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Bladder cancer: Treatment, symptoms, advice and help

About bladder cancer

Bladder cancer refers to the malignancy of the urinary bladder which is located centrally in the pelvic region. It is a hollow organ, responsible for storing urine produced by the kidneys. The cancer (abnormal growth of cells) in the bladder develops in the cells lining the ureter and can be of three types of which the ‘transitional cell cancer’ is most common. The other types are ‘squamous cell cancer’ which arises from infected or inflamed cells, and ‘adenocarcinoma’ in which cancerous growth is seen in mucous secreting cells of the bladder.

Bladder cancer: Incidence, age and sex

Bladder cancer is a common malignant condition encountered in the general population. It is more common in men as compared with women. Middle aged and elderly individuals are more commonly involved, though it may occur in any age group.

Signs and symptoms of bladder cancer: Diagnosis

The clinical features of bladder cancer are not quite exclusive and may mimic other conditions like an urinary tract infection or a prostate enlargement. The affected individual may experience increased frequency of urination or an urgent need to evacuate the bladder at times. At times, significant pain may be experienced during micturition. Blood in urine is a classical feature of bladder cancer and may present with red or orange coloured urine. Sometimes urine appears colourless but may show examination of red blood cells on microscopic examination of urine. In later stages of cancer, complaints of low back pain, low grade fever, loss of appetite and weight loss are common.

The best part of bladder cancer is that it can be diagnosed at an early stage in most of the individuals. Cystoscopy, which is an investigative procedure of examining the interior of bladder, is the investigation of choice. Sample of urine is tested microscopically to look for red blood cells. Biopsy may be done to examine the tissue sample under microscopic. Staging tests like CT and MRI scans are used for staging of cancer.

Causes and prevention of bladder cancer

The exact cause of bladder cancer is not clear but it is several clinical studies point to long standing inflammation of bladder as a strong offending factor. Significant risk factors which may trigger this cancer are smoking, repeated urinary tract infections or stones or family history. Increased risk of bladder cancer is seen in textile workers, painters or people working in rubber factories. Preventive measures like smoking cessation, wearing of protective equipment in high risk occupations and drinking plenty of fluids may help.

Bladder cancer: Complications

The relapse of bladder cancer is a commonly occurring phenomenon. Thus, treatment of bladder cancer demands regular follow-up evaluation, mainly cystoscopic evaluation. Moreover bladder cancer as it progresses, may spread to bones or lungs creating fatal complications.

Bladder cancer: Treatment

The biopsy of bladder tissue is done to help detect the type of bladder cancer in an individual which is essential to know since the treatment differs according to the cancer type. The expert opinion of an urologist and oncologist is mandatory in diagnosing and treating bladder cancer. The treatment modalities include chemotherapy, radiotherapy, surgery and immunotherapy. The most common type of bladder cancer is ‘transitional cell cancer’ in which the tumour can be removed surgically in a procedure called ‘transurethral resection of bladder tumour’ (TURBT). Sometimes extensive spread of cancer may need surgical removal of the entire bladder along with adjacent structures. Chemotherapy and radiotherapy may be used as an adjunct to surgery. ‘Squamous cell cancer’ of the bladder may need both surgery and chemotherapy for its effective treatment. The chemotherapeutic medications can be administered intravenously or even directly into the bladder. Radiotherapy is the mainstay of treatment for ‘adenocarcinoma’ type of bladder cancer. Another mode of treatment namely, immunotherapy which uses interferons or botulinum toxin may also be tried in some affected individuals. Regular follow up is recommended for detecting any relapses, which may occur in future.