.
- Chemotherapy: Antitumor drugs, targeted medicines that target the development of blood vessels feeding the tumor may help.
- Immunotherapy: Newer immune system medicines may help destroy cancer cells.
- Radiation therapy: Using high-energy rays to destroy cancer cells.
- Targeted therapy: Specifically targets the cancer cell depending on certain peculiarities that differentiate them from healthy cells
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Lotan Y, Choueiri TK. Clinical Presentation, Diagnosis, and Staging of Bladder Cancer. UpToDate. https://www.uptodate.com/contents/clinical-presentation-diagnosis-and-staging-of-bladder-cancer?search=bladder-cancer&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
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