Quick Answers about Bladder Cancer
- Bladder Cancer Overview
- The Risk of Developing Bladder Cancer
- Bladder Cancer Signs and Symptoms
- Diagnosing Bladder Cancer
- Bladder Cancer Treatments and Medications
- Staging Bladder Cancer
- The Need for Support
Bladder Cancer Overview
Bladder cancer starts when the abnormal urinary bladder cells begin to grow out of control. Over time, the ever-increasing numbers of cancer cells will begin to form an isolated tumor or spread from its origination point to other areas of the bladder and eventually deeper into the body. Fortunately, many cases involving bladder cancer are detected early due to unusual and unexpected alarming symptoms including blood in the urine (hematuria) and other problems with urinating.
When the level of blood in the bladder caused by cancer becomes high enough, it can change the color of the urine to different shades of red, pink or orange. However, the color of the urine can remain normal even if the individual has bladder cancer. In addition, detectable blood in the urine can be irregular and not observed for weeks or months before reappearing.
In the initial stage of bladder cancer, individuals often experience mild to significant bleeding without pain, discomfort or other common symptoms. It is important to note that simply having blood in the urine and is not an indicator of bladder cancer. Other factors might be the cause of urinating blood including kidney stones, bladder stones, infections, non-cancers (benign) tumors or other non-cancerous kidney diseases.
The Risk of Developing Bladder Cancer
Bladder cancer is a significant problem. Statistics maintained by the National Cancer Institute revealed that approximately 74,000 new cases of bladder cancer were diagnosed in 2015 along with 16,000 bladder cancer-related deaths that year. Nearly three out of four of those cases involved men.
Like all cancers, there are specific factors that can affect the development of bladder cancer that might or might not be under the individual’s control. Scientists and researchers have yet to discover the cause of bladder cancer. However, there are certain risk factors that are believed to increase or exacerbate the chance of developing the disease. These risk factors include:
- Birth-related bladder defect
- Low fluid consumption
- Chronic bladder irritations and infections
- Radiation and chemotherapy
- Growing older
- Long-term urinary catheter use
- Family or personal history involving bladder cancer
- Arsenic exposure in drinking water
- Dietary supplements and some prescription medications including Aristolochic Acid and Actos (pioglitazone) used in diabetic medications
- Being white and/or male (African-Americans, Asian-Americans, Hispanics and Native Americans along with all women have lower bladder cancer rates)
- Exposure to aromatic amines and other specific chemicals
While being exposed to be specific risk factors has the potential of increasing bladder cancer rates, many individuals will not develop the disease over time. In addition, an absence of any risk factor listed above might not prevent the disease from developing and individuals working in certain industries and exposed to various unhealthy chemicals might have increased risk of developing bladder cancer. These industries and professions include:
- Truck drivers
- Manufacturing processes involving paints, textiles, leathers and rubber
Bladder Cancer Signs and Symptoms
While there are many signs and symptoms of bladder cancer, the most common ones include:
- Hematuria – There are varying stages of this symptom including gross hematuria where blood is visible with the naked eye or microscopic hematuria were blood is detected through microscopic urinalysis.
- Burning or Pain Associated with Urination – This often involves a lack of evidence that the individual has a UTI (urinary tract infection).
- Any Change in Normal Bladder Habits – Individuals who have a need to urinate more often or have an ongoing strong urge to urinate without actually urinating or those having difficulty urinating or producing a weak stream of urine.
Diagnosing Bladder Cancer
Numerous procedures and tests can be performed to determine if blood cancer is present. These common diagnostic options include:
- Imaging Tests – The physician can perform a CT (computerized tomography) scan with or without a die injected into the individual’s veins prior to the procedure to examine the urinary tract structure and surrounding tissue to detect early to advanced stages of bladder cancer.
- Cystoscopy – A cystoscope (a narrow fiber-optic and lens system) is inserted into the patient’s urethra to allow the doctor to examine the interior space of the bladder and urethra.
- Biopsy – The doctor may be able to obtain a biopsy while performing a cystoscopy to test for bladder cancer.
- Urine Cytology – A doctor can use a microscope to analyze a urine sample to identify cancer cells.
Bladder Cancer Treatments and Medications
Treatment and medication recommendations are often dependent on the type of bladder cancer along with its advancing stage. During the early stages of developing bladder cancer, the doctor may choose to:
- Surgically remove the tumor
- Surgically remove the tumor and remove portions of the bladder that will not harm bladder function
- Use immunotherapy (biological therapy) to alert the immune system to assist the body in fighting cancer cells.
If bladder cancer is in the advancing stages, the doctor may determine to remove the entire bladder through surgical radical cystectomy and then create a different pathway for the body to expel urine.
Other options include chemotherapy (medications that destroy cancer cells) and radiation therapy (high-energy beams of light) that destroy cancer cells. In some cases, the doctor will use a combination of chemotherapy and radiation therapy to work concomitantly to produce better results.
Staging Bladder Cancer
Doctors use staging categories to describe where the bladder cancer is located and indicate whether it has invaded or spread to other areas of the body. Staging usually requires various diagnostic tests and can provide valuable insight in assisting the doctor in choosing the best methods, treatment, surgery or options to improve the patient’s chance of recovery. Initially, doctors will stage the condition using the TNM staging [Tumor, Node (lymph node), and Metastasis (spreading)] system.
After assigning bladder cancer with a Tumor, Node, or Metastasis classification the doctor will then stage the cancer using a grouping method involving:
- Stage 0 – In its early developing stage, the cancer is typically detected on the bladder’s inner lining. At this stage, the non-invasive papillary urothelial carcinoma has yet to invade the connective tissue or muscle of the bladder wall.
- Stage I – At this stage, cancer has yet to spread to the bladder wall’s thick layer or to other organs or lymph nodes.
- Stage II – Cancer has now spread to the bladder’s thick muscle wall but the developing tumor has yet to spread to the bladder’s fatty surrounding tissue, other organs or lymph nodes.
- Stage III – At this stage, cancer might have spread to the vagina and uterus (female) or prostate (male).
- Stage IV – During this stage, the cancer tumor might have spread to the regional lymph nodes, abdominal wall or pelvic wall, and/or to other parts of the body.
- Recurrent Cancer – During this cancer stage, the disease returns after treatment.
The Need for Support
Individuals living with bladder cancer often must cope with various unexpected side effects including emotional concern, physical pain or social stigma. Not every bladder cancer patient develops the same side effects or manages their condition with the same treatment. In many cases, the side effects from treatments and medications will linger months or years after the treatment, procedure, surgery or use of the drug is over.
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