What is bladder cancer?
Bladder cancer is a type of cancer that begins in the bladder, usually in the cells that line the inside of this organ.
Who gets bladder cancer?
Anyone can get bladder cancer but it is more common among certain populations. It is more likely to occur in men (#4 cancer) than in women (#8 cancer). Additionally, it is more likely to occur in people over the age of 50. Caucasians are at a higher risk of developing this cancer.
Other risk factors:
- SMOKING is one of the strongest risk factors for bladder cancer.
- Chemotherapy / Radiation
- Industrial chemical exposure
- Analgesic abuse
- Chronic infections and Chronic inwelling catheter
- And many others
How is bladder cancer diagnosed?
The most common symptom of bladder cancer is blood in the urine (hematuria). Hematuria can also be caused by other conditions, so you must be evaluated by a urologist. A urologist can perform a cystoscopy, which is the most important test used to diagnose bladder cancer. A cystoscopy is an internal examination of the bladder and urethra using a cystoscope.
If your urologist suspects bladder cancer after performing the cystoscopy, further testing is done including taking a biopsy (tissue sample) and imaging using a CT scan or ultrasound.
How is serious is bladder cancer?
The severity of bladder cancer can vary widely. Most bladder cancer is caught in its early stages when it is very treatable, but you must remember that all bladder cancer is likely to recur. In general, there are 3 categories of severity:
- Premalignant tumour (Carcinoma insitu) – This can progress very rapidly to invasive cancer and must be followed closely. It is treated with medication placed into the bladder.
- Superficial Invasive (Ta, T1)– the least severe, this category can be managed with minor surgery or medication placed in the bladder. Some tumors can progress to a very serious stage and therefore can require strict, sometime lifelong, observation.
- Muscle invasive but localized (T2, T3) – this is a serious category but still curable. Treatment calls for removal of the bladder or the use of chemotherapy and radiation combined.
- Advanced Systemic/metastatic – this third and most serious category of bladder cancer occurs when tumors have spread beyond the bladder and entered the lymph nodes or other areas of the body. This stage is usually incurable and fatal.
How is bladder cancer treated?
Not all bladder cancer is the same, and so it follows that not all treatments for it are the same. Treatment will depend on the individual and the type and aggressiveness of their tumors. All bladder cancer should be treated, as it is often fatal if left untreated. Overall though, there are three types of treatment which roughly correspond to the three categories of bladder cancer:
- Superficial treatment – This is for tumors mainly found in the mucosa or near the surface and which are more nuisance than necessarily life threatening. These are often curable with major surgery. The treatment includes resecting the tumor followed by close surveillance with cystoscopy and urine tests.
- Muscle invasive but localized treatment – This calls for a removal of the bladder and surrounding organs, as well as the pelvic lymph nodes and reconstruction of the urinary tract. Additionally, 3-4 months of chemotherapy is often used.
- Advanced Systemic/metastatic treatment – At this most serious stage, bladder cancer cannot be cured. Treatment is palliative, meaning it focuses on relief of pain and suffering. This palliative care is achieved through chemotherapy, surgery or radiation.
Michelle Strovski, Maple Ridge Urology, Serving Maple Ridge, Coquitlam, Mission, Abbotsford, Langley, and Vancouver.