Bladder Cancer

Bladder Cancer is the fourth prevalent form of cancer in men and is the ninth widely common cancer observed in women in the U.S. There is an annual detection of more than fifty thousand newly evolved bladder cancer cases.

The lining of the bladder wall is made up of transitional cells and squamous cells. Bladder cancers originating in the transitional cells known as transitional cell carcinoma, account for more than 90% of the noted cases. Nearly eight percent of the recorded bladder cancer cases begin in the squamous cells known as squamous cell carcinoma.

Cancer affecting solely the bladder lining is known as superficial bladder cancer and frequently tends to recur following treatment though it does not tend to proliferate. In case of relapse, it forms another superficial cancer in the bladder. Cancer starting as superficial tumor might spread past the lining, making an entry into the muscular wall of the bladder. This form of cancer is called as invasive cancer proliferates past the bladder wall into the adjacent organs like uterus or vagina among women or the prostate gland among men and could spread to other body organs.

In case of the cancer spreading beyond the bladder, the cancerous growth would be noted in the close by lymph nodes. If cancer has spread to the lymph nodes, then there is a likelihood that the cancer cells might have proliferated to the other lymph nodes or organs like the lungs, liver or the bones.

In case metastasis of the cancer occurs from its initial location to other body parts, the newly formed tumor would have the presence of the analogous forms of irregular cells and the similar name like the primary tumor. For instance, if the bladder cancer metastasizes to the lungs, the cancer cells that would be present in the lungs would in actuality be bladder cancer cells. The ailment would be known as metastatic bladder cancer rather than lung cancer and also get treated like bladder cancer and not like lung cancer. Doctors at times dub the new tumor as ‘distant’ disease.

However, the positive aspect about most of the bladder cancers is that they don’t proliferate rapidly and could be treated without the need of surgical intervention. Thus, majority of the patients suffering from bladder cancer have minimal likelihood of the cancer growing to such an extent that it would turn out to be life menacing. Early diagnosis is crucial as it facilitates timely treatment that offers those ailing a better opportunity for a positive outcome.

Bladder Cancer Symptoms:

• Blood passed during urination making the colour somewhat rust-like and even deep red.
• Painful urination.
• Recurrent urination or sensing the need to pass urine but without outcome.
  These signs are not definite symptoms of bladder cancer as the presence of certain infections, benign tumor growths, gall stones or other conditions could also lead to similar symptoms.

Diagnosis & Tests:

In case the patient is exhibiting symptoms that indicate bladder cancer, then the doctor might check the overall health condition and would order to undergo laboratory tests. The procedures conducted include:

• Physical examination – During the course of the physical examination the abdominal and pelvic region are palpated for detecting the tumors. An examination of the rectum or the vagina is also done during the physical exam.
• Urinalysis – The urine collected would be sent for laboratory analysis to detect the presence of blood, cancer cells in the urine and other signs related to the disease.
• Cystoscopy – With the assistance of a fine, illuminated tube known as the cystoscope the interiors of the bladder are diagnosed. The cystoscope is introduced via the urethra into the bladder to study the bladder lining. There is no anesthesia required during the course of the procedure.

Bladder Cancer Treatment:

Bladder cancer patients could avail several treatment alternatives like surgery, radiation therapy, chemotherapy or biological therapy.

Surgery :

Surgery is the most prevalent treatment in case of bladder cancer that is dependent on the staging and the grade of the tumor.

• Transurethral resection (TUR) – TUR is employed in treatment of preliminary or superficial bladder cancer. In TUR, a cystoscope is inserted inside the bladder via the urethra followed by the use of a device having a tiny wire loop on its tip for removing the cancer and scorching away any remnant cancer cells with the help of an electric current known as fulguration. The patient would require to be hospitalised and anesthesized during the procedure. Chemotherapy or biological therapy could also be given to those patients that have undergone TUR.
• Radical cystectomy – This form of surgery is commonly used for treatment of invasive bladder cancer or in case of superficial cancer involving a major section of the bladder. During radical cystectomy, the complete bladder, the adjacent lymph nodes, sections of the urethra and the bordering organs that might have developed cancer are removed. Among men, the adjacent organs like the prostate, seminal vesicles and sections of the vas deferens are removed. Among women, the uterus, ovaries, fallopian tubes and some sections of the vagina would be removed.
• Segmental cystectomy – In certain cases of low-grade cancer that has spread to the bladder wall in only one part, the doctor would remove only that malignant section of the bladder during the procedure of segmental cystectomy.
• Radiation therapy – Also dubbed as radiotherapy, this procedure employs high-intensity beams for annihilating cancerous growths. Radiation therapy much alike surgical intervention is a localised treatment wherein only the inflicted area having the presence of the cancer cells is treated. A small populace of patients would be treated with radiation therapy for shrinking the tumor while others might undergo it following surgery for exterminating the remnant cancer cells in that location. At times, the patients who do not have the option of surgery undergo radiation therapy as a substitute. External radiation therapy is employed by doctors for treating bladder cancers. A mammoth machine from outside targets the area of the tumor with pin-point accuracy. These outpatient-basis sessions are conducted during five days per week spanning 5-7 weeks. This aids in safeguarding the healthy cells and tissues by broadening the overall dosage of the radiation.

• Chemotherapy – Chemotherapy employs the use of a singular or a grouping of drugs to combat cancer. Those ailing from superficial bladder cancer are treated with intravesical chemotherapy subsequent to the cancer being removed with TUR. A local therapy wherein a tube or catheter is introduced via the urethra that disperses liquid drugs within the bladder. The drugs intended to affect the cancerous cells present in the bladder remain active for several hours. This treatment is carried out once during the week for a span of many weeks. At times, the treatment could persist for once or many times during a month that could stretch for a year.

Intravenous drug administration would be done in case of deep invasion of the bladder or proliferation to lymph nodes or other parts of the body. This procedure is known as intravenous chemotherapy.  This is a systemic therapy wherein the drugs pass through the bloodstream to mostly every section of the body. Normally, the drugs are administered in cycles so that a recuperative phase ensues each treatment phase.

Chemotherapy might be given by itself or in combination with surgical intervention, radiation therapy or both of them. Generally, chemotherapy is normally an outpatient procedure that is administered at the hospital, clinic or at the doctor’s office. On the basis of what drugs are administered and one’s overall health, one might need to be hospitalised for short periods of time.

Biological therapy :

Biological therapy also known as immunotherapy best utilises the body’s innate ability or immunity to combat cancer. In superficial bladder cancer cases, biological therapy normally is performed subsequent to TDR. The catheter is employed for delivering the drugs unswervingly into the bladder. This aids in averting a relapse.

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