Bladder cancer

Urinary bladder and bladder cancer

The urinary bladder is a hollow organ in which urine from the kidneys is collected. The organ lies at the bottom of the abdominal cavity, is about the size of a grapefruit and is elastic: the bladder can grow bigger and smaller. Bladder cancer is a disease in which uncontrolled, malignant cells begin to grow in the bladder.

At an early stage, care professionals often refer to a bladder polyp. Therefore, a bladder polyp is malignant, but it is not yet very aggressive and has not yet grown very much. If a bladder polyp remains undiscovered, it can continue to grow, proliferate and spread: it is no longer referred to as a polyp, but as real bladder cancer.

Risk factors

Smoking

There is a causal link between smoking and the development of bladder cancer. Also, if you have smoked for a long time and have smoked many cigarettes each day, you are even more likely to get bladder cancer.

Occupational risks

Some industrial chemicals are associated with bladder cancer. Certainly when there has been prolonged exposure (years). Products used by rubber, leather, textile and dye manufacturers and printers can cause bladder cancer.

Age

The risk of bladder cancer increases with age. More than 70% of people with bladder cancer are over 65 years of age.

Gender

Bladder cancer is more common in men than in women. Bladder cancer in women, on the other hand, is characterised by a poorer prognosis for reasons that are unclear.

Genetics

Bladder cancer is more common in families. People who have family members who have or have had bladder cancer have a higher risk of developing bladder cancer. It is suspected that certain genetic abnormalities are the cause of this.

Chemotherapy and radiation therapy

High doses of cyclophosphamide (Cytoxan), a medicine used in the treatment of cancer, increase the risk of bladder cancer. People who have received radiation therapy in the lower abdomen (e.g. in the treatment of gynaecological cancer or as a treatment for prostate cancer) are also at greater risk for bladder cancer.

Symptoms

Common symptoms of bladder cancer include:

• Blood in the urine (causing the urine to change from slightly rusty to deep red)
• Pain while urinating
• Often having to pee or feeling the urge to pee, but not being able to do so.
• Lower back pain

These symptoms are not definitive indications of bladder cancer. Infections, benign tumours, bladder stones or other problems can also be the cause.

How is the diagnosis determined?

Bladder cancer goes through different stages and there are different diagnostic tests to determine the disease and how advanced it is.

• Urine analysis
• Urinary cytology: urine is examined under a microscope for the presence of abnormal cells.
• Internal examination: the vagina and/or rectum are examined for the presence of nodules.
• Cytoscopy: visual examination of the bladder and urethra in search of abnormal areas.
• MRI scan: to visualise the immediate environment of the bladder tumour
• CT scan: to visualise the tumour and to check whether there is metastasis in the abdomen.
• Biopsy: a piece of tissue is removed from the tumour, examined microscopically and checked for evidence of cancer.

Treatment

The prognosis or likelihood of recovery depends on the stage of the cancer, the exact type of cancer, the patient's age and general health condition. Early detection is vitally important, as most types of bladder cancer can be cured at an early stage. Fortunately, bladder cancer is also usually diagnosed at an early stage (75% of diagnoses).

There are four treatment options for bladder cancer:

• Oncological surgery
• Radiation
• Chemotherapy
• Immunotherapy

Depending on the type and stage of bladder cancer, different treatments can combined to increase the chances of recovery. For bladder cancer (not for bladder polyps), surgery (radical cystectomy) is the gold standard treatment, alone or in combination with another treatment.

Latest publication date: 14/05/2024
Supervising author: Dr Ameye Filip