Bladder cancer

About

Bladder cancer is a type of cancer that develops in the cells of the bladder, a hollow organ in the pelvis that stores urine. Symptoms of bladder cancer include pain during urination, frequent urination, and blood in the urine. Risk factors for bladder cancer include smoking, radiation exposure, certain medications, and certain health conditions. Treatment for bladder cancer may include surgery, chemotherapy, radiation, and immunotherapy.

Symptoms

The early stages of bladder cancer often do not cause any symptoms, which is why it is important to get regular screenings to detect the disease as early as possible. Possible signs and symptoms of bladder cancer include:

Blood in the urine (hematuria)
Frequent urination
Pain or burning sensation during urination
Low back pain on one side
Abdominal pain
Loss of appetite
Fatigue
Weight loss
Difficulty urinating
Pelvic pain

Causes

The exact cause of bladder cancer is unknown, however there are known risk factors that can increase the likelihood of developing it.

Tobacco: Smoking is the biggest risk factor for bladder cancer.
Exposure to certain chemicals: Certain chemicals used in industries such as rubber, leather, textiles, and printing, as well as in certain hairdressing products and paints, are linked to bladder cancer.
Exposure to certain medications: Taking certain medications for a long time can increase the risk for bladder cancer. These include certain blood pressure medicines and some chemotherapy drugs.
Family history of bladder cancer: Having a family member with bladder cancer may increase the risk.
Age and gender: People over 40 years of age and men are more likely to develop bladder cancer than younger people and women.
History of bladder infections or bladder stones: Long-term bladder infections and bladder stones can increase the risk.
Previous radiation therapy: People who have had radiation therapy to the pelvic area or abdomen may have an increased risk.
Immune system disorders: People with weakened immune systems, such as those with HIV or AIDS, may be more likely to develop bladder cancer.

Risk factors

The following are all possible risk factors for bladder cancer:

Age: The risk of bladder cancer increases with age, with most cases occurring in individuals over 55 years old.
Gender: Bladder cancer is more common in men than in women.
Smoking: Smoking cigarettes, cigars, and/or pipe tobacco increases the risk of developing bladder cancer.
Workplace exposures: Individuals who have been exposed to certain chemicals, such as arsenic, benzene, and polycyclic aromatic hydrocarbons, are at higher risk for bladder cancer.
Ethnicity: People of certain ethnic backgrounds, such as Native Americans and whites, are at higher risk for bladder cancer.
Certain medications and supplements: Long-term use of some medications, such as diuretics, and some dietary supplements may increase the risk of bladder cancer.
Certain medical conditions: Individuals who have had long-term bladder infections, bladder stones, or who have had radiation therapy to the abdomen or pelvis are at higher risk for bladder cancer.
Family history: A positive family history of bladder cancer is associated with an increased risk of the disease.

Diagnosis

Bladder cancer is typically diagnosed through a range of tests, including a physical exam, urine tests, imaging tests, and biopsy. During a physical exam, the doctor will feel the patient’s abdomen and check the pelvis to feel for lumps or abnormal shapes in the bladder wall. Urine tests are done to look for the presence of blood or other signs of cancer. Imaging tests such as a CT or MRI scan may also be used to look for an abnormal growth in the bladder or nearby structures. Finally, a biopsy of a sample of bladder tissue will be done to confirm the diagnosis of bladder cancer.

Sub-types

The two main types of bladder cancer are transitional cell carcinoma (TCC) and squamous cell carcinoma. Transitional cell carcinoma (TCC) is the most common type of bladder cancer and starts in the cells that line the inner surface of the bladder. It can grow into deeper layers of the bladder wall, but rarely spreads to other parts of the body.

Squamous cell carcinoma is less common than TCC and starts in the flat, thin cells that make up the inner layers of the bladder. This type is more likely to spread to other parts of the body and may be more aggressive than TCC.

Other, less common bladder cancers include adenocarcinoma, small cell carcinoma, sarcoma, and lymphoma. Adenocarcinoma begins in the cells of the glands in the bladder wall. Small cell carcinoma and lymphoma are both types of cancer that start in cells of the immune system. Sarcoma begins in the connective tissue in the bladder wall.

