Urinary Bladder Cancer

What is Urinary bladder cancer?

Urinary bladder is a muscular organ which stores urine from both the kidneys and act as a reservoir. Bladder Cancer is cancerous growth of the bladder cells mainly of Urothelial or Transitional cells of urinary bladder. Bladder Cancer is one of the most common urological malignancies.

What are types of Bladder Cancers?

Bladder can have both benign tumors as well as malignant/ cancerous tumors. The most common form of bladder cancer are as follows:

• Urothelial carcinoma
  • It arises from the mucosal lining of bladder which is known as urothelium or transitional cells. It is the most common type of bladder cancer. It is highly associated in smokers and dye workers.
• Squamous cell carcinoma.
  • This cancer commonly occurs as the result of chronic irritation of bladder from an infection, chronic irritation from long standing bladder stones or long term use of urinary catheters. It is most commonly associated with parasitic infection from schistosomiasis.
• Adenocarcinoma.
  • It is a rare type of bladder cancer arising from the mucus-secreting glands of the bladder.

What are the risk factors for Bladder Cancer?

Bladder Cancers are mostly associated with following risk factors:

1. Smoking/ Tobacco Chewing
2. Increasing age.
3. Male Gender - Men are more likely to develop bladder cancer as compared to women.
4. Exposure to certain chemicals - like chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products.
5. Previous cancer treatment -Certain anti cancer drugs like cyclophosphamide increases risk of bladder cancer.
6. Chronic bladder inflammation - due to stone/ infection/ urinary catheter etc.
7. Personal or family history of cancer. Like HNPCC (hereditary nonpolyposis colorectal cancer)

What are the Symptoms of Bladder Cancer?

Bladder Cancers mostly present with presence of blood in urine i.e. hematuria. Presence of painless hematuria in people with age> 55 years is most commonly associated with bladder cancer. Following are the most common symptoms of bladder cancer

1. Blood or blood clots in the urine
2. Pain or burning sensation during urination
3. Frequent urination
4. Feeling the need to urinate many times throughout the night
5. Feeling the need to urinate, but not being able to pass urine
6. Lower back pain on 1 side of the body

How a bladder cancer is diagnosed?

Most of the bladder cancers are evaluated by the urologist with:

• History & physical examination
• Routine blood workup with complete blood count, renal function test and liver function test
• Complete urine analysis
• Ultrasound Scan
• CT Urography
• Chest X Ray
• PET Scan/ Bone scan depending upon the stage of patient

What is Trans Urethral Resection of Bladder Tumor or TURBT?

Transurethral resection of bladder tumor is an endoscopic treatment modality where with the help of endoscope the bladder tumor is resected via the urethra. It is the therapeutic treatment of T1 bladder cancer/ Superficial Bladder Cancer. It is diagnostic as well as staging modality for T2 bladder cancer/ Muscle Invasive Bladder Cancer.

What is treatment of T1 Stage of Bladder Cancer?

T1 bladder cancer is surgically treated by the TURBT which is diagnostic as well as therapeutic surgical modality. After TURBT patient is often given intravesical therapy in form of immunotherapy or chemotherapy by the uro-oncosurgeon depending upon the histopathological reports and other patient related factors.

What is Intravesical Immunotherapy/ Chemotherapy?

Superficial/ T1 Bladder Cancers are given intravesical immunotherapy/ Chemotherapy to prevent recurrence of disease. Intravesical immunotherapy is given in the from of BCG. It is the most common intravesical mode of therapy. Apart from it various chemotherapeutic agents like Mitomycin C, Gemcitabine etc. are also used intravesically to treat the bladder cancer. The treating urologist considers various factors to choose the appropriate treatment for the patient.

What is Radical Cystectomy?

This is the radical surgery done in advance stages of bladder cancer. It is the treatment modality of choice in T2 onwards stage of bladder cancer. It is radical surgery where in men whole of bladder along with prostate, seminal vesicles is removed and in women whole of bladder is removed along with uterus and anterior vaginal wall. Apart from these it also includes removal of draining lymph nodes and formation of new tract for passage of urine from the kidneys from the intenstine. The new bladder is formed in three ways: Ileal Conduit, Continent Cutaneous Diversion and Orthotopic Neobladder. For more information on these please visit the urologist.

What is neobladder?

Neobladder is a new urinary reservoir which is made from the intestine of a person when his bladder is removed due to bladder cancer. It is a tedious procedure and only few uro-oncosurgeons do it at highly specialized centers. We at Guru Jambheshwar Multispeciality Hospital, routinely offer this modality of treatment in appropriate cases in the entire Hisar region.

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