Overview of Bladder Cancer

What is Bladder Cancer?

• Bladder cancer is a type of cancer that occurs in the bladder – a hollow organ located in the lower abdomen that stores urine excreted by the kidneys.
• Inside the bladder wall is a mucosal layer made up of transitional cells and squamous cells. About 90% of bladder cancers originate from transitional cells, called transitional carcinoma. Only about 8% of bladder cancers are squamous carcinoma.

Causes of Bladder Cancer

• The cause of bladder cancer is still not completely clear, there are cases of bladder cancer where the cause is not found.
• Bladder cancer is related to smoking, exposure to radiation, parasitic infections, and exposure to chemicals.
• The nature of bladder cancer is that the cells in the bladder are mutated. Normal cells will grow abnormally, uncontrollably, and form tumors in the bladder.

Symptoms of Bladder Cancer

Symptoms of bladder cancer are often difficult to recognize. However, there are signs that can help patients detect the disease early so that they can promptly go to a medical facility for examination, such as:

• Fatigue, weight loss, loss of appetite
• Hematuria is the most common sign. Intermittent hematuria, gross hematuria, total hematuria.
• Pain when urinating
• Urinary frequency, difficulty urinating, incontinence, dark urine: these are the first symptoms to appear, due to bladder irritation or reduced volume.
• Symptoms of urinary tract infection, urinary tract obstruction due to invasive tumor or blood clot.

In the late stages of bladder cancer, cancer cells have metastasized, the following symptoms will appear:

• Back pain
• Pain above the pubic bone
• Lower abdominal pain
• Perineal pain
• Bone pain
• Headache

Subjects at risk for bladder cancer

Like the cause of the disease, the risk factors for bladder cancer have not been clearly studied. Some common risk factors leading to bladder cancer are:

• Older people are at higher risk of bladder cancer than younger people.
• Caucasians are more likely to get bladder cancer than people of other races.
• Men are more likely to get bladder cancer than women.
• A family history of bladder cancer is a risk factor for the disease.
• People who have had bladder cancer are also likely to relapse because treatment with the anti-cancer drug cyclophosphamide increases the risk of bladder cancer.
• Smokers are two to three times more likely to develop bladder cancer than non-smokers.
• Occupations that are susceptible to cancer include rubber, chemical, leather, hairdressers, metalworkers, printers, weavers, and truck drivers. These are occupations that involve frequent exposure to carcinogens.
• People infected with parasites are also at risk of bladder cancer.
• In addition, chronic cystitis, recurrent urinary tract infections, or long-term use of urinary catheters can also cause bladder cancer.

Bladder Cancer Prevention

To prevent bladder cancer, the following should be done:

• Do not smoke
• Avoid exposure to chemicals and new water sources
• Drink plenty of water every day.
• A reasonable diet with lots of green vegetables and fruits.
• Regular health check-ups.

Diagnosis of bladder cancer

To diagnose bladder cancer, the following methods must be performed:

• Urine test to find cancer cells.
• Cystoscopy: using an endoscope inserted into the urethra for examination.
• Biopsy: a biopsy is performed during cystoscopy to take a small tissue sample for examination.
• Intravenous contrast imaging: the patient is injected with contrast into the vein, then excreted by the kidney and reaches the bladder. At this time, an X-ray will show abnormal images of the bladder.
• Computerized tomography can be used to observe the urinary tract and the tissue around it.

Bladder cancer treatment methods

Currently, bladder cancer treatment is very effective, the disease can be easily cured if we detect and treat it at an early stage. There are methods to treat bladder cancer today such as:

Surgery to treat bladder cancer

Is a common method of treating bladder cancer. Surgeries include: removal of bladder cancer tumor urethra, partial cystectomy, radical cystectomy, removal of nearby lymph nodes, partial urethral resection… For men, surgery can remove the prostate, seminal vesicles and part of the vas deferens, women can remove the uterus, ovaries, fallopian tubes and part of the vagina.

Chemotherapy

Injecting chemicals into the body to fight cancer cells. Drugs can be combined to treat patients. Chemotherapy can be used alone or in combination with both surgery and radiation therapy. If the bladder cancer is still superficial, the patient will be given chemotherapy into the bladder after transurethral bladder tumor removal surgery.

Radiation therapy

Radiotherapy before surgery to reduce the size of the tumor.

Radiotherapy after surgery to completely destroy cancer cells.

Patients who cannot have surgery will undergo radiation therapy including internal radiation therapy and external radiation therapy.

In addition, bladder cancer is also treated with a number of other methods such as: biological therapy (immunotherapy): This method is applied after transurethral surgery for tumors on the surface of the bladder, using the existing immune system to fight cancer cells. This is a measure to prevent the recurrence of bladder cancer.