Urinary bladder cancer is a type of cancer that begins in the cells of the bladder, the organ that stores urine in your lower abdomen. It’s one of the more common cancers, especially in older adults, and affects both men and women, although men are more likely to develop it.
Bladder cancer is divided into different types based on the cells where the cancer starts. The most common type is called urothelial carcinoma (formerly known as transitional cell carcinoma), which accounts for about 90% of bladder cancer cases. There are also less common forms like squamous cell carcinoma and adenocarcinoma.
Understanding bladder cancer—its symptoms, causes, and treatment options—can help you take the necessary steps for early diagnosis and effective management.
What is Urinary Bladder Cancer?
Bladder cancer occurs when the cells in the bladder grow abnormally and form a tumor. These cells may start in the inner lining of the bladder and spread to deeper layers as the cancer progresses. When the tumour grows and spreads, it can affect the bladder’s function, leading to various urinary symptoms.
Bladder cancer is categorized as either non-muscle invasive or muscle invasive based on how deeply cancer has spread into the bladder wall. Non-muscle invasive cancer remains in the inner layers, while muscle-invasive cancer has spread to deeper layers of the bladder.
Risk Factors for Urinary Bladder Cancer
Several factors can increase your chances of developing bladder cancer, including:
- Smoking: Smoking is the leading cause of bladder cancer. When you smoke, harmful chemicals enter the body and are passed into the urine, where they can irritate and damage the bladder lining.
- Age: Bladder cancer is more common in older adults, especially those over 55. Most people diagnosed with bladder cancer are over the age of 65.
- Gender: Men are more likely to develop bladder cancer than women. However, when women do develop it, it tends to be more aggressive.
- Chronic bladder inflammation: Long-term urinary tract infections or bladder irritation can raise the risk of bladder cancer.
- Occupational exposure: People working in industries like chemical manufacturing, leather production, and textiles may be exposed to certain chemicals linked to bladder cancer.
- Family history: If someone in your family has had bladder cancer, you may be at an increased risk.
- Previous cancer treatments: People who’ve undergone radiation therapy or certain types of chemotherapy may be at higher risk of bladder cancer.
Symptoms of Urinary Bladder Cancer
The symptoms of bladder cancer can vary depending on its stage. Early signs are often similar to common urinary problems, but they should still be taken seriously. Symptoms may include:
- Hematuria (blood in the urine): The most common sign of bladder cancer is blood in the urine. It might be visible to the naked eye or detected through urine tests.
- Painful urination: You may experience discomfort or pain while urinating, especially if the tumour is near the urethra.
- Frequent urination: An increased urge to urinate, even if the bladder isn’t full, can be a sign of bladder cancer.
- Urinary urgency: A feeling of needing to urinate immediately, even when the bladder isn’t full, can indicate a problem with the bladder.
- Lower abdominal pain: This may occur if the cancer has spread or irritated surrounding tissues.
- Fatigue: Bladder cancer can cause fatigue, especially if it leads to blood loss or affects other body functions.
If you experience any of these symptoms, it’s important to consult a healthcare provider for proper diagnosis and care.
How is Bladder Cancer Diagnosed?
If bladder cancer is suspected, your doctor will conduct a series of tests to confirm the diagnosis and determine how far the cancer has spread. The common tests include:
- Urinalysis: A urine test to check for the presence of blood, abnormal cells, or signs of infection.
- Cystoscopy: A thin tube with a camera (cystoscope) is inserted into the bladder through the urethra to examine the bladder’s interior and check for any abnormal growths or tumors.
- Urine cytology: This test involves examining a urine sample under a microscope to look for cancer cells.
- Imaging tests: A CT scan, MRI, or ultrasound can be used to create images of the bladder and surrounding areas. These images help doctors see if the cancer has spread beyond the bladder.
- Biopsy: During a cystoscopy, if a tumor is found, the doctor may take a small tissue sample for examination. A biopsy helps determine if the tumour is cancerous.
Staging of Bladder Cancer
Bladder cancer is staged based on how deeply the cancer has invaded the bladder wall and whether it has spread to other parts of the body. The most commonly used staging system is the TNM system, which stands for:
- T (Tumor): Describes the size and extent of the tumour.
- N (Nodes): Indicates whether the cancer has spread to nearby lymph nodes.
- M (Metastasis): Shows whether the cancer has spread to other parts of the body.
Bladder cancer is generally divided into five stages:
- Stage 0: Cancer is only in the inner lining of the bladder and hasn’t spread deeper.
- Stage I: Cancer has spread to the deeper layers of the bladder lining but has not yet reached the muscle layer.
- Stage II: Cancer has spread to the muscle layer of the bladder wall.
- Stage III: Cancer has spread beyond the bladder into nearby tissues or organs.
- Stage IV: Cancer has spread to distant organs, such as the liver or lungs.
Treatment Options for Bladder Cancer
Treatment for bladder cancer depends on the stage and type of cancer, as well as the patient’s overall health. Common treatment options include:
- Surgery: The goal of surgery is to remove the cancer. This could involve removing the tumour through a procedure called transurethral resection (TURBT), removing part of the bladder (partial cystectomy), or removing the entire bladder (radical cystectomy).
- Chemotherapy: Chemotherapy uses drugs to destroy cancer cells. It can be administered orally or intravenously and is often used in combination with surgery or to treat advanced stages of bladder cancer.
- Immunotherapy: Immunotherapy helps the immune system fight cancer by stimulating it to recognize and attack cancer cells. It may be given directly into the bladder or through the bloodstream.
- Radiation Therapy: Radiation uses high-energy rays to kill cancer cells or shrink tumours. It is often used for patients who cannot undergo surgery.
- Intravesical Therapy: For non-muscle invasive cancer, drugs may be placed directly into the bladder. These drugs may include chemotherapy or immunotherapy.
Prognosis and Life After Bladder Cancer
The outlook for bladder cancer largely depends on the stage at which it’s diagnosed. Early-stage bladder cancer, which is confined to the bladder lining, is highly treatable, especially if it’s caught early. However, advanced bladder cancer may require more aggressive treatments and may have a lower survival rate.
It’s essential for patients to continue follow-up care after treatment, as bladder cancer can recur. Regular cystoscopies and imaging tests are often required to monitor for any signs of recurrence.
Bladder cancer is a serious condition, but with early detection and appropriate treatment, many patients can lead full, healthy lives. By understanding the risk factors, symptoms, and treatment options, you can take steps to reduce your risk and seek timely medical attention if needed.
If you notice any of the symptoms of bladder cancer or have risk factors, don’t wait—schedule an appointment with our healthcare team today for an evaluation and personalized treatment options. Take control of your health and get the care you need!