Treatments

The treatment options for bladder cancer depend on a variety of factors, such as the type and stage of the cancer, the patient’s age and overall health, and their preferences. The most common treatments for bladder cancer are surgery, radiation therapy, targeted therapy, immunotherapy, and chemotherapy.

Surgery may involve removing the cancerous tumor and/or surrounding tissue, and/or reconstructing the bladder. This may involve removing the bladder entirely (radical cystectomy) and reconstructing the urinary tract (neobladder).

Radiation therapy uses high-energy beams to kill cancer cells. This may be used before or after surgery.

Targeted therapy is a type of treatment that uses drugs which specifically target cancer cells, and can be used to shrink tumors or slow their growth.

Immunotherapy uses drugs that boost the body’s immune system to fight cancer.

Chemotherapy is the use of anti-cancer drugs to target and destroy or damage cancer cells.

Other treatments may also be available for bladder cancer, such as cryosurgery, photodynamic therapy, or intravesical therapy. It is important to speak with a healthcare professional about all of the treatment options to decide which one is best for you.

Prevention

The following steps can be taken to reduce the risk of bladder cancer:

Avoid smoking or use of tobacco products. Tobacco smoke is a leading cause of bladder cancer.
Monitor exposure to certain chemicals, dyes, and solvents that can increase the risk of bladder cancer.
Avoid prolonged exposure to radiation and pollutants in the environment.
Maintain a healthy diet rich in fruits and vegetables and low in fat.
Manage any chronic conditions such as diabetes and kidney disease to minimize the risk of bladder cancer.
Drink plenty of water to help flush out any carcinogenic substances from the urinary tract.
Exercise regularly to maintain a healthy body weight and boost the immune system.
See your doctor regularly for check-ups and screenings to detect any early signs of the cancer.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of bladder cancer. While men and women can both be affected by bladder cancer, there are differences in the risk factors, symptoms, diagnosis, and treatment of the disease.

Men are much more likely to be diagnosed with bladder cancer than women. In the US, males make up approximately 80% of bladder cancer cases, with the highest risk occurring in men over the age of 65.

In terms of symptoms, men and women experience similar signs of bladder cancer, including blood in the urine, frequent urination, and pain during urination. However, women with bladder cancer may also experience pelvic pain and painful intercourse, which can be indicative of more advanced forms of the disease.

The diagnosis of bladder cancer may also differ between men and women. While both men and women can undergo urine tests and imaging studies, women may also need internal exams or biopsies to confirm the presence of bladder cancer.

The treatment of bladder cancer can also vary between men and women. While both genders may require surgery, chemotherapy, and radiation, women may have additional treatment options, such as hormone therapy or immunotherapy. As well, due to a heightened risk of complications in women with bladder cancer, women may have more closely monitored treatments.

Nutrition

Nutrition plays a key role in the management of bladder cancer. Proper nutrition can help the body perform better and provide essential nutrients to help with the healing process. Eating a balanced diet rich in fruits, vegetables, and whole grains can help provide essential vitamins and minerals, which may help fight cancer. A well-rounded diet may also help to maintain weight, reduce fatigue, and improve overall health. Protein is also important in bladder cancer management, as it helps repair and rebuild body tissues. Additionally, consumption of dietary fiber can help improve digestive health and support a healthy immune system. It is also important to limit consumption of processed foods, sugar, and alcohol, as these may increase the risk of bladder cancer. It is best to consult a registered dietician for the best advice about diet and nutrition for bladder cancer management.

Physical Activity

Physical activity can help reduce the risk of bladder cancer, by improving the overall health of the body. Exercise can improve general circulation and blood flow, which helps to flush toxins from the body that could accumulate in the bladder and increase the risk of bladder cancer. Additionally, research suggests that exercise can help improve the body’s natural defenses against cancer, by boosting the immune system. As such, regular physical activity is important for maintaining overall health and reducing the risk of bladder cancer.