Bladder Cancer

Bladder Cancer

Bladder cancer is cancer affecting the urinary bladder. Bladder cancer is a fairly common form of cancer and men are affected two to three times more than women. Most bladder cancers occur after the age of 55. The disease is not contagious. No one can "catch" bladder cancer from another person.

Cause

Research shows that smoking is a major risk factor. Workers in some occupations are at higher risk of developing bladder cancer because of exposure to carcinogens (cancer causing substances) in the workplace. These workers include people in the rubber, chemical, and leather industries, as well as hairstylists, machinists, metal workers, printers, painters, textile workers, and truck drivers.

Symptoms

The most common symptom of kidney cancer is the presence of blood in the urine. It may be present one day and not the next. Another symptom of kidney cancer is a lump or mass that can be felt in the kidney area. The tumor may cause a dull ache or pain in the back or side.

Diagnosis

Carcinoma of Urinary Bladder

To diagnose bladder cancer, a personal and family medical history is taken and a thorough physical examination is conducted. Often, the doctor orders an Ultrasonograpy or x-ray called an IntraVenous Urogram (IVU). A biopsy is needed to make a definite diagnosis of bladder cancer.

Treatment

Treatment of the bladder cancer depends on a number of factors. These are

  1. How quickly the cancer is growing?
  2. The number, size, and location of the tumors,
  3. Whether the cancer has spread to other organs
  4. The patient's age and general health.

Before treatment begins, it is important to know exactly where the cancer is located and whether it has spread from its original location. Staging procedures include a complete physical exam and additional blood tests and scans such as CT scan, Ultrasound or MRI .

Early (superficial) bladder cancer in which, the tumors are found superficially in the bladder wall, generally can be treated using the cystoscope in a procedure called transurethral resection of the bladder tumor (TUR-BT). The entire tumor can be removed cryptographically.


Bladder Tumor Before TURBT Surgery


Bladder Tumor After TURBT Surgery

When several tumors are present in the bladder or when there is a risk that the cancer will recur, TURBT may be followed by treatment with drugs. The doctor may put a solution containing the Bacillus Calmette-Guerin (BCG), a form of biological therapy, directly into the bladder. Chemotherapy (anticancer drugs) may also be inserted directly into the bladder. Radiation therapy (also called radiotherapy) may be needed when the cancer cannot be removed with TUR because it involves a larger area of the bladder.

When the cancer involves much of the surface of the bladder or has grown into the bladder wall infiltrating into the bladder muscles, standard treatment is to remove the entire bladder. This surgery is called a Radical Cystectomy. In this operation, the surgeon removes the bladder as well as nearby organs. In women, this operation includes removing the uterus, fallopian tubes, ovaries, and part of the vagina. In men, the prostate and seminal vesicles are removed.

When cancer involves the pelvis or has spread to other parts of the body, chemotherapy may be required.

The methods used to treat bladder cancer are very powerful. Side effects depend on the type of treatment used and on the part of the body being treated.


Dr. Dilip Raja Surgeon

Side Effects

When the bladder is removed, the patient needs a new way to store and pass urine. A newer method uses part of the small intestine to make a new storage pouch (called a continent reservoir) inside the body. The urine collects there and does not empty into a bag. Instead, the patient learns to use a tube (catheter) to drain the urine through a stoma. Other methods are being developed that connect a pouch made from the small intestine to a remaining part of the urethra. When this procedure is possible, a stoma and bag are not necessary because urine leaves the body through the urethra.

Radical Cystectomy causes infertility in both men and women. This operation can also lead to sexual problems. In the past, nearly all men were impotent following this procedure, but improvements in surgery have made it possible to prevent this in many men. In women, the vagina may be narrower or shallower, and intercourse may be difficult.

During radiation therapy, patients may become very tired as the treatment continues. Resting as much as possible is important. Radiation treatment to the lower abdomen may cause nausea, vomiting, or diarrhea. Usually, certain foods or medications can ease these problems. Radiation therapy can also cause problems with fertility and can make sexual intercourse uncomfortable.

Chemotherapy causes side effects because it damages not only cancer cells but other rapidly growing cells as well. The side effects of chemotherapy depend on the specific drugs that are given. In addition, each patient reacts differently. Chemotherapy commonly affects blood-forming cells and cells that line the digestive tract. As a result, patients may have side effects such as a lowered resistance to infection, loss of appetite, loss of hair, nausea and vomiting, less energy, and mouth sores. These are short-term side effects that usually end after treatment stops. When drugs are put directly into the bladder, these side effects may be limited. However, it is common for the bladder to be irritated.