Bladder Neoplasm

Definition

Definition of Bladder Neoplasm
Bladder cancer is the sixth most common cancer in the United States. The American Cancer Society (ACS) estimated that in 2001, approximately 54,300 new cases of bladder cancer would be diagnosed (about 39,200 men and 15,100 women), causing approximately 12,400 deaths. The rates for men of African descent and Hispanic men are similar and are approximately one-half of the rate among white non-Hispanic men. The lowest rate of bladder cancer occurs in the Asian population. Among women, the highest rates also occur in white non-Hispanic females and are approximately twice the rate for Hispanics. Women of African descent have higher rates of bladder cancer than Hispanic women.

The urinary bladder is a hollow muscular organ that stores urine from the kidneys until it is excreted out of the body. Two tubes called the ureters bring the urine from the kidneys to the bladder. The urethra carries the urine from the bladder to the outside of the body.

Bladder cancer has a very high rate of recurrence. Even after superficial tumors are completely removed, there is a 75% chance that new tumors will develop in other areas of the bladder. Hence, patients need frequent and thorough follow-up care.

Symptoms

Symptoms of Bladder Neoplasm
One of the first warning signals of bladder cancer is blood in the urine. Sometimes, there is enough blood to change the color of the urine to a yellow-red or a dark red. At other times, the color of the urine appears normal but chemical testing of the urine reveals the presence of blood cells. A change in bladder habits such as painful urination, increased frequency of urination and a feeling of needing to urinate but not being able to do so are some of the signs of possible cancer. All of these symptoms also may be caused by conditions other than cancer, but it is important to see a doctor and have the symptoms evaluated. When detected early and treated appropriately, patients have a very good chance of being cured completely.

Causes

Causes of Bladder Neoplasm
Although the exact cause of bladder cancer is not known, smokers are twice as likely as nonsmokers to get the disease. Hence, smoking is considered the greatest risk factor for bladder cancer. Workers who are exposed to certain chemicals used in the dye industry and in the rubber, leather, textile, and paint industries are believed to be at a higher risk for bladder cancer. The disease also is three times more common in men than in women; caucasians also are at an increased risk. The risk of bladder cancer increases with age. Most cases are found in people who are 50-70 years old. In 2003, studies showed that hormone replacement therapy (HRT), a treatment used by many postmenopausal women, significantly increased the risk of bladder and other cancers.

Diagnosis

Diagnosis of Bladder Neoplasm
If a doctor has any reason to suspect bladder cancer, several tests can help find out if the disease is present. As a first step, a complete medical history will be taken to check for any risk factors. A thorough physical examination will be conducted to assess all the signs and symptoms. Laboratory testing of a urine sample will help to rule out the presence of a bacterial infection. In a urine cytology test, the urine is examined under a microscope to look for any abnormal or cancerous cells. A catheter (tube) can be advanced into the bladder through the urethra, and a salt solution is passed through it to wash the bladder. The solution can then be collected and examined under a microscope to check for the presence of cancerous cells.
A test known as the intravenous pyelogram (IVP) is an x-ray examination that is done after a dye is injected into the blood stream through a vein in the arm. The dye travels through the blood stream and then reaches the kidneys to be excreted. It clearly outlines the kidneys, ureters, bladder, and urethra. Multiple x rays are taken to detect any abnormality in the lining of these organs.

Treatment

Treatment of Bladder Neoplasm
Treatment for bladder cancer depends on the stage of the tumor. The patient's medical history, overall health status, and personal preferences also are taken into account when deciding on an appropriate treatment plan. The three standard modes of treatment available for bladder cancer are surgery, radiation therapy, and chemotherapy. In addition, newer treatment methods such as photodynamic therapy and immunotherapy also are being investigated in clinical trials.

Surgery is considered an option only when the disease is in its early stages. If the tumor is localized to a small area and has not spread to the inner layers of the bladder, then the surgery is done without cutting open the abdomen. A cytoscope is introduced into the bladder through the urethra, and the tumor is removed through it. This procedure is called a transurethral resection (TUR). Passing a high-energy laser beam through the cytoscope and burning the cancer may treat any remaining cancer. This procedure is known as electrofulguration. If the cancer has invaded the walls of the bladder, surgery will be done through an incision in the abdomen. Cancer that is not very large can be removed by partial cystectomy, a procedure where a part of the bladder is removed. If the cancer is large or is present in more than one area of the bladder, a radical cystectomy is done. In this operation, the entire bladder and adjoining organs also may be removed. In men, the prostate is removed, while in women, the uterus, ovaries, and fallopian tubes are removed.

Prognosis

Prognosis of Bladder Neoplasm
Consult with your doctor.

Prevention

Prevention of Bladder Neoplasm
Consult with your doctor.