What is Bladder cancer?

Bladder cancer is a less common type of tumour that originates in the lining of the bladder, a crucial organ in the urinary system. The bladder’s primary function is to store urine produced by the kidneys until it is excreted. Bladder cancer can present in various forms and stages, necessitating an integrated treatment approach. Given its potential for recurrence, continuous awareness and follow-up with healthcare professionals are essential.

Symptoms and Causes

Common Symptoms

The most prominent symptom of bladder cancer is the presence of blood in the urine, known as hematuria. While this is a key indicator, it is not exclusive to bladder cancer and can result from other urinary system disorders or injuries. Other symptoms include:

• Painful Urination (Dysuria): A burning or stinging sensation while or after urinating.
• Increased Urination Frequency: Frequent need to urinate, particularly at night.
• Difficulty Urinating: Issues such as a weak urine stream or incomplete bladder emptying.
• Chronic Bladder Infections: Recurrent infections that do not improve with antibiotics.

Causes and Risk Factors

Although the exact causes of bladder cancer are not fully understood, several risk factors have been identified:

• Smoking: Both active and passive smoking are significant risk factors.
• Radiation Exposure: Previous radiation therapy for other cancers increases risk.
• Chemical Exposure: Prolonged contact with certain chemicals used in dyes, rubber, and textiles.
• Chronic Infections and Catheter Use: Long-term infections and catheter use can increase the risk of bladder cancer.

Diagnosis and Tests

Diagnostic Procedures

To diagnose bladder cancer, healthcare providers use several tests:

• Urinalysis: Examines urine for infection or blood.
• Cytology: Analyzes urine cells under a microscope for cancerous changes.
• Cystoscopy: A procedure where a cystoscope is inserted through the urethra to visualize the bladder and obtain tissue samples if needed.

Additional Diagnostic Tests

If initial tests suggest bladder cancer, further diagnostic procedures may include:

• Transurethral Resection of Bladder Tumor (TURBT): Removes bladder tumors for investigation and treatment.
• Imaging Studies: MRI and CT scans provide detailed views of the bladder and check for cancer spread. Chest X-rays and bone scans assess if cancer has metastasized.

Cancer Staging

Bladder cancer is staged from TA (confined to the internal lining) to IV (advanced spread). The TNM system assesses tumor size (T), lymph node involvement (N), and metastasis (M).

Management and Treatment

Treatment Options

Bladder cancer treatment may involve a combination of therapies:

• Surgery: Includes TURBT for early-stage cancers and radical cystectomy for more advanced cases. Radical cystectomy involves removing the bladder and surrounding organs if necessary.
• Chemotherapy: Administered intravesically (directly into the bladder) or systemically (through the bloodstream).
• Immunotherapy: Utilizes the body’s immune system to target cancer cells. Examples include BCG therapy and PD-1/PD-L1 inhibitors.
• Radiotherapy: Uses ionizing radiation to kill cancer cells, sometimes as an alternative to surgery.
• Targeted Therapy: Focuses on specific genetic changes in cancer cells, such as FGFR gene inhibitors.

Prevention and Risk Reduction

While complete prevention is not possible, risk factors can be minimized through:

• Avoiding Tobacco: Both smoking and second-hand smoke are risk factors.
• Minimizing Chemical Exposure: Reducing contact with hazardous chemicals.
• Managing Infections: Treating chronic bladder infections and abnormalities.
• Regular Check-ups: Especially for those at high risk or with a history of bladder cancer.

Outlook and Prognosis

Prognosis varies based on the stage of the disease and treatment response. Early detection and intervention significantly improve survival rates. For early-stage bladder cancer, the five-year survival rate is 96%. Overall, the five-year survival rate for all stages is 77%, highlighting the importance of early intervention and ongoing follow-up.

Living With Bladder Cancer

Self-Care and Follow-Up

Living with bladder cancer involves continuous care and lifestyle adjustments. Effective strategies include:

• Healthy Diet: Focus on fruits, vegetables, and whole grains.
• High-Fiber Foods: Can help manage diarrhea associated with treatment.
• Exercise: Engage in regular, gentle exercise to manage stress.
• Support Groups: Seek support from cancer support groups and others with similar experiences.

Urinary Diversion

If bladder removal surgery is necessary, urinary diversion may be required. This involves creating a new pathway for urine using a part of the intestine. Understanding the types of urinary diversion and their implications can help manage the transition.

When to Seek Medical Advice

Regular follow-ups are crucial to monitor for recurrence. Any new symptoms should be promptly discussed with a healthcare provider.

Conclusion

Bladder cancer is a multifaceted disease that requires a comprehensive understanding of its symptoms, causes, and treatment options. Early diagnosis and timely intervention are key to better outcomes. With ongoing research and advancements in treatment, individuals with bladder cancer have a hopeful prognosis. Continuous follow-up care, a healthy lifestyle, and staying informed about new developments are essential for managing the disease effectively.