Bladder Cancer

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Bladder Cancer Facts

The bladder is the organ in your body that stores urine. The majority (90 to 95 percent) of bladder cancers begin in the cells of the inner lining of the bladder and are called transitional cell (or urothelial) carcinomas.

More rare types of bladder cancers include:

  • Squamous cell carcinomas, which begin in the thin, flat cells of the bladder.
  • Adenocarcinomas, which begin in cells that make and release mucus and other fluids. These can develop in the inner lining of the bladder because of chronic irritation and inflammation.
  • Small-cell carcinomas, which originate in signaling stem cells in the bladder. 

The different types of bladder cancers require very different treatments. About 75 percent of transitional cell bladder cancers are noninvasive (also called superficial) at the time of diagnosis. The remaining 25 percent of these cancers are invasive, requiring more complicated treatment. Although commonly referred to as bladder cancer, this cancer can be found in the urethra, bladder, ureters, and kidneys.  

Symptoms

Like most cancers, bladder cancer can be hard to diagnose initially. While there are several symptoms you should be aware of, many other conditions also cause the same symptoms. Anyone exhibiting the following symptoms should consult a doctor immediately:

  • Blood (a rusty, red or pink hue) or blood clots (dark particles) in the urine
  • Frequent urination 
  • Needing to urinate but not being able to
  • Pain during urination

Diagnosis

If your doctor suspects that you may have bladder cancer, several methods are used to help make a diagnosis.

  • Microscopic urinalysis: Testing your urine will help rule out infections. It will also help determine if there is blood (hematuria), sugar, bacteria, and proteins that should not be present.
  • Urine cytology: This testing of your urine helps to identify cancerous cells. It is often combined with fluorescent in-situ hybridization (FISH) or protein tests to identify bladder cancer. 
  • Physical exam: A doctor will examine your rectum or vagina to feel for bumps that may indicate cancerous tumors. 
  • Cystoscopy: A urologist uses a cystoscope (a thin camera inserted through the urethra) to examine your bladder. The cystoscope can also be used to take a tissue sample (biopsy) to help determine the type and stage of the cancer. 
  • Imaging tests: Tests, such as magnetic resonance imaging (MRI), computed tomography (CT), X-rays, ultrasound, and bone scans can help the doctor determine whether the cancer has spread.

Risk Factors

As with most cancers, there is no definitive cause of bladder cancer. Research has found many links between heredity, diet, smoking, exposure to environmental conditions, and other factors that increase a person’s chance of developing bladder cancer. The following factors may increase bladder cancer risk:

  • Smoking: Smokers are two to four times as likely to develop bladder cancer as nonsmokers, making smoking the most significant risk factor. Smoking is estimated to be responsible for 47 percent of bladder cancers in men and 37 percent in women. 
  • Race: Caucasians are at highest risk. Bladder cancer is diagnosed twice as often in Caucasians as African Americans. Hispanics have a lower risk than both groups. African Americans tend to be diagnosed with a more advanced form of the cancer. Bladder cancer is also twice as likely to be fatal to African Americans. 
  • Gender: Men are four times as likely to be diagnosed with bladder cancer as women are. Bladder cancer is the fourth most diagnosed cancer in men. 
  • Genetics: Some people are genetically predisposed to be more sensitive to carcinogens and can develop cancer at higher rates. 
  • Cyclophosphamide and arsenic: People who have taken the drug cyclophosphamide, used to treat some cancers, are at a higher risk for bladder cancer. Similarly, people who use, or have used, arsenic to treat cancer and other conditions are at an increased risk. 
  • Age: Nearly 90 percent of all cases of bladder cancer are found in people over the age of 55. 
  • Family history: People with family members who have been diagnosed with bladder cancer are at greater risk. 
  • Chronic bladder inflammation: People who have had chronic bladder inflammation, such as from recurring bladder infections, kidney stones, and bladder stones, are at greater risk.