Hearing a diagnosis of bladder cancer may cause great anxiety. To a great extent, other risk factors depend on each of us, some of us do not notice them throughout our lives. Learn who is at the greatest risk of developing the disease, and what are prognoses after the diagnosis.
Blood in urine is a worrying symptom that may be a sign of bladder cancer. Only when it appears, patients decide to visit a specialist. Treatment of this type of cancer usually involves surgical removal of lesions; however, it is not always possible. Alternate methods may prolong life, as well as minimise pain affecting patients on a daily basis.You can learn more about this subject from the article below.
Overview and types of bladder cancer
Bladder cancer is one of the most frequently diagnosed cancers of the urinary system. It affects the bladder lining, where abnormal tissue develops and cancer cells proliferate. Sometimes, the developed tumour involves the bladder muscles. It may develop in the body for many years without any symptoms, so the majority of people do not visit a doctor.
However, it is worth knowing what is usually the first symptom of bladder cancer. An early worrying symptom is appearance of blood in urine. So if you notice that symptom in yourself, you should not disregard it. However, it does not always mean bladder cancer. Other ailments should also be noticed, such as bladder pain, usually during urination, frequent infections of the urinary system, and problems with complete emptying of the bladder. At more advanced stages, bladder cancer pain may be also perceptible in the lower back and above the pubic bone.
The bladder cancer diagnosis may be crushing; however, it should be remembered that it is classified on a basis of a site to which it disseminated. The following types are distinguished:
- urothelial carcinoma – the most common type of bladder cancer. Abnormal cells spread from the inner lining into deeper layers surrounding the bladder;
- squamous cell carcinoma – it usually develops in consequence of infection with Schistosoma haematobium, causing schistosomiasis. Frequently, this bladder cancer is aggressive;
- adenocarcinoma – is a consequence of recurring urinary tract infections. Its share in all bladder cancer cases is low, at a level of about 5%.
Bladder cancers can also be classified as:
- invasive papillary carcinoma;
- invasive squamous cell carcinoma;
- non-invasive squamous cell carcinoma.
In some cases, bladder cancer may also involve other organs. Then it is called metastatic cancer.
What are the main causes of bladder cancer?
The risk of developing bladder cancer depends on many factors, majority of which can be influenced as they are related to your lifestyle. The following factors may increase the risk of developing bladder cancer:
- smoking tobacco products, including cigarettes, cigars, and pipes;
- radiotherapy;
- chemotherapy and medicines used during it;
- frequent bladder infections;
- contact with certain chemicals;
- frequent use of an urinary catheter.
If anybody in your family had bladder cancer, the likelihood that you will also develop it is higher. However, you should remember that there are other cancers that develop more frequently, and genetic mutations are not always inherited.
Nevertheless, it is estimated that one in three cases are caused by smoking, so this habit is considered a factor that increases the risk of having not only bladder cancer, but also other diseases.
Who is at the highest risk of developing the disease? Risk factors
In this section we will present information about the group of bladder cancers. How common bladder cancer is? Is bladder cancer a fatal disease?
Bladder cancer more frequently affects men than women. The risk increases with age, so usually it develops in elderly men. Main factors causing bladder cancer, i.e. smoking or exposure to chemicals, to a greater extent are associated with men. This type of cancer is diagnosed less often than prostate or lung cancer. In Poland, bladder cancer is diagnosed in about 8 thousand patients every year. In the UK, this cancer is in the top twenty of most common cancers.
Table 1. Most common types of cancer in the U.S.A. in 2022
Women | Men |
Breast cancer (30.8%) | Prostate cancer (27.3%) |
Lung cancer (12.7%) | Lung cancer (12.0%) |
Cervical cancer (8.6%) | Colon cancer (8.5%) |
Colon cancer (8.2%) | Bladder cancer (6.3%) |
Melanoma (4.6%) | Melanoma (5.8%) |
In the U.S.A., bladder cancer is in the TOP5 of the most common cancers in men. Therefore, prevention and appropriate treatment may help to reduce the prevalence of this disease. The general five-year survival rate according to SEER is 77%. In the UK, around 80% of bladder cancer patients survive for at least five years after their diagnosis.
However, survival rates are influenced by various factors, especially the bladder cancer type and stage at the moment of its diagnosis. At initial stages of the disease that has not spread beyond the inner layer of the bladder, the 5-year survival of bladder cancer is 96%. About half of cancer patients are diagnosed at this stage. In the case of advanced bladder cancer that has already spread to distant organs, that ratio is estimated as being around 6%. This stage is diagnosed in about 4% of patients.
How to treat and live with bladder cancer?
Before you select an appropriate treatment, you should first get an answer to an important question: is bladder cancer aggressive? This will facilitate selection of appropriate methods for bladder cancer treatment, as well as estimation of your prognosis. The diagnosis should be based on results of many tests:
- urinalysis;
- urethral cytology;
- cystoscopy.
If any of these results is worrying, diagnostic tests are expanded with magnetic resonance imaging and computed tomography, and in some cases also X-ray scans of the chest, to check for possible metastases. The estimation of the disease stage helps to plan treatment and evaluate results.
Bladder cancer treatment is based on one of several methods. The basic method is a surgical procedure called transurethral resection of bladder tumour (TURBT), during which the tumour is removed endoscopically. Before the surgery, a cystoscopy is performed to evaluate the bladder. This method is used for treatment of bladder cancer that has not yet spread to other tissues or organs.
The advanced bladder cancer, characterised by numerous infiltrations, cannot be treated by tumour removal. At this stage, the resection of the bladder is necessary; frequently also accompanied by removal of lymph nodes in the area, and of the prostate in men. In women, the uterus with appendages is also resected. An important problem associated with this procedure is a method for subsequent removal of urine from the bladder. This is arranged individually with the patient before the surgery.
There are also alternate treatment methods that prolong the survival in patients with bladder cancer when surgical treatment is not possible. They include chemotherapy, radiotherapy, targeted treatment, and immunotherapy.
Bladder cancer - conclusion
Concluding, bladder cancer more often affects men above 60 years of age, because they are more exposed to factors increasing the risk of developing this disease:
- smoking;
- long-term exposure to chemicals;
- urinary tract infections;
- frequent insertion of a catheter.
It should also be remembered that men less often undergo preventive testing or pay attention to worrying signs, and this may also increase the risk of developing the disease in this group of the society.