Overview of Bladder Cancer
The urinary bladder is part of the urinary tract that transports and stores urine. Bladder cancer is a type of cancer that begins in the cells of the bladder, which is a hollow a balloon-like organ in the lower abdomen responsible for storing urine. It’s one of the most common types of cancer, usually affecting older adults, although it can occur at any age.
The inside or lining of the urinary bladder is composed of a layer of cells that protect the tissues beneath them from contact with urine. Occasionally, these cells start to multiply uncontrollably and form a growth or a tumor. When found and treated in the early stages, cancerous bladder tumors are not likely to be life-threatening. Prompt medical attention and regular check-ups are necessary to treat bladder tumours and to monitor for new growths.
Types of bladder cancer:
The type of bladder cancer depends on how the tumor’s cells look under the microscope. The 3 main types of bladder cancer are:
- Urothelial carcinoma. Urothelial carcinoma (or UCC) accounts for about 90% of all bladder cancers. It also accounts for 10% to 15% of kidney cancers diagnosed in adults. It begins in the urothelial cells that line the urinary tract. Urothelial carcinoma used to be called transitional cell carcinoma or TCC.
- Squamous cell carcinoma. Squamous cells develop in the bladder lining in response to irritation and inflammation. Over time, these cells may become cancerous. Squamous cell carcinoma accounts for about 4% of all bladder cancers.
- Adenocarcinoma. This type accounts for about 2% of all bladder cancers and develops from glandular cells.
There are other, less common types of bladder cancer, including micropapillary, plasmacytoid, sarcomatoid carcinoma of the bladder, and small cell bladder cancer, among others. Sarcomas of the bladder often begin in the fat or muscle layers of the bladder. Small cell bladder cancer is a rare type of bladder cancer that is likely to spread to other parts of the body.
Other ways of describing bladder cancer
In addition to its cell type, bladder cancer may be described as noninvasive, non-muscle-invasive, or muscle-invasive.
Non invasive. Noninvasive bladder cancer includes noninvasive papillary carcinoma and carcinoma in situ (CIS). Noninvasive papillary carcinoma is a growth found on a small section of tissue that is easily removed. This is called stage Ta. CIS is cancer that is found only on or near the surface of the bladder, which is called stage Tis.
Non-muscle-invasive. Non-muscle-invasive bladder cancer typically has only grown into the lamina propria and not into muscle, also called stage I. Non-muscle-invasive cancer may also be called superficial cancer, although this term is being used less often because it may incorrectly suggest that the cancer is not serious.
Muscle-invasive. Muscle-invasive bladder cancer has grown into the muscle of the bladder wall and sometimes into the fatty layers or surrounding tissues or organs outside the bladder.
It is important to note that non-muscle-invasive bladder cancer has the potential of spreading into the bladder muscle or to other parts of the body. Additionally, all cell types of bladder cancer can spread beyond the bladder to other areas of the body through a process known as metastasis.
Risk Factors
Several factors may increase the risk of developing bladder cancer, including smoking, exposure to certain chemicals (such as those used in dye manufacturing), chronic bladder infections or irritation, older age, being male, white, or having a family history of bladder cancer.
Symptoms
Early-stage bladder cancer may not cause any symptoms. As the cancer progresses, symptoms may include blood in the urine (hematuria), frequent urination, pain or burning during urination, and back or pelvic pain.
Diagnosis
Diagnosis often involves a combination of medical history review, physical examination, urine tests to detect blood or cancer cells, imaging tests such as CT scans or ultrasounds, and cystoscopy, where a thin tube with a camera is inserted into the bladder to examine it.
Staging
Bladder cancer staging determines the extent of the cancer’s spread. Stages range from 0 (cancer is confined to the inner layer of the bladder) to IV (cancer has spread to distant organs).
Treatment
Treatment options depend on the stage and type of bladder cancer but may include surgery to remove the tumor or the entire bladder (radical cystectomy), chemotherapy, radiation therapy, immunotherapy or a combination of these.
Prognosis
The prognosis for bladder cancer varies depending on the stage at diagnosis and other factors such as the patient’s overall health and response to treatment. Early detection and treatment generally lead to better outcomes.
Follow-up Care
After treatment, regular follow-up visits are essential to monitor for any signs of recurrence or complications. This may involve regular cystoscopies, imaging tests, and urine tests.