About Bladder Cancer - Patient's Guide
Despite treatment advances, bladder cancer
remains one of the most commonly diagnosed cancers. In fact, roughly 50,000 people will develop bladder cancer this year, and more than 12,000 of those people will ultimately die of this disease. Statistics show that approximately 35,000 men and 15,000 women are diagnosed with cancer of the bladder every year. Overall, the disease appears more often among Caucasians than among either Hispanics or African Americans and the lowest rates of occurrence appear among Asians. Furthermore, studies conducted by the National Cancer Institute have shown that cancers of the bladder primarily affect men and women 40 years of age or older. Unfortunately, as with cancer of the prostate, cancer of the bladder typically develops quietly and early symptoms are not easily recognizable.
Bladder Cancer Causes
As with many cancers, bladder cancer’s precise causes are unknown. However, research has demonstrated that a variety of cancer-causing agents found in the urine may facilitate the development of the disease. Cigarette, cigar and pipe smoking
have been shown to be a causal factor in roughly 50% of bladder cancer occurrences.
, such as benzidine and beta-naphthylamine, compounds known as arylamines, at even a low fluid consumption have been associated with bladder cancer. Unfortunately, risk factors for developing cancer of the bladder do increase with age. Men and women over the age of 70 tend to develop the disease two to three times more often than those aged 55 to 69 – which is 15 to 20 times more likely than people between the ages of 30 and 54.
Here are a few more basic facts: Roughly 90% of bladder cancers originate in the cells lining the bladder (the transitional epithelium). Though symptoms of the onset of the disease are mild at first, cancer of the bladder may lead to anemia, urinary incontinence or a blockage of the urethra which prevents urine from draining into the bladder normally (known as hydronephrosis). The most serious complication of bladder cancer, by far, is that the disease commonly spreads into distant organs.
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Bladder Cancer Symptoms
Generally speaking, the only common early symptom of bladder cancer is the presence of blood in the urine (known as hematuria). Because the condition is not always visible to the naked eye, it often delays diagnosis. Similarly, diagnosing bladder cancer is often missed because the bleeding may occur intermittently and may not show up during a routine urinalysis, or showing up as slightly reddish or darker than normal. Diagnosis may be further complicated by the fact that, even if there is a discoloration or blood in the urine, it may not mean bladder cancer is present, and people are less likely to seek immediate medical advice. The truth is that a variety of common ailments ranging from simple urinary tract infections to kidney disease, bladder or kidney stones, and other prostate-related issues can be the culprit behind hematuria, and other frequent symptoms of cancer.
Because conditions such as an enlarged-prostate and urinary tract infections present symptoms similar to those of bladder cancer, it is essential to involve a general practitioner or urologist as soon as one of them is detected. That way, regardless of the illness, it will be treated promptly.
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Please Contact a Doctor if Any of These Symptoms Occur:
- Chronic bladder inflammation, urinary stones or chronic urinary tract infections.
- Unusually slow urine stream or uncomfortable temporary retention of urine.
- Inflammation of the lumbar area – between the diaphragm and sacrum.
- Difficulty urinating or abnormally frequent urination.
- Painful spasms (bladder tenesmus) or a burning sensation while urinating.
- Spasms or pain and discomfort centered in the pelvic area or groin. Or, any unexplained swelling in the lower extremities.
Cancers of the bladder are usually diagnosed by examining urine for cancer cells under a microscope (known as urine cytology) or during cystoscopy – an inspection of the bladder with a slender tube (known as a cystoscope) equipped with a lens and a light inserted into the bladder through the urethra.
If bladder cancer is suspected, the doctor will examine a small piece of tissue removed during a cystoscopic procedure. If the results indicate bladder cancer, a CT Scan (computed tomography) will most likely be needed to determine its stage and type and whether the cancer has metastasized to other areas of the body such as the lungs, lymph nodes, bones, or liver.
