Bladder cancer is cancer that forms in the cells of the bladder. Males and smokers have twice the risk of bladder cancer than the general population. When diagnosed and treated at a localized stage, bladder cancer is highly treatable, with a 5-year cancer-specific survival approaching 95%.
Smoking is the most important risk factor for bladder cancer. The incidence increases in people 50 years of age or older. Chronic bladder problems, such as infections and kidney stones, may also be risk factors, although a direct link has not been confirmed.
Types of bladder cancer
The different types of bladder cancer are:
Transitional cell bladder cancer: About 90% of bladder cancers are transitional cell carcinomas, that is, cancers that start in the cells that line the bladder. Cancer that is confined to the lining of the bladder is superficial bladder cancer.
Squamous cell bladder cancer: Bladder cancer that begins in squamous cells, which are thin, flat cells that can form in the bladder after long-term infection or irritation.
Adenocarcinoma: Bladder cancer that begins in the inner lining of the bladder because of chronic irritation and inflammation.
Symptoms of bladder cancer
The most common symptom of bladder cancer is blood in the urine (hematuria), which makes the urine turn rusty or deep red. However, hematuria is not always visible to the naked eye and can also be a symptom of other conditions, such as kidney stones and urinary tract infection. If you have hematuria or any of the other symptoms of bladder cancer listed below, see your doctor:
- Pain when urinating
- Frequent urination
- Urge to urinate, but without success
There are no absolute methods to prevent bladder cancer. Abstaining from smoking is the best way to reduce your risk of bladder cancer. It is recommended that people who are exposed to aromatic amines in their work environment always follow healthy work habits. Other healthy practices, such as drinking plenty of fluids (mainly water) and eating a diet rich in fruits and vegetables, have been shown to protect against bladder cancer.
Although the exact cause of bladder cancer is unknown, different studies have identified the following risk factors for this disease:
Age: The chance of getting bladder cancer increases with age and is rare in people under 40 years of age.
Tobacco: Tobacco use is a major risk factor for bladder cancer. Smokers, including those who smoke cigars and pipes, are two to three times more likely than non-smokers to develop the disease.
Sex: Men are two to three times more likely than women to develop bladder cancer.
Family history: People with a family history of bladder cancer are more likely to develop the disease than those without such a family history. Studies are ongoing to determine whether certain genes increase the risk of developing the disease.
Personal history of bladder cancer: Bladder cancer has a recurrence rate of 50% -80%, the highest of all cancers, including skin. Survivors of bladder cancer are more likely to have the disease again.
Profession: Workers exposed to high amounts of carcinogens in the workplace are at increased risk. This includes the rubber, chemicals, and leather sectors, along with hairdressers, machinists, metal workers, printers, painters, textile workers, and truck drivers.
Infections: People infected with certain parasites are at increased risk of bladder cancer. These parasites are often prevalent in more tropical climates.
Cyclophosphamide or arsenic treatment: These drugs are sometimes used to treat cancer and other diseases and increase the risk of bladder cancer.
Bladder cancer can be diagnosed by a cystoscopy, imaging test, or cytology procedure. Patients considered high-risk must undergo one or more of these procedures regularly to detect the cancer at a more treatable early stage.
People at high risk for bladder cancer are:
- Minimum age of 50 years with hematuria (blood in urine)
- Under 50 years of age with visible hematuria
Cystoscopy is the most common and reliable test to detect bladder cancer. A thin tube with a camera (cystoscope) is inserted into the bladder through the urethra to view the suspicious area. The cystoscope can also be used to obtain a tissue sample for biopsy, as well as to treat superficial tumors without surgery. However, cystoscopy is not perfect. You can miss flat lesions (carcinoma in situ) and small papillary tumors. MD Anderson recommends combining cystoscopy with the other tests listed below to achieve the most accurate diagnosis possible.
Imaging studies, such as computed tomography (CT), ultrasound, or intravenous pyelography (IVP), supplement the information provided by cystoscopy. An IVP involves the injection of a contrast that is seen on an X-ray as it travels through the urinary system.
Urine tests use a urine sample to determine the presence of cancer. Cytology is the oldest test of this type and consists of examining the sample under a microscope to identify the presence of abnormal cells. There are several types of urine tests available that focus on specific “markers” for bladder cancer. The urologist will choose the most appropriate test for each patient.