Bladder Cancer

Definition

Definition of Bladder Cancer
Bladder cancer is a type of cancer that begins in your bladder - a balloon-shaped organ in your pelvic area that stores urine. Bladder cancer begins most often in the cells that line the inside of the bladder. Bladder cancer typically affects older adults, though it can occur at any age.

The great majority of bladder cancers are diagnosed at an early stage - when bladder cancer is highly treatable. However, even early-stage bladder cancer is likely to recur. For this reason, bladder cancer survivors often undergo follow-up tests to look for bladder cancer recurrence for years after treatment.

Symptoms

Symptoms of Bladder Cancer
Symptoms of bladder cancer can include:

1. Abdominal pain
2. Blood in the urine
3. Bone pain or tenderness
4. Fatigue
5. Painful urination
6. Urinary frequency
7. Urinary urgency
8. Urine leakage (incontinence)
9. Weight loss

Causes

Causes of Bladder Cancer
In the United States, bladder cancers usually start from the cells lining the bladder (called transitional cells).

These tumors are classified based on the way they grow:

1. Papillary tumors have a wart-like appearance and are attached to a stalk.
2. Nonpapillary (sessile) tumors are much less common. However, they are more invasive and have a worse outcome.

The exact cause of bladder cancer is uncertain. However, several things may make you more likely to develop it:

1. Cigarette smoking: Smoking greatly increases the risk of developing bladder cancer. Up to half of all bladder cancers in men and several in women may be caused by cigarette smoke.
2. Chemical exposure at work: About one in four cases of bladder cancer is caused by coming into contact with to cancer-causing chemicals at work. These chemicals are called carcinogens. Dye workers, rubber workers, aluminum workers, leather workers, truck drivers, and pesticide applicators are at the highest risk.
3. Chemotherapy: The chemotherapy drug cyclophosphamide (Cytoxan) may increase the risk of bladder cancer.
4. Radiation treatment: Women who had radiation therapy to treat cervical cancer have an increased risk of developing bladder cancer.
5. Bladder infection: A long-term (chronic) bladder infection or irritation may lead to a certain type of bladder cancer.

Diagnosis

Diagnosis of Bladder Cancer
The health care provider will perform a physical examination, including a rectal and pelvic exam.

Tests that may be done include:

1. Abdominal CT scan
2. Bladder biopsy (usually performed during cystoscopy)
3. Cystoscopy (examining the inside of the bladder with a camera)
4. Intravenous pyelogram - IVP
5. Pelvic CT scan
6. Urinalysis
7. Urine cytology

Treatment

Treatment of Bladder Cancer
Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health.

Stage 0 and I treatments:

1. Surgery to remove the tumor without removing the rest of the bladder.
2. Chemotherapy or immunotherapy directly into the bladder.

Stage II and III treatments:

1. Surgery to remove the entire bladder (radical cystectomy).
2. Surgery to remove only part of the bladder, followed by radiation and chemotherapy.
3. Chemotherapy to shrink the tumor before surgery.
4. A combination of chemotherapy and radiation (in patients who choose not to have surgery or who cannot have surgery).

Prognosis

Prognosis of Bladder Cancer
After treatment for bladder cancer, you will be closely monitored by a doctor. This may include:

1. Bone scans and CT scans to check for the spread or return of cancer.
2. Monitoring symptoms that might suggest the disease is getting worse, such as fatigue, weight loss, increased pain, decreased bowel and bladder function, and weakness.
3. Complete blood count (CBC) to monitor for anemia.
4. Bladder exams every 3 to 6 months after treatment.
5. Urinalysis if you did not have your bladder removed.

Prevention

Prevention of Bladder Cancer
If you smoke, quit. Smoking can increase your risk of bladder cancer. Avoid exposure to chemicals linked to bladder cancer.