Bladder Cancer

Cancer and Neoplasms, Renal and Urogenital

Bladder cancer occurs when the cells that line the bladder and urinary tract grow out of control. The bladder is a hollow muscular organ that stores urine from the kidneys before being emptied through the urinary tract. Bladder cancer is found when a person visits his or her healthcare provider complaining of blood in the urine or inability to hold urine. However, there are many causes of these symptoms in other disorders and your physician will be sure to rule out these causes before moving forward with testing for cancer. Bladder cancer most commonly occurs in people over the age of 55 and in men (who are three times more likely to be diagnosed). Exposure to environmental and occupational toxins (including tobacco smoke) greatly increases your risk of developing bladder cancer. The good news is that this type of cancer is usually found very early in the disease and treatment tends to be successful during these early stages.

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Symptoms

The American Cancer Society lists the following symptoms:

  • Mild incontinence (inability to hold the urine)
  • Bleeding that comes and goes when you urinate
  • Blood in the urine (very visible and in large amounts)
  • Pain when urinating
  • Urinary urgency
  • Bladder distention
  • Unable to urinate
  • Urinary tract infection
  • Lower back pain
  • Abdominal pain
  • Bone pain
  • Swelling in the feet and ankles
  • Fatigue
  • Weight loss

Types

Urothelial carcinoma (transitional cell carcinoma). The most common form of bladder cancer. The urothelial cells line the inside of the bladder, the urinary tract, the ureters, and the urethra. Urothelial carcinoma begins in the inner lining of the bladder when abnormal cancer cells start to reproduce exponentially.

Other, less common forms of bladder cancer include:

Squamous cell carcinoma. Cancer of flat cells that are found on the surface of the skin.Adenocarcinoma. Usually are invasive and have similar cell typing to colon cancers.

Small cell carcinoma. Requires aggressive treatment because these nerve-like cells grow quickly.

Sarcoma. Originate in the muscle cells of the bladder.Sarcoma. Originate in the muscle cells of the bladder.

Risk Factors

While the exact causes of bladder cancer are still unknown, certain risks factors associated with bladder cancer include:

Smoking. Smoking is detrimental to your health on many levels. Half of all people diagnosed with this cancer are smokers. Smokers are three times more likely to get bladder cancer than non-smokers.

Chemical exposure. Exposure to certain cancer-causing chemicals like rubber, textiles, leather dyes, paints, and metals.

Inflammation. Inflammation of the bladder can lead to bladder cancer. You are at risk if you get frequent bladder infections, stones, or have a history of non-cancerous bladder tumors.

Nitrates. The nitrates in smoked meats may increase the risk of bladder cancer.Genetics. If you have a family history of bladder cancer or a family history of Lynch syndrome, you may be at higher risk.

Aristolochia fangchi. The use of this Chinese herb as a weight-loss supplement may raise the risk of bladder cancer.

Chemotherapy. If you have had chemotherapy to treat another type of cancer, you may be more likely to develop bladder cancer.

Age, ethnicity, and sex. White males over forty years of age are more likely to develop bladder cancer.

Diabetic medication. Pioglitazone has been associated with an increased risk of bladder cancer.

Diagnosis

If you are concerned that you are having symptoms related to bladder cancer, see your physician right away. Any severe or excessive bleeding that is constant should be evaluated in the emergency room. If the bleeding is not constant but happens intermittently, make an appointment with your healthcare provider as soon as possible. The doctor will check the following:

  • Medical and family history
  • Rectal, prostate (men), or pelvic exam (women)
  • Lab work (e.g., blood count, urine analysis, and imaging)

There are a few tests that can help the doctor diagnose the reason you are having hematuria (blood in urine), pain, discomfort, or strange symptoms related to your urinary system that will rule out bladder cancer.

Cystoscopy. Your doctor will insert a lighted tube into your bladder and look for abnormal spots on the walls. Samples will be biopsied to check for cancer cells.

Intravenous pyelogram. The radiologist will inject dye into a vein so that when it passes from the kidneys to the bladder, abnormalities can be more easily seen.

Ultrasound. This can help the doctor see the bladder and associated structures to detect abnormalities.

Treatments

The treatment for bladder cancer depends on the stage the cancer is in at diagnosis. If you are diagnosed with bladder cancer you will be referred to an oncologist who will want to move very quickly to start treatment. Do not be afraid to ask questions, especially about your treatment plan or your condition. Your oncologist will use one of the following or a combination of them:

Radiation. External beam radiation.

