Bladder Cancer

Bladder Cancer Overview

The bladder is a hollow organ in the lower abdomen (pelvis). It collects and stores urine produced by the kidneys.

• As it fills with urine, the muscular wall of the bladder stretches and the bladder gets larger.
• When the bladder full of urine, the bladder wall contracts, although adults have voluntary control over the timing of this contraction. At the same time, a urinary control muscle (sphincter) in the urethra relaxes. The urine is then expelled from the bladder.
• The urine flows through a narrow tube called the urethra and leaves the body. This process is called urination, or micturation.

Cancer occurs when normal cells undergo a transformation whereby they grow and multiply without normal controls.

There are  different types of cells that form the bladder, the cells lining the inside of the bladder wall are most likely to develop cancer. Any of three different cell types can become cancerous. The resulting cancers are named after the cell types.

·       -  Urothelial carcinoma transitional carcinoma(tcc bladder): This is by far the most common type of bladder cancer in the United States. The so-called transitional cells are normal cells that form the innermost lining of the bladder wall. In transitional cell carcinoma, these normal lining cells undergo changes that lead to the uncontrolled cell growth characteristic of cancer.

·      -   Squamous cell carcinoma. These cancers originate from the thin, flat cells that typically form as a result of bladder inflammation or irritation that has taken place for many months or years.

·       -  adenocarcinoma. These cancers form from cells that make up glands. Glands are specialized structures that produce and release fluids such as mucus.

Bladder cancer causes and risk factors

Some of the possible causes of bladder cancer, or risk factors for bladder cancer developing include:

1.      Age, It’s unusual for anyone under the age of 40 to get bladder cancer. It becomes more common as people get older.

2.      Infection, Repeated (chronic) urinary infections and untreated bladder stones have been linked with a less common type of bladder cancer called squamous cell cancer. People who are paralysed have more bladder infections and also a higher risk of getting this type of bladder cancer.

3.      Smoker

4.      Gender,man has more chance to get bladder cancer than women,

5.      Exposure to chemical at work.

What are the symptoms of bladder cancer?

The following are the most common symptoms of bladder cancer found in patient. However, each individual may experience symptoms differently. Symptoms may include:

• visible blood in the urine
• hematuria - the presence of microscopic red blood cells (RBCs) in the urine.
• painful urination
• urgency - frequently feeling the need to urinate without results.
• frequent urination
• pelvic or flank pain

The symptoms of bladder cancer may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

Test and exams to diagnose bladder cancer

when we consult to physician ussualy they will request from the patient to do some test to diagnose the bladder cancer.its may include:

·         Ultrasound abdomen and pelvis

·         CT Scan

·         Urine cytology

·         Bone scan

·         Cystoscopy

·         Urinalysis and culture

·         Biopsy

Treatment of bladder cancer

Treatment depends on the position and size of the cancer in your bladder and how far it has spread. Your doctor will discuss your treatment options with you.

Transurethral resection of bladder tumour (TURBT)

This is a procedure used to remove any unusual growths or tumours on the bladder wall. Using a rigid cystoscope a special wire loop is passed into your bladder. An electric current is passed down the wire loop and used to cut or burn off the growth or tumour and a border of healthy tissue around it. For more information, see transurethral resection of bladder tumour, TURBT.

Bladder treatment with mitomycin C or Bacille Calmette-Guérin (BCG)

Mitomycin C is a chemotherapy medicine used to destroy cancer cells. BCG is an immunotherapy that contains a weak form of the bacterium Mycobacterium bovis, which is also used to vaccinate against tuberculosis (TB). BCG works by encouraging the immune system to attack cancer cells. Mitomycin C or BCG treatment is usually given after bladder surgery, sometime it may be used alone to treat bladder cancer. For more information, see bladder treatment with mitomycin C or Bacille Calmette-Guérin (BCG).

Surgery (complete or radical cystectomy)

Removing your bladder and surrounding tissues is the main treatment for muscle-invasive bladder cancer. The operation is called a complete or radical cystectomy. It is usually followed by radiotherapy