The cancer that starts in the bladder is known as bladder cancer. The bladder is situated right in the center of the lower abdomen. The bladder cancer begins in the lining of the cells of the bladder that are commonly referred to as transitional cells. The cancer is a form of malignant tumor that grows as a result of abnormal growth of the cells.
The tumors can be classified in a bladder cancer as per the way they grow. The papillary tumors have a wart-like appearance and get attached at the very stalk when they begin to grow. The other kind of the tumor is known as a nonpapillary tumor. Also known as sessile tumors, these tumors are flat and are much less common in occurrence. When this kind of a tumor occurs, then it tends to become much more invasive and worse in their outcome.
The exact cause of bladder cancer still remains a mystery worth baffling the medical world. However, risk factors have been shaded that make a person more prone to bladder cancer. Some of these risk factors are:
Smoking- cigarette and other forms of smoking increase the chances of contracting bladder cancer. As per the statistics, bladder cancers in men and women alike can be traced back to smoking in almost half the reported cases of bladder cancer.
Chemical exposure and Radiation- employees who regularly face chemical exposure or come in direct contact with chemicals that are carcinogens are at a greater risk of contracting bladder cancer. Cancer due to a chemical exposure or radiation therapy can be accounted for almost 25% of the cases amongst the total cases of bladder cancer. People who come under this category are dye workers, rubber workers, leather workers, truck drivers and the people who apply pesticides on plants and crops.
Chemotherapy- chemotherapy is another form of radiation that uses the drug known as cyclophosphamide, also referred to as Cytoxan. This particular drug is often known to be a threat for bladder cancer. Keeping this in mind, the doctors prescribe a particular drug to all those patients who undergo chemotherapy, to reduce the side effects of this drug.
Bladder infection- studies show that patients, who regularly complain of bladder infections, tend to have an irritated lining of the bladder and the administration of bladder infection drugs furthermore irritate the lining. This makes the patient more vulnerable to bladder cancer.
Artificial sweeteners- some studies have also indicated a connection between the chronic use of artificial sweeteners and the development of a bladder cancer. However, no certain evidence has been provided regarding the same.
Symptoms of bladder cancer are not generally generic and rather alarming. The occurrence of any of the following symptoms must be bought to immediate notice of a physician, if not an oncologist.
Finding out Bladder Cancer
When bladder cancer is suspected, a patient is required to undergo certain signs and tests to confirm or cancel out the assumption. These tests include an Abnominal CT scan, an abdominal MRI, Bladder biopsy and are usually performed during a cystoscopy. This procedure uses a 360degree camera that gives a complete view inside the bladder. A Pelvic CT scan, Urinalysis, Intravenous pyelogram and urine cytology further confirm the staging of the bladder cancer.
For further figuring out the stage at which the bladder cancer is at, the TNM staging system is bought. TNM stands for tumor, nodes, and metastasis. Tumor helps in figuring out if the tumor is localized or has spread to the other organs. If the tumor is still localized then it indicates that the cancer cells have not spread elsewhere than the primary affected organ. This is good news for the cancer patient as the cancer can be relatively easily cured with surgery and just a few rounds of chemotherapy. Under this there are multiple degrees of T to help specify the extent.
Ta stands for the cancer that hasn’t spread anywhere except the lining of the bladder.
T1 stands for the degree of cancer that has spread out of the bladder lining but has yet to reach the bladder muscle.
T2 is the stage of cancer where the cancer has reached the bladder muscle.
T3 indicates the stage of cancer that has moved past the bladder and now engulfs the fatty tissue that surrounds the bladder.
T4 is a rather advanced stage when the cancer begins to spread to the nearby structures such as the vagina, rectum, abdominal wall or the pelvic wall etc.
N stands for nodes and helps in specifying if the cancer has spread to the lymph nodes.
Treating the Bladder Cancer
The treatment to get rid of bladder cancer depends on the severity and the degree of cancer a patient is at. The treatment for bladder cancer is a combination of surgical procedures and chemotherapy combined with immunotherapy. The surgery usually considers removal of the part of the bladder affected with cancer and not the complete bladder. The surgery to remove the complete bladder is known as radical cystectomy. This surgery also removes the bladder along with the surrounding lymph nodes.
Sometimes chemotherapy can be combined with surgical procedures to reduce the size of the tumor before surgically operating on it. Patients with an advanced stage of tumor are sometimes not advised to go forward with a surgical procedure. In this case, sometimes solely chemotherapy is recommended.
To administer medicine to the bladder, a Foley catheter is used. This kind of administration sometimes comes up with side effects such as bladder wall irritation and extreme pain while urination. Chemotherapy in this case is administered intravenously.
In other cases, immunotherapy is considered where the medication helps in triggering the immune system to train it to attack and kill the cancer cells. Under this procedure, a drug called BacilleCalmette-Guerin vaccination is used with sometimes interferon being considered as a common option.
Once the apt treatment is administered, then the doctor closely monitors the patient. On regular intervals, bone and CT scans help in keeping any relapse at bay. Periodically, bladder exams and blood count is done to monitor anemia. The risk of bladder cancer relapsing is quite high in general, however if caught early on, surgery can remove and cure the bladder cancer.