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WHAT IS BLADDER CANCER?
The bladder is a hollow, flexible pouch in your pelvis. Its main job is to store urine before it leaves your body. Bladder cancer begins when healthy cells in the bladder lining, most commonly urothelial cells, change and grow out of control, forming a tumor. In some cases, the tumor spreads into the bladder muscle. Bladder cancer is rare. It accounts for just 5% of all new cancers in the U.S.
CAUSES OF BLADDER CANCER
Doctors are still not sure as to what factors specifically cause bladder cancer. But they do know that several things increase your risk for the disease. Causes of bladder cancer mainly includes the following-
· Exposure to certain industrial chemicals
· Taking certain diabetes medications.
· Prior chemo or radiation treatment
· Chronic bladder inflammation.
· Genetic makeup, race, and family history.
· Long-term bladder stones
· Having an early menopause (before the age of 45)
· An untreated infection called schistosomiasis, which is caused by a parasite that lives in fresh water.
· Being older, more likely if older than 65 years.
· Gender, as men are 3 to 4 times more likely to develop bladder cancer than women.
SYMPTOMS OF BLADDER CANCER
Blood in your urine is the most common symptom of bladder cancer.The medical name for this is haematuria and it's usually painless. You may notice streaks of blood in your urine or the blood may turn your urine brown. It may turn orange, pink, or darker red. You may see blood one day, but not the next.
People with bladder cancer may experience the following symptoms or signs. Sometimes, people with bladder cancer do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer.
· Blood or blood clots in the urine
· Pain or burning sensation during urination
· Frequent urination
· Feeling the need to urinate many times throughout the night
· Feeling the need to urinate, but not being able to pass urine
· Lower back pain on one side of the body
· Losing weight without planning for it
· Not feeling hungry as usual
· Swelling of the legs and feet
· Often feeling extremely tired or weak.
If you ever have blood in your urine, no matter if it is visible regularly or not, you should visit your doctor, so the cause can be investigated. They could also signal that you have something other than bladder cancer.
DIAGNOSIS OF BLADDER CANCER
Doctors use many tests to find, or diagnose, cancer. Your doctor probably will ask you about your complete medical history. He may ask about your symptoms, family history and whether you've been exposed to any possible causes of bladder cancer. A urine sample may be collected to be tested in a laboratory for traces of blood, bacteria or abnormal cells.
The following tests and procedures may be used:
Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Internal exam : An exam of the vagina and/or rectum. The doctor inserts lubricated, gloved fingers into the vagina and/or rectum to feel for lumps.
Urinalysis : A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
Urine cytology : A laboratory test in which a sample of urine is checked under a microscope for abnormal cells.
Cystoscopy : A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
STAGES AND GRADES OF BLADDER CANCER
After completing these necessary tests, the doctor would be able to tell the grade of the cancer and what stage it is.
Staging is a measurement of how far the cancer has spread. Lower-stage cancers are smaller and have a better chance of successful treatment.
Grading is a measurement of how likely a cancer is to spread. The grade of a cancer is usually described using a number system ranging from G1 to G3. High-grade cancers are more likely to spread than low-grade cancers.
The most widely used staging system for bladder cancer is known as the TNM system, where:
T stands for how far into the bladder the tumour has grown
N stands for whether the cancer has spread into nearby lymph nodes
M stands for whether the cancer has spread into another part of the body (metastasis), such as the lungs.
Your doctor will assign a number or letter after T, N, and M. The higher the number, the more the cancer has spread. Once T, N, and M stages is determined, your doctor will use this information to give you an overall cancer stage. The following stages are used for bladder cancer:
Stage 0 (Noninvasive Papillary Carcinoma and Carcinoma in Situ)
Stage 0: In stage 0, abnormal cells are found in tissue lining the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stages 0a and 0is, depending on the type of the tumor.
Stage I: In stage I, cancer has formed and spread to the layer of connective tissue next to the inner lining of the bladder.
Stage II: In stage II, cancer has spread to the layers of muscle tissue of the bladder.
Stage III: Stage III is divided into stages IIIA and IIIB.
In stage IIIA,
· cancer has spread from the bladder to the layer of fat surrounding the bladder and may have spread to the reproductive organs (prostate, seminal vesicles, uterus, or vagina) and cancer has not spread to lymph nodes; or
· cancer has spread from the bladder to one lymph node in the pelvis that is not near the common iliac arteries (major arteries in the pelvis)
In stage IIIB,
· cancer has spread from the bladder to more than one lymph node in the pelvis that is not near the common iliac arteries or to at least one lymph node that is near the common iliac arteries.
Stage IV: Stage IV is divided into stages IVA and IVB.
In stage IVA:
· cancer has spread from the bladder to the wall of the abdomen or pelvis; or
· cancer has spread to lymph nodes that are above the common iliac arteries (major arteries in the pelvis).
In stage IVB,
· cancer has spread to other parts of the body, such as the lung, bone, or liver.
TREATMENT OF BLADDER CANCER
Different types of treatment are available for patients with bladder cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials.
There are four types of standard treatment that are used-
· Radiation therapy
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
The more information you have about the stage of your bladder cancer, the better able you’ll be to choose the right treatment option for you.