Bladder cancer is a disease that occurs when cancer cells form in the tissues of the bladder.
Understanding the Bladder
The bladder is a hollow organ in the lower part of the abdomen that is shaped like a small balloon and has a muscular wall that allows it to get larger or smaller. The bladder stores urine until it is passed out of the body. Urine is the liquid waste that is made by the kidneys when the kidneys clean the blood. The urine passes from the two kidneys into the bladder through two tubes called ureters. When the bladder is emptied during urination, the urine goes from the bladder to the outside of the body through another tube called the urethra.
There are three types of bladder cancer that begin in cells in the lining of the bladder. These cancers are named for the type of cells that become cancerous, which include:
- Transitional cell carcinoma
- Squamous cell bladder carcinoma, also known as squamous cell bladder cancer
- Adenocarcinoma.
Transitional Cell Carcinoma
Transitional cell carcinoma is cancer that begins in cells in the innermost tissue layer of the bladder. In this type of cancer, the cells are able to stretch when the bladder is full and shrink when the bladder is emptied. Most types of bladder cancer begin in the transitional cells.
Squamous Cell Bladder Carcinoma
Squamous cell bladder cancer is cancer that begins in squamous cells. Squamous cells are thin, flat cells that may form in the bladder after a long-term infection or irritation.
Adenocarcinoma
Adenocarcinoma is cancer that begins in glandular (secretory) cells. Glandular cells, which are found in the lining of the bladder, make substances such as mucus.
Cancer that is confined to the lining of the bladder is called superficial bladder cancer. Cancer that begins in the transitional cells may spread through the lining of the bladder and invade the muscle wall of the bladder or spread to nearby organs and lymph nodes; this is called invasive cancer of the bladder.
What Are the Causes and Risk Factors?
No one knows the exact cause of this cancer, and doctors can seldom explain why one person will get it and another person will not. However, it is clear that the cancer is not contagious, and no one can "catch" it from another person.
Research has shown that people with certain risk factors are more likely than others to develop the condition. A risk factor is anything that increases a person's chance of developing a disease. Although risk factors do not cause cancer of the bladder, risk factors may act together to increase a person's risk.
Specific risk factors for this type of cancer include:
- Age
- Tobacco use
- Occupation
- Infection
- Treatment with cyclophosphamide or arsenic
- Race
- Gender
- Family history
- Previous history of bladder cancer.
Symptoms of Bladder Cancer
Common symptoms include:
- Blood in the urine (making the urine slightly rusty to deep red)
- Pain during urination
- Frequent urination, or feeling the need to urinate without results
- Lower back pain.
These possible symptoms are not sure signs of bladder cancer. Other health problems can also cause these symptoms. People who have possible signs or symptoms of cancer should see a doctor as soon as possible, because only a doctor can diagnose and treat the problem.
If a person has possible symptoms of cancer, the doctor will need to perform a physical exam, ask about the patient's personal and family medical history, and recommend additional tests and procedures that examine the bladder. The exams and tests that are used to make a diagnosis may include:
- Urine tests
- Intravenous pyelogram
- Cystoscopy with biopsy.
Staging of Bladder Cancer
If a diagnosis is made, the doctor will need to determine the stage, or extent, of the disease in order to plan the best treatment. Bladder cancer staging is an attempt to find out the size of the tumor, whether the disease has spread, and if so, to what parts of the body.
The bladder cancer stages include:
- Stage 0
- Stage I
- Stage II
- Stage III
- Stage IV
- Recurrent.
Treatment of Bladder Cancer
Treatment options will vary based on:
- The type of bladder cancer (see Bladder Cancer Types).
- The stage of bladder cancer (see Bladder Cancer Staging).
- The tumor grade. (The grade tells how closely the cancer cells resemble normal cells and suggests how fast the cancer is likely to grow. Low-grade cancers are likely to grow and spread more slowly than high-grade cancers.)
- The patient's age and general health.
In general, treatment can include:
Doctors can describe treatment choices and the expected results of each treatment with their patients. Patients should work with their doctors to develop a treatment plan that meets their medical needs and personal values. Choosing the most appropriate treatment is a decision that ideally involves the patient, the family, and the healthcare team.
The American Cancer Society estimated that 63,210 men and women (47,010 men and 16,200 women) would be diagnosed with this type of cancer and 13,180 men and women would die of bladder cancer in 2005.
A person's prognosis will depend on:
- The stage of the cancer (whether it is superficial or invasive bladder cancer, and whether it has spread to other places in the body)
- The type of bladder cancer cells, and how the cells look under a microscope
- The patient's age and general health.
