What Is Bladder Cancer?
When a tumor, or abnormal tissue growth, forms in the bladder lining, bladder cancer occurs. The tumor may occasionally spread to the bladder muscle. Blood in the urine, which has no pain, is the most frequent symptom of bladder cancer.
If blood is noticed in the urine, the patient should visit the family doctor for control purposes. Depending on how far it has spread after diagnosis, bladder cancer can be categorized into three categories:
- non-muscle invasive cancer,
- muscle invasive cancer,
- advanced or metastatic cancer.
The majority of bladder cancer cases seem to result from long-term exposure to hazardous substances that change bladder cells in an abnormal way. Older people are more likely to get bladder cancer, and most newly diagnosed cases are found in those 60 years of age or older.
Many factors, such as the stage and grade of bladder cancer, general health conditions, and preferences are taken into account when deciding on the treatment method. (1)
Definition and Overview
Bladder cancer occurs when the cells that make up the bladder begin to multiply uncontrollably. As more cancer cells grow and multiply, they can eventually form a tumor and spread to other parts of the body.
In the lower pelvis, the bladder is a hollow organ and its primary function is to store urine. The kidneys produce urine, a liquid waste product, which is subsequently carried to the bladder by tubes called ureters. The muscles in the bladder's walls stretch during urination, allowing urine to be released from the bladder through a tube known as the urethra. (2)
The cancer care team considers several factors, including the stage and grade of the cancer, the patient's overall health and preferences. Taking these factors into account, they develop the most appropriate treatment plan for the patient. These treatment plans may include a single procedure or may include several procedures together as needed. Most common bladder cancer treatment procedures include;
The most common treatment for bladder cancer is surgery. The type of surgery depends on the location and size of the cancer. Types of surgery to treat bladder cancer include:
- Transurethral resection (TUR) with fulguration,
- Partial cystectomy,
- Radical cystectomy with urinary diversion.
- Radiation therapy
High-energy radiation, such as X-rays or other forms, is used in radiation therapy to either kill or stop the growth of cancer cells. External beam radiation therapy is sometimes used to treat bladder cancer. This type of radiation therapy utilizes a machine outside the body to send radiation to the cancerous area of the body. Radiation therapy can be administered on its own or in combination with other forms of treatments like chemotherapy.
Chemotherapy, also called "chemo," is the procedure of using drugs to stop or kill cancer cells from dividing in order to prevent cancer cells from multiplying. Chemotherapy can be used alone or combined with other types of treatment as needed. The type and stage of the disease being treated determine how chemotherapy is administered. Intravesical chemotherapy and systemic chemotherapy are the two subtypes of chemotherapy.
Immunotherapy enables a person's immune system to fight cancer. The doctor may recommend biomarker tests to help predict the patient's response to certain immunotherapy drugs. It has 2 types including systemic immunotherapy and intravesical immunotherapy.
With targeted therapy, specific enzymes, proteins, or other molecules involved in the development and spread of cancer cells are inhibited using medications or other substances. The doctor may recommend biomarker tests to help learn the patient's response to certain targeted therapy drugs. (3)
Symptoms and treatment methods of bladder cancer can vary from person to person. However, if the patient with bladder cancer has the following symptoms, treatment should be started as soon as possible.
- frequent urination
- pain or burning when urinating
- feeling like you need to urinate even if your bladder isn't full
- frequent urination during the night
- inability to urinate
- lower back pain on one side of the body
- stomach ache
- bone pain or tenderness
- unintended weight loss and loss of appetite
- swelling in the feet
- feeling tired (4)
Risks and Side Effects
Cancer treatment aims to eliminate cancer, reduce tumor size and prevent recurrence. However, as with any treatment, most of the treatments used have some risks and side effects. These include:
- High-frequency hearing loss and tinnitus
- Low blood counts
- Nausea and vomiting
- Peripheral neuropathy
- Sexual Dysfunction and urinary incontinence
- Frequency, urgency, temporary blood in urine, slow return to bowel function (5)
Post-Procedure and Follow-up
To diagnose or stage cancer, various tests may be performed further after treatment. To assess how well the treatment is working, some tests might be repeated. Based on the outcomes of these tests, decisions about whether to continue, change, or stop treatment can be made. These tests are often known as follow-up examinations or checks. (6)
For some people with bladder cancer, treatment can eliminate or eradicate the cancer. Treatment completion can be both anxious and exciting. Even while the end of therapy may bring some relief, being concerned about the cancer coming back can be stressful.
Some people may never completely recover from bladder cancer, or it may return in another area of the body. For the purpose of keeping the cancer under control, some patients may undergo regular chemotherapy, immunotherapy, or other treatments. Emotional support and help, especially in the healing process, play a major role in influencing this process well.
According to the research, the 5-year success rates of bladder cancer treatment are as follows.
- 97% for carcinoma in situ of the bladder alone (abnormal cells found in the tissue lining the inside of the bladder)
- 71% for localized bladder cancer (cancer is in the bladder only)
- 39% for regional bladder cancer (cancer has spread beyond the bladder to nearby lymph nodes or organs). (7)
1- NHS. Bladder cancer. (https://www.nhs.uk/conditions/bladder-cancer/)
2- American Cancer Society. What Is Bladder Cancer? (https://www.cancer.org/cancer/types/bladder-cancer/about/what-is-bladder-cancer.html)
3,4,6- National Cancer Institute. Bladder Cancer Treatment (https://www.cancer.gov/types/bladder/treatment)
5- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. Effects of Bladder Cancer Treatment. (https://siteman.wustl.edu/treatment/cancer-types/bladder/effects-of-treatment/)
7- National Cancer Institute. Bladder Cancer Prognosis and Survival Rates. (https://www.cancer.gov/types/bladder/survival#:~:text=97%25%20for%20carcinoma%20in%20situ,nearby%20lymph%20nodes%20or%20organs))