8 Things You Need To Know About Bladder Cancer

Even though bladder cancer is common, it is one form of cancer that most people know very little about. Read through 8 quick FAQs to stay educated and protected!

1. What is Bladder Cancer?

The urinary bladder is an organ located in the lower abdominal area near the pelvic bones that acts as a holding area for urine. Cells in the body generally grow and divide to replace old or damaged cells in the body. This growth is highly regulated, and once enough cells are produced to replace the old ones, normal cells stop dividing. When cells of the bladder grow out of control, they form a tumor. The two most common types of bladder cancer are: one that starts in the innermost lining or the one that starts in other parts of the bladder. When the diagnosis is confirmed by tests, scans, and biopsies, the stage and grade are also noted. The stages of bladder cancer range from stages 0 to 4. Cancer of the bladder that has spread to another part of the body is called metastatic cancer.

2. What are my risks for bladder cancer?

It affects men more commonly than women and is more common in those over the age of 65. While the causes of bladder cancer are not definite, genetic history, genetic mutations and the use of tobacco or exposure to chemicals are known risk factors. Others are:

• Bladder defects at birth
• Chronic bladder infections and irritations
• Exposure to chemicals, including aromatic amines and arsenic in water
• Aristolochic (a Chinese herb)
• Chronic cystitis (inflammation of the bladder)
• Low fluid consumption
• Family genetic history of bladder cancer
• Side-effects of chemotherapy and radiation therapy
• Being male

3. How can I prevent bladder cancer?

Staying away from tobacco and alcohol can reduce the chance of developing bladder cancer. In addition to that, the exposure to cancer-causing agents should decrease and early detection and screening of high-risk individuals is key to reducing risks.

4. What are the screening recommendations for bladder cancer?

There are no standard screening tests available.

It is generally advised that if you have blood in the urine, your doctor needs to examine the urine under a microscope. This can detect cancer cells and is fairly inexpensive. But fair amounts of cancer can be missed in this method as well. If blood in the urine is detected, on account of another cause like infection, further tests should be carried out.

5. What are the signs and symptoms of bladder cancer?

One of the most common symptoms is finding blood in the urine. Others:

• Increased frequency of urination
• Urgency
• Nocturia
• Pain or burning with urination
• The feeling of incomplete emptying of the bladder

More advanced cancer in the bladder can cause the following symptoms:

• Pain in the upper back, abdomen or the sides of these areas
• Kidney damage
• Infection

6. How is bladder cancer diagnosed?

Anyone with blood in the urine is required to get tested immediately. In which case, the first thing that is done is urine cytology, in which procedure, the urine is examined under a microscope to detect abnormal appearing cells.  If these cells are seen, a cancer diagnosis may be suspected. Other diagnostic tools are as follows:

• Ultrasound:  There determine the size and spread of the tumor. They particularly use sound waves to image abnormalities.
• CT Scan: A CT scan is an imaging test that examines the structure of the kidneys, ureters, and bladder were conducted with the help of contrast dye. This determines if there is a blockage in the urinary tract and if the cancer has spread to the regions of the body outside the bladder.
• Retrograde Pyelogram: The contrast dye is injected into the bladder by a direct catheter. The dye outlines the bladder and associated organs, making the tumors visible on the X-rays.
• MRI: A magnetic resonance imaging of the kidneys, ureters, and bladder is employed to evaluate the urinary tract. This imaging may provide useful information in staging of bladder cancer.
• IVP: Here a radiopaque dye (one that is visible on X-ray) is injected into the vein. The dye collects in and is excreted by the kidneys. As the dye passes through the urinary drainage system any abnormal lumps may be detected on X-ray images. It might be useful to note that there is a small risk of having an allergic reaction to the dye. People who are allergic to contrast dye, iodine or shellfish should let the radiologist know.
• Cystoscopy: A cystoscopy is a procedure that is done to directly visualize the lining of the urethra and bladder. It can be conducted by a urologist/oncologist in an operating room. Also known as the cystourethroscopy & a biopsy can be taken during the same procedure.

Apart from scans, the following are more effective diagnostic tools:

• Biopsy: Apart from these imaging tests, a biopsy exclusively for the examining of abnormal tissue can be taken. This may be examined in a laboratory or an operating room. A biopsy is usually done as an office procedure by cystoscopy.
• Transurethral resection of bladder tumor (TURBT): Upon diagnosis of bladder cancer, imaging tests are performed. This is followed by resection of bladder mass by cystoscopy under anesthesia to confirm the extent of the tumor, a procedure called TURBT. Further, the tumor can be classified as invading the muscle or not which has a bearing on further treatment planning.

7. How is bladder cancer treated?

Treatment for bladder cancer depends on the type of bladder cancer you have and the stage. And treatment generally varies between two types of bladder cancer: Superficial Bladder Cancer and Muscle Invasive Bladder Cancer

Superficial Bladder Cancer: This type of cancer has not invaded the muscle. Treatments include:

• Transurethral resection of bladder tumor (TURBT)- The goal of the TURBT is to completely remove cancer.
• After a TURBT, the patient will receive intravesical chemotherapy or BCG, which is chemotherapy or BCG  that is infused directly into the bladder to kill any remaining cancer cells & reduce the chances of recurrence.

Muscle-Invading Bladder Cancer: Bladder cancer that has invaded the muscle wall requires more extensive treatment. Treatment can include:

• Removal of the bladder (called cystectomy).
• Chemotherapy may be used before to shrink the tumor to make surgery easier, & after surgery to prevent a recurrence.
• Radiation, chemotherapy, and TUR may be used to avoid cystectomy.

For patients with advanced or metastatic disease that can not receive chemotherapy, immunotherapy may be a treatment option. There are many options that can be used to treat muscle-invading bladder cancer and each case is unique. Speak to your provider about which course of treatment is right for you.

8. How do I go about follow-up and care after treatment?

Health care providers will watch you after treatment is complete. Follow-up appointments will be scheduled and continual assessment of anything unusual will be monitored. Tests like cystoscopy, urine cytology and imaging tests may be recommended to monitor the recurrent disease. If treatment is complete and there are no signs of disease, it is likely that your follow-up appointments will be scheduled for every 3 to 6 months. Your doctor will assess any side-effects that may have resulted from treatment. It is important that you speak with your physician about any new or recurrent issues that you are experiencing.

Apart from medical issues, when you are faced with emotional and practical issues, you may reach out to support communities and or the management for further assistance. Visit Onco.com if you have more questions or call us on +91 7996579965.