What is Bladder Cancer?
Bladder cancer occurs when cancerous cells grow within the bladder tissue. Anyone can contract this disease, but it is more common in men than women. (1)
As with most types of cancer, bladder cancer can range from mild to severe.
Your chance of recovery depends on a variety of factors. These include: how far the cancer has progressed, your age, general health and whether the cancer has returned after treatment. (2)
Your bladder is where urine collects before being passed out through the urethra. The bladder can contract to expel urine, and stretch to hold urine. (3)
Bad habits increase your risk of bladder cancer, such as smoking. On the other hand, staying well hydrated can lower the chances of bladder cancer.
People who are exposed to chemicals regularly also have a higher risk. This includes workers in the leather, textile and painting industries among others. (4)
The potential symptoms of bladder cancer can be described as follows:
Blood can appear in the urine for various reasons. An injury to the urethra or a serious urinary tract infection can result in bloody urine. (5)
Bloody urine is also the most common symptom of bladder cancer. In fact, early stage bladder cancer can cause bloody urine which is not accompanied by any other symptoms. (6)
Signs of bladder cancer can manifest as changes in urination. This symptom can mimic that of other conditions, like bladder stones or an overactive bladder.
You might experience painful, uncomfortable or frequent urination. You can also feel strong urges to urinate regardless of the fact you have recently been.
Advanced bladder cancer can make it difficult or impossible for you to urinate at all. (7)
Lower Back Pain
Lower back pain is a frequently reported symptom with various causes. If cancer has spread from the bladder to other areas, it may cause discomfort.
Individuals with bladder cancer can experience lower back pain, often on just one side.
If you are suffering from lower back pain along with urination changes or bloody urine, seek medical attention. (8)
Each stage of bladder cancer is usually measured according to the TNM scale.
The “T” indicates to what degree and locations the tumor has advanced. “N” refers to the growth of cancerous cells in nearby lymph nodes. Finally, “M” details if the cancer has metastasized (spread) to other areas of the body.
The higher the letter or number accorded on the TNM scale, the more serious the classification. For example, a “Tb” tumor means it has spread further than a “Ta” tumor.
“N0” signifies the cancer is not growing to the lymph nodes. “M0” means the cancer has not advanced to distant areas.
The stages of bladder cancer are as follows: (9)
Below Stage #0
If you’re at this stage, your bladder is cancer-free.
At this stage the cancer is non invasive, yet it’s growing towards the center of the bladder, which is hollow.
This category of tumor is classed as “Ta”. It does not affect the bladder wall muscles, connective tissue or any other areas (“N0” and “M0”).
Stage “0b” cancer grows into the inner lining of the bladder rather than towards the center. The tumor is classified as “Tis”.
As with stage “0a”, it has not spread to other parts of the bladder or anywhere else therefore it’s classified as “N0” and “M0”.
By now, a “T1” tumor is growing into the connective tissue underneath the inner lining layer.
The malignancy has yet to affect the bladder muscle walls or advance to other sites.
It’s also still falls under “N0” and “M0”.
A “T2a” tumor has advanced to the bladder’s inner muscle wall, whereas cancer growing in the outer muscle wall layer is “T2b”.
The cancer is still contained to the bladder and remains at “N0” and “M0”.
At this point, bladder cancer can take one of four directions.
A “T3a” tumor has advanced into the connective tissue underneath the bladder wall lining. A “T3b” indicates cancerous cells have spread to fatty tissue around the bladder.
A “T4a” means the tumor has spread to nearby sites. It may affect the vagina, uterus or prostate.
However, it has yet to affect lymph nodes (N0) or grow to distant areas (M0).
By the fourth level of stage 3A, the cancer is now “N1”. It has targeted a lymph node in the pelvic area.
Tumors can be graded between “T1” and “T4a” based on what part of the bladder they affect. The malignant cells have not reached the abdominal or pelvic wall yet.
More than two lymph nodes in the pelvis are affected (N2). Cancerous growth may have spread to arterial lymph nodes (N3).
There is still no serious advancement to other organs (N0).
There are two possible scenarios for cancer at this stage.
