Bladder Cancer

Written by Rose Kivi | Published on 16 July 2012
Medically Reviewed by George Krucik, MD

What Is Bladder Cancer?

Bladder cancer occurs in the tissues of the bladder, which is the organ in the body that holds urine. According to the National Institutes of Health (NIH), approximately 45,000 men and 17,000 women per year are diagnosed with the disease. (NIH, 2007)

What Causes Bladder Cancer?

The exact cause of bladder cancer is unknown. It occurs when abnormal cells grow and multiply quickly and uncontrollably, and invade other tissues.

Types of Bladder Cancer

There are three types of bladder cancer:

Transitional Cell Carcinoma

Transitional cell carcinoma is the most common type of bladder cancer.NIH, 2007It begins in the transitional cells in the inner layer of the bladder. Transitional cells are cells that change shape, without becoming damaged, when the tissue is stretched.

Squamous Cell Carcinoma

Squamous cell carcinoma is a rare cancer in the United States. It begins when thin, flat squamous cells form in the bladder after a long-term infection or irritation in the bladder.

Adenocarcinoma

Adenocarcinoma is also a rare cancer in the United States. It begins when glandular cells form in the bladder after long-term bladder irritation and inflammation. Glandular cells are what make up the mucus-secreting glands in the body.

Who Is at Risk for Bladder Cancer?

The following factors increase your risk of developing bladder cancer:

  • smoking (half of bladder cancers in men and women are caused by smoking)
  • exposure to cancer causing chemicals at work
  • chronic bladder infections
  • low fluid consumption
  • being male
  • being white
  • being older - according to the American Cancer Society (ACS), the majority of bladder cancers occur in people over the age of 55 (ACS, 2011)
  • eating a high fat diet
  • a family history of bladder cancer
  • previous treatment with a chemotherapy drug called Cytoxan
  • previous radiation therapy to treat cancer in the pelvic area

What are the Symptoms of Bladder Cancer?

There are a number of disparate symptoms that might indicate bladder cancer like fatigue, weight loss, and bone tenderness. However, you should pay particular attention to the following triggers:

  • blood in the urine, painful urination, frequent or urgent urination, and urinary incontinence
  • pain in the abdominal area and in the lower back

How Is Bladder Cancer Diagnosed?

Your doctor may diagnose bladder cancer using one or more of the following methods:

  • urinalysis
  • internal examination (a doctor inserts gloved fingers into your vagina or rectum to feel for lumps)
  • cystoscopy (a doctor inserts a narrow tube that has a small camera on it through your urethra to see inside your bladder)
  • biopsy (a doctor inserts a small tool through your urethra and takes a small sample of tissue from your bladder to test for cancer)
  • CT Scan to view the bladder
  • intravenous pyelogram (IVP) X-rays

Doctors rate bladder cancer with a staging system that goes from stage 0 to stage IV, to identify how far the cancer has spread. The stages of bladder cancer mean:

Stage 0 Bladder Cancer

The cancer has not spread past the lining of the bladder.

Stage I Bladder Cancer

The cancer has spread past the lining of the bladder, but has not reached the layer of muscle in the bladder.

Stage II Bladder Cancer

The cancer has spread to the layer of muscle in the bladder.

Stage III Bladder Cancer

The cancer has spread into the tissues that surround the bladder.

Stage IV Bladder Cancer

The cancer has spread to the neighboring lymph nodes or to other areas of the body.

How Is Bladder Cancer Treated?

Your doctor will decide what treatment to provide based on the type and stage of your bladder cancer, your symptoms, and your overall health. Bladder cancer treatments may include:

Stage 0 and Stage I Bladder Cancer Treatments

  • surgery to remove the tumor from the bladder
  • chemotherapy or immunotherapy (medication that causes your immune system to attack the cancer cells)

Stage II and Stage III Bladder Cancer Treatments

  • chemotherapy, radiation therapy, or immunotherapy to shrink the tumor before surgery. This may be used when surgery is not an option, or after surgery to kill remaining cancer cells, or to prevent the cancer from recurring.
  • removal of part of the bladder in addition to chemotherapy
  • removal of the whole bladder (radical cystectomy), followed by a surgery to create a new way for urine to exit the body

Stage IV Bladder Cancer Treatments

  • chemotherapy without surgery to relieve symptoms and extend life
  • radical cystectomy and removal of the surrounding lymph nodes, followed by a surgery to create a new way for urine to exit the body
  • chemotherapy, radiation therapy, and immunotherapy after surgery to kill remaining cancer cells or to relieve symptoms and extend life
  • clinical trial drugs

Outlook

Your outlook after bladder cancer depends on the stage of the cancer. Stage 0 and stage I bladder cancers can usually be cured. There is a high risk that the cancer will return, but the returning cancer is often curable. There is less than a 50 percent chance that stage III bladder cancers can be cured. Stage IV bladder cancer is rarely curable. (NIH, 2011)

Prevention

Because doctors do not yet know what causes bladder cancer, it may not be preventable in all cases. However, the following factors and behaviors can reduce your risk of getting bladder cancer:

  • not smoking
  • avoiding secondhand cigarette smoke and carcinogenic chemicals
  • drinking plenty of water
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