Bladder cancer is a malignant neoplasm developing in the bladder.
The bladder is a hollow organ located in the lower part of the abdomen where urine is collected.
Incidence of bladder cancer
It is the most common urinary tract cancer and the 4th most frequent type of cancer.
Men are affected most often than women; the ratio is 3.8 to 1 respectively.
Causes and risk factors for developing bladder cancer
The exact etiology is not known.
However, there are risk factors which can increase the likelihood of developing bladder cancer.
- Smoking (the greatest risk factor)
- Occupational exposure to chemical substances (workers in the leather, textile, rubber, petroleum and paint industries)
- Prior radiation to the pelvis (risk multiplied by 2 to 4 times)
- Chronic inflammation
- Schistosomiasis (5 times the risk)
- Co-existing upper urinary tract cancer
Symptoms of bladder cancer
The most common symptom is painless hematuria, which may be occasional and with clear urine intervals.
For this reason, it is really important that you visit a urologist on the first episode of hematuria.
Other, less common bladder cancer symptoms are:
- Frequent urination – Urgency
- Painful urination
- Weakness – exhaustion
- Loss of weight
Diagnosis of bladder cancer
The following are necessary:
- Detailed history
- Clinical examination
- Urine cytology examination (to detect any cancerous cells)
- Upper and lower abdominal CT scan
It depends on the stage of the disease, the aggressiveness of the cancerous cells and the overall health status of the patient.
For superficial tumors
The treatment comprises transurethral resection of the tumor. Next, the tumor tissue specimens are sent to the pathologist for examination.
A complementary intravesical therapy may be required, either with chemotherapy or immunostimulant agents.
For infiltrating tumors at an advanced stage
Radical cystectomy and urinary diversion are required.
After the surgery, if a lymph node disease is identified, systemic therapy is required.
In patients whose overall health status does not allow for a cystectomy or who are unwilling to undergo a surgical procedure, a combination of transurethral resection, chemotherapy and radiotherapy is applied.