Chemotherapy. Injected directly into a vein or given in pill form.

Intravesical therapy. Immune therapy to fight cancer injected directly into the bladder. This form of chemotherapy is often used after surgical intervention to kill any cancer cells left in the bladder.

Surgical intervention. Transurethral resection of bladder tumor (TURBT) is used to confirm a bladder cancer diagnosis and stage if cancer has spread into the muscle layer of the bladder. This is the most common treatment for early-stage bladder cancer. If cancer cells have spread into the muscle layer an extensive TURBT is performed to make sure all cancer is removed. In later stages of bladder cancer, part or all of the bladder may be removed (radical cystectomy).

Non-muscle invasive bladder cancer treatments. There is a high rate of recurrence with bladder cancer, so often the doctor will opt to do a radical cystectomy, which is the removal of the entire bladder right away. They rebuild the bladder out of a pouch cut from your intestines. This is one wa4y to prevent a recurrence, but there are some side-effects to this treatment including electrolyte imbalances, bowel obstructions, kidney obstructions, infections, and scar tissue formation.

Alternative Treatments and Home Remedies

Bladder cancer, and any form of cancer for that matter, is a serious condition and should be treated by trained oncologists. Inform your healthcare provider about any new supplement you are taking as well as physical activity. Alternative treatments for bladder cancer can help improve your quality of life, relieve symptoms of disease and treatment, and provide mental health support when using stress-relieving techniques.

Acupuncture. Thin needles are inserted into points on your body to treat a variety of symptoms, like nausea or pain.

Aromatherapy. Using essential oil from plants has been shown to improve mood, reduce stress, and relieve nausea.

Art and music therapy. Finding an outlet in art or music therapy is highly beneficial in improving your quality of life, lifts your mood, and cope with the overwhelming number of emotions that come with battling cancer.

Massage therapy. A skilled massage therapist who specializes in chronic disease pain will help relieve muscle tension, relieves stress, anxiety, and depression, and may relieve your pain.

Tai chi. This Chinese martial art teaches meditation, controlled breathing, and coordinated systems of movement. The practice of Tai Chi can improve your strength and balance and lift your spirit.

Prevention

recent study has shown that at least 80% of all cases of bladder cancer studied between the years of 1995 through 2015 were connected with a preventable cause. The following lifestyle changes can reduce your risk of getting bladder cancer.

Lifestyle Changes

Diet. Increasing fruits and vegetables in your diet decreases your risk of developing bladder cancer.

Quit smoking. The greatest risk factor for getting bladder cancer is smoking.

Practice work safety. Responsible work safety procedures in industries that expose their workers to carcinogenic chemicals.

Avoid toxic chemicals. Limit exposure to occupational and environmental chemicals known to cause bladder cancer.

Physical activity. There is reduced risk for developing bladder cancer among physically active individuals.

References

Al-Zalabani, A. H., F. J. Stewart, K., Wesselius, A., Annemie, M. W., Schols, J., & Zeegers, M. (2016, March 21). Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses. European Journal of Epidemiology, 31(9), 811-851. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010611/

American Cancer Society. (2020, December 23). Bladder cancer signs and symptoms. Retrieved from cancer.org: https://www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/signs-and-symptoms.html

American Cancer Society. (2020, December 26). Bladder cancer risk factors. Retrieved from cancer.org: https://www.cancer.org/cancer/bladder-cancer/causes-risks-prevention/risk-factors.html

Nortier, J. L., Martinez, M.-C. M., Schmeiser, H. H., & Arlt, V. M. (2000, June 08). Urothelial carcinoma associated with the use of a chinese herb (Aristolochia fangchi). The New England Journal of Medicine, 342, 1686-1692. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJM2000060834223015

Saginala, K., Barsouk, A., Aluru, J. S., Prashanth, R., Padala, S. A., & Barsouk, A. (2020, March 13). Epidemiology of bladder cancer. Medical Sciences, 8(1), 15-. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151633/

Zeng, Y., Xie, X., & Cheng, A. S. (2019, April 6). Qigong or Tai Chi in Cancer Care: an Updated Systematic Review and Meta-analysis. Current Oncology Reports, 48-. Retrieved from Qigong or Tai Chi in Cancer Care: an Updated Systematic Review and Meta-analysis

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