The bladder is located in the lower abdomen. It is a hollow organ with flexible muscular walls. It stores urine until a person is ready to urinate. Bladder cancer is a disease in which cancer cells grow in the bladder.
Three main types of cancer affect the bladder. They are named for the type of cell that becomes cancerous: Transitional cell (urothelial) carcinomaSquamous cell carcinomaAdenocarcinoma
Cancer occurs when cells in the body, in this case bladder cells, divide without control or order. Sometimes, cells divide uncontrollably when new cells are not needed. A mass of tissue called a growth or tumor can form. The term cancer refers to malignant tumors. Malignant tumors can invade nearby tissue and spread to other parts of the body.
What causes the changes in the cells is not clear. It is likely to be a combination of genetic and environmental factors.
This condition is more common in adults between 65 and 85 years old. It is also more common in men and people who are Caucasian. Factors that may increase your chance of developing bladder cancer include: Smoking
Occupational exposures: Rubber, leather, and textilesPaintingChemicals used in hairdressingMachinesPrintingTruck drivingPetroleum industryGeneticsChronic bladder inflammation or urinary tract infectionsPersonal or family history of bladder cancerChemotherapy drugs, such as cyclophosphamide and ifosfamideObesityThe use of pioglitazone to treat diabetesExposure to arsenic
treatment of the pelvisBladder birth defectsChemicals such as nitrosamines and benzidineRecurrent urinary stonesLong-term in-dwelling catheterBladder diverticuli—an area of weakness in the bladder wall through which some of the lining of the bladder is forced outMetastasis from another cancer
Symptoms include: Blood in the urineFrequent urination, or feeling the need to urinate without being able toPainful urinationLower back painWeight loss, bone pain, or abdominal pain in advanced cases
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will feel the abdomen and pelvis for abnormalities. The physical exam may include a rectal or vaginal exam. Urine can be evaluated with: Urine cytologyUrine cultureImaging tests assess the bladder and surrounding structures. These may include: CystoscopyIV pyelogram (IVP)CT scanMRI scan
A sample of bladder tissue may need to be tested. This can be done with a biopsy.
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Bladder cancer is staged from 0-IV. Stage 0 is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Stages of Bladder Cancer
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Treatment options depend on the stage and may include:
Surgery involves removing cancerous cells and nearby tissue. Types of surgery to treat bladder cancer include: Transurethral resection—This is done for early stage or superficial bladder cancer. A cystoscope is placed into the bladder through the urethra. A small wire loop at the end of the cystoscope is used to remove cancer cells. Fulguration can be done during this procedure. It uses electrical current to burn away remaining cancer cells.Cystectomy
is the surgical removal of all or part of the bladder—This is done when bladder cancer is invasive. Segmental or partial cystectomy is the removal of part of the bladder. Radical cystectomy is the removal of the entire bladder and nearby lymph nodes. In men, the prostate may be removed. In women, the uterus, ovaries, part of the vagina, and the fallopian tubes may be removed. A form of urinary diversion must be created to store the urine if the bladder is removed.
is the use of radiation to kill cancer cells and shrink tumors. Radiation therapy may be:
External—Radiation is directed at the tumor from a source outside the body.Internal (brachytherapy)—Radioactive materials are placed near the cancer cells in the bladder through the urethra or through an incision in the abdomen.
is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms, including pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. For bladder cancer, chemotherapy is often given directly into the bladder. This is called intravesical chemotherapy.
Biologic therapy (immunotherapy) uses the body’s immune system to fight cancer. Substances made by the body or in a laboratory are given directly into the bladder to help boost, direct, or restore the body’s defenses against the cancer.
This type of therapy is used only for superficial low-grade cancers that have been resected transurethrally.
To help reduce your chance of bladder cancer:
or use tobacco products, talk to your doctor about ways to quit. Avoid or minimize occupational exposure to certain chemicals; follow good work safety practices.Eat a diet rich in fruits and vegetables.Avoid excess intake of high fat or high cholesterol foods.
Bladder cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003085-pdf.pdf. Accessed September 6, 2016.
Bladder cancer. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/bladder-cancer. Accessed September 6, 2016.
General information about bladder cancer. National Cancer Institute website. Available at
http://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq. Updated July 7, 2016. Accessed September 6, 2016.
Torpy JM, Lynm C, Glass RM. Bladder cancer. JAMA. 2005;293(7):890.
7/21/2015 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Sun JW, Zhao LG, Ma X, Wang YY, Xiang YB. Obesity and risk of bladder cancer: a dose-response meta-analysis of 15 cohort studies. PLoS One. 2015;10(3).
Last reviewed May 2016 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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