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Bladder Cancer

Bladder Cancer

Definition

The bladder is located in the lower abdomen. It is a hollow organ with flexible muscular walls. It stores urine until a person is ready to urinate. Bladder cancer is a disease in which cancer cells grow in the bladder.

Three main types of cancer affect the bladder. They are named for the type of cell that becomes cancerous:

  • Transitional cell (urothelial) carcinoma
  • Squamous cell carcinoma
  • Adenocarcinoma

Causes

Cancer occurs when cells in the body, in this case bladder cells, divide without control or order. Sometimes, cells divide uncontrollably when new cells are not needed. A mass of tissue called a growth or tumor can form. The term cancer refers to malignant tumors. Malignant tumors can invade nearby tissue and spread to other parts of the body.

What causes the changes in the cells is not clear. It is likely to be a combination of genetic and environmental factors.

Risk Factors

This condition is more common in adults between 65 and 85 years old. It is also more common in men and people who are Caucasian. Factors that may increase your chance of developing bladder cancer include:

  • Smoking
  • Occupational exposures:
    • Rubber, leather, and textiles
    • Painting
    • Chemicals used in hairdressing
    • Machines
    • Printing
    • Truck driving
    • Petroleum industry
  • Genetics
  • Chronic bladder inflammation or urinary tract infections
  • Personal or family history of bladder cancer
  • Chemotherapy drugs, such as cyclophosphamide and ifosfamide
  • Obesity
  • The use of pioglitazone to treat diabetes
  • Exposure to arsenic
  • Radiation treatment of the pelvis
  • Bladder birth defects
  • Chemicals such as nitrosamines and benzidine
  • Recurrent urinary stones
  • Long-term in-dwelling catheter
  • Bladder diverticuli—an area of weakness in the bladder wall through which some of the lining of the bladder is forced out
  • Metastasis from another cancer

Symptoms

Symptoms include:

  • Blood in the urine
  • Frequent urination, or feeling the need to urinate without being able to
  • Painful urination
  • Lower back pain
  • Weight loss, bone pain, or abdominal pain in advanced cases

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will feel the abdomen and pelvis for abnormalities. The physical exam may include a rectal or vaginal exam.

  • Urine can be evaluated with:
    • Urine cytology
    • Urine culture
  • Imaging tests assess the bladder and surrounding structures. These may include:
    • Cystoscopy
    • IV pyelogram (IVP)
    • CT scan
    • MRI scan
    • Ultrasound
    • Bone scan
  • A sample of bladder tissue may need to be tested. This can be done with a biopsy.

The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Bladder cancer is staged from 0-IV. Stage 0 is a very localized cancer, while stage IV indicates a spread to other parts of the body.

Stages of Bladder Cancer
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Treatment

Treatment options depend on the stage and may include:

Prevention

To help reduce your chance of bladder cancer:

  • If you smoke or use tobacco products, talk to your doctor about ways to quit.
  • Avoid or minimize occupational exposure to certain chemicals; follow good work safety practices.
  • Eat a diet rich in fruits and vegetables.
  • Avoid excess intake of high fat or high cholesterol foods.
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