The first is that a tumor classed as “T4b” has reached the walls of the pelvis or abdomen. Although it has not yet arrived at the lymph nodes or beyond (N0 and M0).
The second is that the tumor can be of any level. It may or may not have spread to one or more nearby lymph nodes.
However, if the cancer has begun growing on distant lymph nodes it would be classed as “M1a”.
Bladder cancer at this level has dramatically progressed. Tumors can be of any level (any T) and the same applies for how many lymph nodes are now cancerous (any N).
It’s at this point the disease has started to spread to other organs, like the liver or lungs (M1b).
Suspected bladder cancer is diagnosed through several tests. A urine sample may be taken and then analyzed for any abnormal or unusual cells.
Your bladder can then be examined through a cystoscopy. This basically involves inserting a thin viewing instrument (a cystoscopy) up your urethra to the bladder.
Your doctor might recommend other imaging tests on your bladder and surrounding areas to check for cancer.
A biopsy will be performed to define the type and progress of the cancer. A sample of bladder tissue may be removed during the procedure for a biopsy. (10)
Most bladder cancers will be treated with surgery. In the case of smaller early stage tumors, your doctor will likely perform a transurethral resection.
This is a simple procedure that does not require cutting open the abdomen. An instrument will be inserted through your urethra to remove or burn out the tumor.
Later stage cancers may require a cystectomy, a procedure which involves removing of parts of the bladder.
In serious cases, you can receive a radical cystectomy – all of your bladder will be removed.
Reconstructive surgery will be conducted to allow you to urinate in another way. (11)
Radiation therapy involves targeting radiation at cancerous cells, usually from outside the body.
For patients who have undergone a transurethral resection, radiation therapy can be performed to destroy any remaining cancer cells.
This type is often suggested for patients with early stage cancers who can’t have surgery. It’s also an option for more advanced bladder cancer. (12)
Chemotherapy is the use of cancer-fighting drugs which are taken orally or intravenously through your veins.
This treatment can involve the use of one or more drugs depending on your case. It is usually used alongside radiation therapy.
The drugs travel through your bloodstream to attack cancer cells throughout your body. Chemotherapy is the main treatment besides radiation therapy for advanced cancers.
For less serious bladder cancers, your doctor may use intravesical chemotherapy. This is when chemotherapy drugs are put into the bladder directly.
In these cases, chemotherapy can help reduce the size of the tumor before surgery. It is also used after surgery, to ensure unseen cancer cells are destroyed. (13)
What is bladder cancer? Bladder cancer is a result of malignant cells growing inside the bladder. Rarely, cancers from other areas of the body can spread to the bladder. (14)
What are the signs of bladder cancer? Symptoms of bladder cancer include: bloody urine, painful or frequent urination, and pelvic or lower back pain.
How do you develop bladder cancer? This type of cancer develops when malignant cells begin to grow and reproduce in the bladder.
What is the best treatment for bladder cancer? Your treatment plan will depend on the severity of your bladder cancer. It may consist of surgery, chemotherapy, radiation therapy or immunotherapy. Two or more of these treatments can be used together.
What are the long term complications of bladder cancer? Bladder surgery to remove the whole bladder or treatment of it may cause side effects. Both men and women can experience sexual dysfunction as nerves can be damaged. Another common effect of partial bladder removal is urinating more frequently. (15)
Is bladder cancer considered a disability? If your bladder cancer has spread to other areas of your body or is inoperable, you can qualify for disability. (16)
Is there any cure for bladder cancer? Depending on how advanced the cancer is, malignant growths and cells can be entirely removed or destroyed. However, there is always a risk that the cancer may return. (17)
Is bladder cancer life threatening? Bladder cancer can be life threatening, especially if it has spread beyond the bladder. The 5 year survival rate from diagnosis of stage 4 bladder cancer patients is 15 percent. (18)
Bladder cancer cannot be prevented entirely. However, healthy lifestyle practices can lower your risk of bladder cancer.
Avoiding smoking in particular can make a difference. Approximately half of bladder cancer cases are believed to be caused by this bad habit. (19)
Fortunately, the chances of successfully treating bladder cancer are higher if it is caught early. If you notice any troubling symptoms like bloody urine, check with your doctor.