Bladder Cancer

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What is Bladder Cancer?

Cancer occurs when the cells grow abnormally and also invade nearby tissues and eventually spreading to other organs in the body through the bloodstream or the lymph nodes.

Bladder Cancer is the cancer of bladder wherein the cells in the bladder grow abnormally & form a tumour. Bladder is a hollow organ located in the pelvis. The main function of the bladder is it stores the urine & allows urination to be infrequent and controlled.

Causes of Bladder Cancer

  • Inflammation of the bladder.
  • Having family history of bladder cancer.
  • Smoking
  • Exposure to harmful chemicals especially working in a job that requires exposure to chemicals
  • Intake of certain diabetes medications can raise the risk of bladder cancer.
  • Bladder cancer risk increases with age. 

Types of Bladder Cancer

  • Urothelial Carcinoma: Urothelial carcinoma occurs in the cells that line the inside of the bladder.
  • Squamous Cell Carcinoma: Squamous cell carcinoma occurs when there is chronic irritation of the bladder like in the cases where there is long-term use of a urinary catheter.
  • Adenocarcinoma: Adenocarcinoma originates in the cells that produces mucus-secreting glands in the bladder.

Signs & symptoms of Bladder Cancer

  • Blood in the urine (hematuria).
  • Frequent urination
  • Burning sensation or pain during urination
  • Pain in the pelvic region & lower back.
  • Loss of weight
  • Swelling in the feet
  • Fatigue & weakness

What are the stages of Bladder Cancer

  • STAGE 0:  Cancer is present in the centre of the bladder.
  • STAGE I: Cancer has spread to the inner lining of the bladder.
  • STAGE II:  The cancer has spread to the connective tissue in the bladder and into the muscle layer of the bladder.
  • STAGE III: Cancer is now is present in the fatty tissue that surrounds your bladder & it may also have spread to the prostate, uterus or vagina (for females)
  • STAGE IV: The cancer has spread into your pelvic or abdominal wall, to nearby lymph nodes & has spread to distant sites like the bones, liver, or lungs.

Diagnosis of Bladder Cancer

The following diagnostic tests are generally done for Bladder Cancer:

Digital rectal exam

During digital rectal exam, the doctors put on a glove and insert the finger into the rectum to feel a tumour in the bladder.

Urinalysis

Urinalysis is done to check for blood or other substances in the urine.

Urine culture

Urine Culture allows to check for bladder infection.

Urine tumour marker

Urine tumour marker tests allows to check for substances that are released by bladder cancer cells.  A thin tube with a flash and video camera at the end is inserted into the bladder. Thereafter, salt water is injected in through it. The camera allows the doctor to see the inner lining of the bladder assisting in better diagnosis.

Transurethral Resection of Bladder Tumour (TURBT)

During Transurethral Resection of Bladder Tumour (TURBT), the doctor removes the tumour & some nearby muscles as well. This sample is sent to the lab to check for cancer.

Intravenous pyelogram (IVP)

During Intravenous pyelogram (IVP), the doctor injects dye into the vein & this highlights tumours in the urinary tract.

Retrograde pyelogram

During retrograde pyelogram, the doctor inserts a thin tube (catheter) into the urethra and bladder. A dye is injected through the catheter so the doctor can see the lining of the bladder. & if there are any tumours in the urinary tract, they’ll show up here.

CT Scan

CT Scan is used to measure the tumor’s size and to identify enlarged lymph nodes.

MRI

MRI is used to identify if the cancer has spread.

Ultrasound

Ultrasound helps find out if the kidneys or ureters are blocked.

Bone scan

Bone Scan is used to check if the cancer that has spread from the bladder to the bones.

Treatment options for Bladder Cancer

Following are the treatment options for Bladder Cancer-

Surgery

The surgical options for the treatment of Bladder Cancer are:

  • Transurethral resection of bladder tumour (TURBT)- In this procedure, a retroscope is inserted into the bladder through the urethra. Retroscope is a tube through which the urine flows & has a wire loop at the end. The doctor uses it to remove abnormal tissues or tumours.
  • Cystectomy- It may be partial cystectomy, removal of part of the bladder or radical cystectomy, removal of entire bladder.

Chemotherapy

Chemotherapy is the use of anti-cancer drug that helps to slow or stop the growth of rapidly dividing cells that cause cancer. It prevents the growth of rapidly dividing cells by killing the dividing cells. Chemotherapy is often used in combination with other interventions such as surgery or radiation and other therapies.

Sometimes, chemotherapy is administered prior to a surgery, like therapy can be used to shrink a tumour before surgery. This is called as Neo-adjuvant Therapy. And when chemotherapy is used to remove any remaining cancer cells, after surgery, this is known as Adjuvant Chemotherapy.

Radiation Therapy

Radiation Therapy is a kind of cancer treatment that uses high doses of radiation beams to kill cancer cells to shrink the tumors. Radiation kills the cancer cells by destroying the DNA. Cancer cells with damaged DNA fail to multiply and die. They are then removed by the body’s mechanism.

Brachytherapy

Brachytherapy is an internal beam radiation therapy technique where radiation seeds, the size of rice grains are placed in the location of tumor using a needle, guided by ultrasound imaging. The radioactive seeds keep emitting low dose radiation beams to the cancer over a long period of time. At one point, the seeds stop emitting radiation, but do not need to be removed.

Immunotherapy

Immunotherapy (also called biologic therapy) is a new type of cancer treatment where the body’s immune system is boosted to help the body fight cancer by itself. Immunotherapy uses substances made by the body or in a laboratory to improve or restore immune system function.

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