Bladder cancer is a type of cancer that begins in the cells of the bladder, an organ in the lower abdomen that stores urine. Most bladder cancers start in the cells that line the inside of the bladder, known as urothelial cells (formerly called transitional cells), and are referred to as urothelial carcinoma.
The exact cause of bladder cancer is not fully understood, but several risk factors can increase the likelihood of developing the disease. These include smoking (the most significant risk factor), exposure to certain chemicals, chronic bladder infections, and a family history of the disease.
There are two main types of bladder cancer:
Symptoms of bladder cancer can include:
Bladder cancer is caused by a variety of factors, including:
Bladder cancer is staged based on how far the cancer has spread. The main stages include:
The diagnosis of bladder cancer typically involves several steps, including medical history evaluation, physical examinations, and various diagnostic tests. The goal is to confirm the presence of cancer, determine its type, and assess how far it may have spread (its stage).
- Your doctor will ask about any symptoms you're experiencing (e.g., blood in urine, pain, urinary issues) and any risk factors (e.g., smoking history, exposure to chemicals, family history of bladder cancer).
- Physical exams may include palpating the abdomen to check for abnormal masses.
- **Urinalysis**: A routine urine test to identify blood or other abnormalities.
- **Urine cytology**: This test looks for abnormal cells in the urine.
- **Urinary biomarkers**: Special tests to detect cancer-related markers in the urine.
- **Cystoscopy**: A thin, flexible tube with a camera is inserted through the urethra to directly visualize the bladder.
- **CT Scan/MRI**: These imaging techniques help visualize the bladder and check for spread to other organs or tissues.
- A biopsy may be taken during cystoscopy to analyze tissue for cancer cells.
- Further tests like CT/MRI of the chest or bone scans may be done to assess cancer spread.
The treatment of bladder cancer depends on several factors, including the cancer's stage, grade, and the patient's overall health. Treatment options include:
Surgery is often the primary treatment for bladder cancer. It can involve:
- **Intravesical chemotherapy**: Chemotherapy drugs are delivered directly into the bladder.
- **Systemic chemotherapy**: Used for muscle-invasive or advanced bladder cancer, delivered through intravenous infusion.
Immunotherapy uses the body's immune system to fight cancer. Examples include BCG therapy and checkpoint inhibitors (e.g., pembrolizumab, atezolizumab).
Radiation therapy may be used to shrink tumors or treat symptoms in advanced cancer cases.
Targeted therapies aim to attack cancer cells specifically. One example is erdafitinib, which targets specific genetic mutations in cancer cells.
For advanced stages, palliative care focuses on symptom management and improving quality of life.
Treatment for bladder cancer varies depending on its stage and grade. Early-stage bladder cancer typically has a high cure rate, while more advanced cancer requires a multi-faceted approach.