Bladder cancer is a form of cancer that can develop in the cells and tissues of the bladder, the organ in your body that stores urine. According to the National Institutes of Health, upwards of 50,000 men and 20,000 women are diagnosed with the disease each year.
There are three primary types of Bladder Cancer:
Transitional cell carcinoma is a frequent and common type of bladder cancer that starts in the transitional cells in the inner layer of the bladder. Transitional cells are those which change shape without being damaged when the tissue is stretched.
Squamous cell carcinoma is a relatively rare cancer in the United States. It occurs when thin, flat squamous cells form in the bladder after a sustained period of infection or irritation.
Adenocarcinoma is another rare form of cancer in the United States. It occurs when glandular cells form in the bladder after sustained, long term bladder irritation and inflammation. The mucus-secreting glands throughout the body are comprised of glandular cells.
What are the Symptoms of Bladder Cancer?
Many people with early stage bladder cancer may discover blood in their urine, but they experience little-to-no pain while urinating. There are a number of symptoms that may indicate bladder cancer including fatigue, weight loss and bone tenderness. These particular symptoms suggest that the disease has evolved to a more advanced state. Individuals should pay particular attention to the following symptoms:
- blood in the urine
- painful urination
- frequent urination
- urgent urination
- urinary incontinence
- pain in the abdominal area
- pain in the lower back
What causes Bladder Cancer?
Unfortunately, the exact cause of bladder cancer has not yet been established. However, it occurs when abnormal cells multiply uncontrollably and invade the surrounding tissues.
Who is at risk for Bladder Cancer?
Smoking significantly increases the risk of developing bladder cancer. In fact, smoking is the leading cause of over 50% of all diagnosed incidents of bladder cancer in both men and women. The following have been identified as significant risk factors for developing bladder cancer:
- exposure to cancer-causing chemicals
- chronic bladder infections
- low fluid consumption
- being male
- being white
- being older, since the majority of bladder cancers occur in people over the age of 55
- eating a high-fat diet
- having a family history of bladder cancer
- having previous treatment with a chemotherapy drug called Cytoxan
- having previous radiation therapy to treat cancer in the pelvic area
How is Bladder Cancer diagnosed?
Your doctor can accurately diagnose bladder cancer through one or more of the following methods:
- Internal examination, which involves your doctor inserting gloved fingers into your vagina or rectum to feel for lumps that may indicate a cancerous growth
- Cystoscopy, which involves your doctor inserting a narrow tube that has a small camera on it through your urethra to see inside your bladder
- Biopsy in which your 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)
Based on the findings of the examinations noted above, your doctor will rate the state of bladder cancer using a staging system that ranges from stages 0-4. The stages of bladder cancer can be interpreted as follows:
- Stage 0 – bladder cancer has not spread past the lining of the bladder.
- Stage 1 – bladder cancer has spread past the lining of the bladder, but it has not reached the layer of muscle in the bladder.
- Stage 2 – bladder cancer has spread to the layer of muscle in the bladder.
- Stage 3 – bladder cancer has spread into the tissues that surround the bladder.
- Stage 4 – bladder cancer has spread past the bladder to the surrounding areas of the body.
How is Bladder Cancer treated?
Your doctor will work with you to determine a course of treatment to provide based on the type and stage of your bladder cancer, your symptoms, and your overall health.
Treatment for stage 0 and stage 1 bladder cancer may include:
- surgery to remove the tumor from the bladder, chemotherapy, or immunotherapy, which involves taking a medication that causes your immune system to attack the cancer cells.
Treatment for stage 2 and stage 3 bladder cancer may include:
- removal of part of the bladder in addition to chemotherapy
- removal of the whole bladder, which is a radical cystectomy, followed by surgery to create a new way for urine to exit the body
- chemotherapy, radiation therapy, or immunotherapy that can be done to shrink the tumor before surgery, to treat the cancer when surgery isn’t an option, to kill remaining cancer cells after surgery, or to prevent the cancer from recurring
Treatment for stage 4 bladder cancer may include:
- 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
What is the outlook for individuals diagnosed with Bladder Cancer?
The long-term outlook ultimately depends on a number of variables, including the type and stage of cancer. Per the American Cancer Society, the 5 year survival rates by stage are as follows:
- The five-year survival rate for people with stage 0 bladder cancer is ~98%.
- The five-year survival rate for people with stage 1 bladder cancer is ~88%.
- The five-year survival rate for people with stage 2 bladder cancer is ~63%.
- The five-year survival rate for people with stage 3 bladder cancer is ~46%.
- The five-year survival rate for people with stage 4 bladder cancer is ~15%.
Rest assured, there are treatment options available for all stages of bladder cancer. It’s also worth noting that survival rates don’t tell the entire story and they cannot predict your future. You are encouraged to speak with your doctor about any questions or concerns you may have regarding your diagnosis and treatment options.
Bladder Cancer Prevention
As doctors and medical researches have yet to determine what causes bladder cancer, it may or may not be a preventable disease. However, the following factors and personal behaviors may reduce your risk of developing bladder cancer:
- not smoking
- avoiding secondhand cigarette smoke
- avoiding other carcinogenic chemicals
- drinking plenty of water