Important facts about Bladder Cancer

Here we take an overview of bladder cancer – the different types, causes and risk factors, symptoms and treatments available.

Bladder cancer develops when abnormal cells in the bladder start to mutate and grow uncontrollably and more rapidly than normal cells. A mass of cancerous cells is called a malignant tumour, or more simply, cancer.

The bladder is a muscular sac in the pelvis, roughly the size of a pear when empty with a capacity somewhere between 400 and 500ml when full. It receives urine from the kidneys and stores it for excretion via the urethra. The bladder is lined with a membrane, and the cells of this membrane are called urothelial cells. The membrane lining is called the urothelium.

Types of Bladder Cancer

Nearly all bladder cancers begin in the urothelial cells. This is called a urothelial carcinoma, formally known as transitional cell carcinoma, and constitutes roughly 80-90% of all bladder cancers. In some cases, cancer may grow into deeper layers of the bladder wall.

Other less common types of cancer include squamous cell carcinoma or adenocarcinoma.

Treatment for bladder cancer will depend on the progression of the malignant cells and how far they have spread into the layers of the bladder:

Non-muscle invasive tumours – The malignant cells are found only in the urothelium or in the next layer of tissue (lamina propria). They haven’t progressed any further into layers of the bladder wall. This accounts for most instances of cancer.

Muscle-invasive tumours – Cancer has spread into layers of the bladder wall and infiltrated the bladder’s detrusor muscle, which is a thick muscle located deep in the walls of the bladder. of the bladder.

Causes and Risk Factors of Bladder Cancer

Like other forms of the disease, we don’t know exactly what causes bladder cancer. However, there are several risk factors associated with it developing:

• Age – bladder cancer usually occurs in people over 60 years of age. Providing treatments and care to elderly individuals diagnosed with this type of cancer requires specific information about a number of geriatric clinical issues. This knowledge can help identify the best treatment plan for the particular individual.

• Smoking – this is a major risk factor for cancer, particularly prolonged smoking. Reportedly, individuals who smoke are at least three times more likely to develop bladder cancer than those who do not.

• Gender – males have a higher risk of bladder cancer. This is due to a number of factors, including higher rates of smoking among males, as well as increased occupational exposure to certain toxins in the environment.

• Prolonged exposure to certain chemicals – this is usually work-related. For example, chemicals used in dyeing in the textile and rubber industries.

• Chronic inflammation of the bladder or repeat bladder infections – for a myriad of reasons, these conditions can occur more frequently in some individuals than others. For example, prolonged usage of a urinary catheter could lead to the development of squamous cell bladder cancer, which accounts for roughly 4% of all bladder cancers.

• Family history – individuals with family members who have been diagnosed with bladder cancer are at an increased risk of developing it also. This may be due to exposure to the same cancer-inducing chemicals that their relatives were exposed to, such as tobacco smoke. An additional reason could be shared changes in particular genes, including GST and NAT. For people who possess these genes, their body finds it difficult to break down specific toxins, which can generate an increased likelihood of developing cancer of the bladder.

• Previous cancer treatments, such as radiotherapy to the pelvic area – radiation therapy is a form of cancer treatment. However, undergoing pelvic radiation therapy carries certain risks, such as developing bladder cancer.

• Diabetes – studies have uncovered a link between diabetes mellitus and the risk of developing bladder cancer, as well as the risk of cancer mortality.

Symptoms of Bladder Cancer

Sometimes, bladder cancer doesn’t present any symptoms, and it is found during urine tests and routine checkups.

Blood in the urine (haematuria) is the most common symptom of bladder cancer. Often this comes on suddenly and is not painful, with only a small amount of blood present for a short time.

Although a small amount of blood in the urine may not seem troublesome, it is crucial to see your urologist right away. Even if it is not the result of cancer, it may be a symptom of another condition such as bladder stones, an infection, or an enlarged prostate.

Other common symptoms of bladder cancer include:

• Trouble urinating
• Feeling a burning sensation while urinating
• Frequent urge to pass urine
• Pain in the lower back or abdomen

Treatment of Bladder Cancer

Surgery – Non-muscle invasive cancers can be removed surgically using a cystoscope. Burning the tumour base or using a high-energy laser to damage or kill the cells can also be an effective way to treat bladder cancer. A cystectomy – the surgical removal of part or all of the bladder – may be required to treat muscle-invasive tumours.

Immunotherapy – Non-muscle invasive cancers can also be treated with immunotherapy – also known as ‘biological therapy’ – which involves using vaccines to encourage your immune system to fight cancer. The most common immunotherapy used is a vaccine called Bacillus Calmette-Guérin (BCG).

Intravesical Chemotherapy – It is not as effective as immunotherapy but can be used if BCG has failed or cannot be tolerated.

Palliative Care – If cancer is diagnosed late and/or has spread too far to be treated, palliative care is often the best option. This involves focusing on improving the quality of life by alleviating cancer symptoms and managing pain and discomfort.

Treating Bladder Cancer with Urology Specialist

Dr Arianayagam is an expert in urological cancer surgery, including robotic surgery to treat bladder cancer. He is one of the most experienced robotic surgeons in Sydney and routinely performs robotic bladder removal with intracorporeal diversion (where the urine is diverted using the robot internally). He is one of the most experienced robotic surgeons in Sydney.

If you have any further questions about bladder cancer and would like to book an appointment, please feel free to call.

Want to learn more about what Urology Specialist can help with? Check out these posts below:

Kidney Cancer and what you need to know

Prostate Cancer and what you need to know

Smoking and its Urological Impacts