A Comprehensive Overview
Bladder cancer is a type of cancer that originates in the bladder, a hollow organ in the pelvis that stores urine. It’s the 10th most common cancer worldwide, with a higher incidence in men than women.
Types of Bladder Cancer
1. Transitional Cell Carcinoma (TCC): The most common type, accounting for about 90% of cases. It starts in the urothelial cells lining the bladder.
2. Squamous Cell Carcinoma: Associated with chronic irritation or infection, this type is more common in areas with schistosomiasis.
3. Adenocarcinoma: A rare type, often linked to urachal remnants or glandular metaplasia.
4. Small Cell Carcinoma: An aggressive and rare type, often presenting with widespread disease.
Causes and Risk Factors
1. Smoking: The leading cause, responsible for about 50% of cases.
2. Chemical Exposure: Aromatic amines and other industrial chemicals increase risk.
3. Infections: Chronic urinary tract infections or schistosomiasis.
4. Family History: Increased risk with a first-degree relative.
5. Age and Gender: More common in men over 55.
Symptoms
1. Painless Hematuria: Blood in urine, visible or microscopic.
2. Urinary Frequency and Urgency: Often mistaken for UTI.
3. Dysuria: Painful urination.
4. Pelvic Pain: Advanced disease.
Diagnosis
1. Urine Tests: Cytology, FISH, or NMP22.
2. Cystoscopy: Gold standard for diagnosis.
3. Imaging: CT urogram or MRI for staging.
4. Biopsy: Confirms diagnosis and type.
Treatment Options
1. Surgery: TURBT (transurethral resection of bladder tumor) or cystectomy.
2. Chemotherapy: Intravesical (BCG) or systemic.
3. Immunotherapy: Checkpoint inhibitors for advanced disease.
4. Radiation Therapy: For muscle-invasive or inoperable cases.
Prognosis
Depends on stage and grade at diagnosis. Non-muscle invasive bladder cancer has a high recurrence rate, while muscle-invasive disease has a poorer prognosis.
Prevention
1. Quit Smoking: Reduces risk significantly.
2. Avoid Chemical Exposure: Use protective gear and follow safety protocols.
3. Stay Hydrated: May help flush out carcinogens.
Bladder cancer requires a multidisciplinary approach for optimal management. Early detection and treatment can significantly improve outcomes.
Dr. V. Manjunath
MBBS, MS – General Surgery, MCh – Urology
Consultant – Urology and Andrology
