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Bladder Cancer

Bladder cancer is a disease in which malignant cells form in the tissues of the bladder, the hollow, muscular organ in the lower abdomen that stores urine. It is the fourth most common cancer in men and less common in women. Bladder cancer most often begins in the cells that line the inside of the bladder (urothelial cells), though it can develop in other cell types. Early detection and treatment are crucial, as bladder cancer has a high recurrence rate, requiring ongoing surveillance after initial treatment.

Causes

  • Tobacco use - Smoking is the single most important risk factor, causing about half of all bladder cancers.
  • Occupational exposure to chemicals - Workers in industries that use certain organic chemicals, such as dyes, rubber, leather, textiles, paint, and printing products, may be at higher risk.
  • Chronic bladder inflammation - Recurring urinary infections, kidney and bladder stones, or other causes of chronic bladder irritation may increase risk.
  • Age - Risk increases with age, with most diagnoses occurring in people over 55.
  • Gender - Men are 3-4 times more likely to develop bladder cancer than women.
  • Race and ethnicity - White/Caucasian individuals have a higher rate of bladder cancer than other ethnic groups.
  • Personal or family history of bladder cancer - Having had bladder cancer increases risk of recurrence; some genetic factors may also increase risk.
  • Previous cancer treatment - Treatment with certain chemotherapy drugs or radiation therapy directed at the pelvis.
  • Arsenic in drinking water - High levels of arsenic in drinking water increase bladder cancer risk.
  • Genetic mutations - Certain inherited gene mutations may increase bladder cancer risk.

Signs and Symptoms

  • Blood in urine (hematuria) - The most common symptom, which may appear bright red or rusty/dark brown.
  • Frequent urination - Feeling the need to urinate more often than usual.
  • Painful urination - Discomfort or burning sensation during urination.
  • Back pain - Pain in the lower back on one side of the body.
  • Pelvic pain - Discomfort or pressure in the pelvic region.
  • Urinary urgency - Feeling an immediate need to urinate, even when the bladder isn't full.
  • Inability to urinate - Despite feeling the urge.
  • Swelling in the lower legs - In advanced cases.
  • Unexplained weight loss - Particularly in advanced cases.
  • Fatigue - Persistent tiredness that doesn't improve with rest.

Diagnosis

Urinalysis and Urine Cytology

Laboratory tests to examine urine for blood, cancer cells, and other signs of disease. Cytology involves examining cells from the urine under a microscope.

Cystoscopy

A procedure where a thin, lighted tube (cystoscope) is inserted through the urethra into the bladder to examine the bladder lining for abnormalities. If suspicious areas are seen, tissue samples (biopsies) can be taken for examination.

Imaging Tests

CT urogram, MRI, ultrasound, or other imaging studies may be used to visualize the bladder and surrounding structures, detect tumors, and determine if cancer has spread beyond the bladder.

Transurethral Resection of Bladder Tumor (TURBT)

A surgical procedure that serves both diagnostic and treatment purposes. It removes the tumor and surrounding tissue for pathological examination to determine the type and stage of cancer.

Urine Marker Tests

Specialized tests that look for specific substances in the urine that may indicate bladder cancer, such as NMP22, BTA, and fluorescence in situ hybridization (FISH).

Treatment Options

Transurethral Resection of Bladder Tumor (TURBT)

A surgical procedure that removes cancerous tissue from the bladder using instruments inserted through the urethra. This is often the first treatment for non-muscle invasive bladder cancer and may be followed by intravesical therapy.

Intravesical Therapy

Medication is placed directly into the bladder through a catheter. Bacillus Calmette-Guérin (BCG) immunotherapy or chemotherapy drugs may be used to reduce the risk of cancer recurrence or progression after TURBT.

Radical Cystectomy

Surgical removal of the entire bladder and possibly surrounding tissues and organs. In men, this typically includes the prostate and seminal vesicles; in women, it may include the uterus, fallopian tubes, ovaries, and part of the vagina. A urinary diversion procedure is performed to create a new way for urine to leave the body.

Chemotherapy

Drugs that kill cancer cells may be administered before surgery (neoadjuvant), after surgery (adjuvant), or as the primary treatment for advanced or metastatic bladder cancer. It may be given intravenously or directly into the bladder (intravesical).

Home Remedies

Stay Hydrated

Drinking plenty of water helps flush toxins from the bladder and may reduce irritation. Aim for at least 8 glasses of water daily, unless contraindicated by other medical conditions.

Dietary Modifications

Some patients find relief by avoiding potential bladder irritants such as caffeine, alcohol, spicy foods, artificial sweeteners, and acidic foods. A diet rich in fruits, vegetables, and whole grains may help support overall health during treatment.

Smoking Cessation

Quitting smoking is crucial as it is a major risk factor for bladder cancer development and recurrence. Seek professional help if needed to quit successfully.

Pelvic Floor Exercises

Kegel exercises can help strengthen pelvic floor muscles and improve bladder control, which may be affected by bladder cancer or its treatments.

Stress Reduction

Practices such as meditation, yoga, deep breathing, or guided imagery can help manage stress and anxiety associated with a cancer diagnosis and treatment.

Preventive Care

  • Avoid tobacco - Not smoking is the most important way to reduce bladder cancer risk.
  • Limit exposure to certain chemicals - If you work with chemicals, follow all safety instructions to avoid exposure.
  • Drink plenty of fluids - Staying hydrated helps flush potential carcinogens from the bladder.
  • Eat a diet rich in fruits and vegetables - A balanced diet may help reduce cancer risk.
  • Limit alcohol consumption - Heavy alcohol use may increase the risk of certain cancers.
  • Watch for symptoms - Seek prompt medical attention for any blood in urine or other urinary symptoms.
  • Get regular check-ups - Particularly important if you have risk factors for bladder cancer.
  • Consider screening if you're at high risk - Those with significant risk factors may benefit from periodic screening.
  • Be aware of medications and supplements - Some medications may affect bladder cancer risk; discuss with your doctor.
  • Maintain a healthy weight through proper diet and regular exercise.

Surgical Options

Transurethral Resection of Bladder Tumor (TURBT)

A minimally invasive procedure performed through the urethra using a resectoscope to remove cancerous tissue from the bladder lining. It's used for diagnosis, staging, and treatment of non-muscle invasive bladder cancer. The procedure can often be done on an outpatient basis, with a recovery period of a few days to weeks.

Radical Cystectomy

Complete removal of the bladder and nearby tissues, such as lymph nodes and part of the urethra. In men, the prostate and seminal vesicles are typically removed; in women, the uterus, fallopian tubes, ovaries, and part of the vagina may be removed. This is followed by urinary diversion to create a new way for urine to exit the body.

Partial Cystectomy

Removal of only a portion of the bladder, preserving bladder function. This is an option only for select patients with single tumors in certain locations that have not spread deeply. The remaining bladder is reconnected, allowing for normal urination.

Urinary Diversion Procedures

After bladder removal, several options exist for diverting urine flow: ileal conduit (using a piece of intestine to create a tube for urine to exit through a stoma), continent urinary reservoir (an internal pouch made from intestinal tissue that requires catheterization), or neobladder (creating a new bladder from intestinal tissue that allows near-normal urination).

Robotic-Assisted Laparoscopic Surgery

Advanced minimally invasive techniques using robotic systems for precise surgical control. This approach may be used for radical cystectomy and urinary diversion, potentially resulting in less blood loss, shorter hospital stays, and faster recovery compared to traditional open surgery.

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If you're experiencing symptoms of bladder cancer, our expert team is here to help you find the right treatment approach for your specific needs.

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