Transitional Cell Carcinoma is the Most Common Form of Bladder Cancer
Essentially, there are three types of bladder cancers, transitional cell carcinomas which begin in the layer of cells lining the bladder, squamous cell carcinomas which originate in one type of cell in the bladder’s lining, and adenocarcinomas that begin in glandular cells. Bladder cancers are further identified according to how they’ve spread. If the cancer is only found within in the bladder’s lining, it’s characterized as superficial cancer, while carcinomas which have spread to the muscle wall are referred to as invasive. Transitional cell carcinoma (or TCC) is the most common type of cancer of the bladder and accounts for approximately 90% of bladder cancer cases.
It’s worth noting that 70% of transitional cell carcinoma cases are the superficial kind and, therefore, unlikely to metastasize. Unfortunately, the remaining 30% of TCC occurrences fall into the muscle invasive group, having invaded the bladder’s muscular wall and potentially other nearby organs. Prompt diagnosis is crucial as treatment options are determined by how deeply the carcinoma has invaded the bladder, whether or not it’s metastasized, and if so, to where.
As for the less common forms of bladder cancer, squamous cell carcinomas account for roughly 8% of cancer cases, and adenocarcinomas make up between 1% and 2% of bladder cancer cases. Adenocarcinomas, however, account for approximately 90 to 95% of all colorectal cancer occurrences. As can be expected, the various forms of bladder cancer respond to treatment differently and the approach to treatment is individual to each patient.
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Taking a More Active Role in the Treatment and Care of Bladder Cancer
If diagnosed with bladder cancer, treatment options will primarily depend on the depth of the tumor. For example, it's possible to “shave off” a superficial tumor, one which has not invaded the muscle layer, with electrocautery during a procedure known as robotic-assisted laparoscopic cystectomy
Immunotherapy in the form of Bacillus Calmette-Guerin (BCG) instillation can also be used to treat and prevent the reappearance of superficial tumors related to cancer of the bladder. Immunotherapy has been shown to be fairly effective in up to 2/3 of the cases at this stage. It’s also possible to use instillations of chemotherapy to treat superficial bladder carcinomas.
When left untreated, even a superficial tumor can begin to infiltrate and, once such tumors have metastasized, require a more radical surgery where either a portion of or the entire bladder is removed and the urinary stream diverted. In certain cases, skilled urologists can create a substitute bladder (or neobladder) from intestinal tissues, but such a procedure would depend on age, level of renal function, and the precise location of the tumor.
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Steps to Take to Substantially Reduce the Risk of Bladder Cancer:
- Eat more cabbage, broccoli and other cruciferous vegetables.
- Quit smoking or don’t start smoking.
- Be cautious with chemicals and private water sources, and drink plenty of fluids.
And, if there is blood in the urine, it has developed an inexplicable redness, or there is any urinary dysfunction, it is imperative to contact a doctor.
There are a variety of causal and risk factors studies have shown to contribute to the development of bladder cancer. Anyone over the age of 40 should request a bladder cancer screening be included in their existing check-up regimen if any of the items listed below apply to them:
- Used weight-loss formulas containing the herb Aristolochia Fangchi.
- Have a diet that’s high in saturated fats.
- Are a smoker or are regularly exposed to second-hand smoke.
- Have had external beam radiation therapy.
- Has a family history of bladder cancer.
- Have been treated with cancer drugs such as cyclophosfamide.
- Have been exposed to Schistosoma Haematobium parasites which are fairly common in developing countries.
about bladder cancer prevention
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Taking an active role in the decisions affecting treatment involves a consult with the physician and learning as much as possible about cancer of the bladder and the options available to treat it. Consider getting a second opinion from a bladder cancer specialist, such as a urologist, a medical oncologist, or a urologic oncologist.
The best treatment will depend on factors ranging from the age and weight to the type, stage, and extent of the bladder cancer, as well as overall physical condition and personal preferences of each patient.
For additional info on bladder cancer’s symptoms or care, contact Dr. Samadi today.
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