Cancerous Diseases

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Bladder Cancer

Overview:

The tumor often starts in the innermost layer of the bladder and may attack the rest of the bladder.
The cause of this cancer is still unknown; however, there are risk factors that could increase the likelihood of its occurrence.
Smoking is the most common risk factor for bladder cancer.
Its symptoms are similar to other urinary tract diseases. This is why you should see a doctor to confirm the diagnosis.
It is crucial to see a doctor right away if you notice blood in your urine, even if it appears inconsistently.
There is no sure way to prevent it; however, it is possible to reduce its occurrence by avoiding risk factors.

What is cancer?

It is a common term for tumors that affect body organs. There are two types of tumors: Benign tumors and malignant tumors (known as cancerous tumors). They are distinguished by examining the organ tissues (biopsy).

Bladder:

It is a hollow, expandable muscular organ located in the pelvis (lower part of the abdomen). Its function is to collect urine produced by the kidneys until a person is ready to expel it.

What is bladder cancer?

Most types of cancer are named after the place of the body where they form, so a tumor that appears in the bladder is called “bladder cancer”. Most types of bladder cancer begin appearing in the inner layer. The condition gets worse as the tumor increases in size and attacks the rest of the layers. Over time, it may grow outside the bladder all the way to the lymph nodes and other organs (e.g. Bones, lungs, liver, etc).

Types of bladder cancer:

The most common type is urothelial carcinoma, (formerly known as: transitional cell carcinoma). This type starts in the inner cells lining the bladder and can spread to other parts of the urinary system.

Less common types: Squamous cell carcinoma, adenocarcinoma, and other types.

Cancer classification according to how far the tumor has penetrated the bladder layers:

Non-invasive cancer: It is the type of cancer that stays in the inner layer of the bladder and does not extend to other layers.
Invasive cancer: It is the type of cancer that penetrates other layers of the bladder lining. It can spread to other areas and is often difficult to treat.

Classification of cancer according to the way the tumor grows:

Papilloma: It grows in a cylindrical shape starting from the inner layer of the bladder towards the inside. This type is called: Non-invasive papilloma.
Flat tumor or carcinoma in situ (CIS): It only grows on the bladder lining.

Cause:

The cause of this cancer is still unknown; however, there are risk factors that could increase the likelihood of its occurrence.

Risk factors:

Smoking: It is the most common risk factor for bladder cancer.
Family history.
Exposure to direct radiation on the pelvis.
Radiation therapy used to treat other types of cancer that formed in an area near the bladder (e.g. Colon cancer).
Exposure to chemotherapy to treat other types of cancer.
Exposure to pollutants at a workplace (e.g. Chemicals used to manufacture plastics, dyes, rubber, etc.).
Frequent and chronic urinary tract irritation (e.g. urinary tract infections, kidney and bladder stones, prolonged urinary catheterization, etc).
Some types of parasitic infections.

Who is at high risk?

Gender: Men are more prone to bladder cancer than women.
Age: Anyone can get bladder cancer; however, older age makes a person more susceptible to it.

Symptoms:

The most common symptom is bloody urine, which is usually not accompanied by pain. The blood may not be very clear in the urine.
Frequent urination
Painful urination
Pain in the lower part of the abdomen
Back pain
Sudden need to urinate

In more advanced cases, the following symptoms may appear:

Inability to urinate
Loss of appetite and weight
Fatigue
Feet pain
Bone pain

The previous symptoms do not necessarily mean that you have bladder cancer. They may be the result of another health problem. Consequently, it is necessary to conduct a medical examination to find out the cause and treat it.

When to see a doctor?

When blood appears in the urine (even if it appears inconsistently), along with other worrisome symptoms, it is essential to see your doctor.

Complications:

Psychological effects: increased risk of depression
Urinary tract inflammations
Urinary retention
Enlarged kidney
Tumor recurrence
Sexual problems: Erectile dysfunction and vaginal tightness.
Urinary incontinence (UI)
Post-surgery complications (e.g. inflammation at the place of the surgery).

Diagnosis:
Medical history
Clinical examination
Laboratory tests: A urine analysis is done to look for other potential causes of the symptoms.
Cystoscopy.
Bladder biopsy.
Other screenings, including: CT scan, MRI, bone examination, and chest x-ray.

A regular check-up is necessary following your recovery from bladder cancer because it can reoccur.

Treatment:

There are many treatment methods. Choosing the most proper treatment method for your case depends mainly on the type of bladder cancer, its size, the stage it has reached, and your health in general. Treatment methods include:

Surgery, including: Removing the tumor or all or part of the bladder (cystectomy).
Surgery to create a urinary tract after cystectomy.
Radiation therapy
Chemotherapy
Immunotheraphy
Palliative care.

Prevention:

There is no sure way to prevent it; however, it is possible to reduce its occurrence by avoiding risk factors.
If you are a smoker, quit smoking. If you are not a smoker, do not get exposed to second-hand smoke.
Be cautious when you handle chemicals at your workplace, and make sure you follow safety instructions.
Try to eat healthy foods with lots of vegetables.
Drink enough fluids (especially water).

Myths & Truths:

Holding my urine can cause bladder cancer.

Incorrect. However, it may be a risk factor among others (e.g. the spread of parasitic and bacterial infections that could affect the bladder lining) leading to changes, along with other genetic factors and your personal susceptibility to infection.

Clinical Education General Department

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