INTRODUCTION: Bladder cancer refers to any of several types of malignant growths of the urinary bladder. It characteristically causes blood in the urine; this may be visible to the naked eye (frank haematuria) or detectable only by using a microscope (microscopic hematuria).
It is the fourth most common cancer in men and the 9th most common cancer in women, affecting almost 61,000 Americans a year and is about four times more likely to be found in men than women. It is considered very common in the U.S.
TREATMENT: It depends on how deep the tumor invades into the bladder wall and is usually performed once a week for several weeks and can be repeated several times if the cancer returns. The most common treatment for superficial bladder cancer is BCG, a kind of biologic therapy which elevates the body’s immune system to fight the tumor. Medicines available include mitomycin-C, thiotepa, interferon and a newly available agent, valrubicin.
It has not yet been determined how the effectiveness of this form of treatment compares to that of radical ablative surgery. More than half of patients who opt for this treatment experience recurrence of the tumor (the cancer coming back).
TYPES: The most common kind begins in cells lining the inside of the bladder and is called urothelial cell or transitional cell carcinoma (UCC or TCC). World-class pathologists at Fox Chase Cancer Center examine tissues under a microscope to diagnose the type, as follows: Urothelial carcinoma or transitional cell carcinoma–accounting for 90 percent of bladder cancers as well as Squamous cell carcinoma, Adenocarcinoma and Small cell Related Cancers.
Surgeons at Fox Chase Cancer Center are highly capable in treating all types. Persons with cancer of the bladder sometimes have a similar kind of cancer in the lining of the kidneys (called the renal pelvis), the ureters or the urethra.
SYMPTOMS: While the symptoms of bladder cancer are few, they are noticeable. These signs and symptoms are not however specific to cancer of the bladder, and are also caused by non-cancerous conditions, including prostate infections and cystitis. Possible symptoms include pain during urination, frequent urination (Pollakiuria) or feeling the need to urinate without results.
Many patients with a history, signs and symptoms suspicious for the disease are referred to a urologist or other doctor trained in cystoscopy, a procedure in which a flexible tube carrying a camera and various instruments is introduced into the bladder via the urethra.
RISK: Approximately 20% of cases occur in patients without predisposing risk factors. It has been proposed that hair dyes are a risk factor. Hairdressers are thought to be at risk as well because of their frequent exposure to permanent hair dyes. Occupations at risk are metal industry workers, rubber industry workers, workers in the textile industry and people who work in printing. Some studies also suggest that auto mechanics have an elevated risk due to their frequent exposure to hydrocarbons and petroleum-based chemicals. A family history of the disease is also a risk factor.
Conclusion: Cancer of the bladder is a disease in which cancerous cells form in the tissues of the bladder. Such cases may be treated with surgery, radiation therapy, chemotherapy, biologic therapy or a combination of methods. Exposure to environmental carcinogens of various kinds is primarily responsible for the development of most bladder cancers.
The gold standard for diagnosing the disease is urine cytology and transurethral (through the urethra) cystoscopy. Cytology is very specific (a positive result is highly indicative of bladder cancer) but suffers from low sensitivity (a negative result does not exclude the diagnosis of cancer). 90% of cases are Transitional cell carcinomas (TCC) that arise from the inner lining of the bladder called the urothelium.
In the U.S., bladder cancer is the 4th most common type of cancer in men and the 9th most common cancer in women. Over 47,000 men and 16,000 women are diagnosed with the disease each year. There are now newer urine bound markers for the diagnosis of bladder cancer.