The bladder is an organ of the urinary system that’s responsible for storing urine. It’s located in the lower area of the pelvis and is made up of flexible walls that have the ability to stretch, grow, and contract when needed. When the bladder is full, a signal is sent to the brain indicating that it’s time to expel stored urine. During urination, the bladder muscles contract to force the urine from the bladder, through the urethra, and out of the body. While there are several conditions that can affect the bladder and how it functions, one of the most serious is bladder cancer. Here, we’ll discuss important information needed for understanding the basics of bladder cancer.
What is Bladder Cancer?
Bladder cancer develops when the cells inside the bladder lining begin to multiply and grow out of control. Most commonly, this growth occurs in the urothelial cells, which also line the ureters and renal pelvis. This can lead to the formation of tumors and without treatment, the cancer can metastasize (spread) to other areas of the body. Bladder cancer is one of the most common cancers of the United States. However, it can be difficult to detect without understanding the warning signs. Bladder cancer can also mimic other conditions that affect the urinary system, making it essential to find a urologist and see them regularly.
Different Types of Bladder Cancer
Bladder cancer can be described as either noninvasive, non-muscle invasive, or muscle invasive. Noninvasive bladder cancer is considered an accessible growth that’s found on a small section of bladder tissue. It’s usually easily removed and considered very easily treatable. Non-muscle invasive bladder cancer describes cancer that has grown into the connective tissue in the bladder but has not yet reached the muscular lining. This does not necessarily mean that the cancer is less invasive or serious, it could just be in early stages. Muscle invasive bladder cancer refers to cancer that has passed into the wall muscles and/or beyond. Since invasive cancers have already spread into deeper layers of the bladder, they’re often more aggressive and harder to treat.
The type of bladder cancer depends on the cells within the tumor, which can be determined by a biopsy. The different types of bladder cancer are as follows:
Urothelial Carcinoma
Urothelial carcinoma, also referred to as transitional cell carcinoma, is a type of bladder cancer that starts in the urothelial cells lining the bladder’s interior walls. This is the most common type of bladder cancer that affects individuals. Since urothelial cells are also present in various parts of the urinary tract, it’s important to check for signs of tumor growth there as well. Nine out of 10 cases of bladder cancer are urothelial carcinomas.
Squamous Cell Carcinoma
Squamous cell carcinoma is a rare type of bladder cancer that produces flat cells. While they only account for about 1% to 2% of bladder cancer diagnoses, it’s often a more invasive type that doesn’t respond as well to treatment.
Adenocarcinoma
Adenocarcinoma is one of the rarest types of bladder cancer, as it only accounts for roughly 1% of all cases. This type of bladder cancer is also extremely invasive and requires an aggressive approach to treatment.
Small Cell Carcinoma
Small cell carcinoma bladder cancer also accounts for about 1% or fewer cases. This begins in the neuroendocrine cells and tends to grow quickly. Treatment is similar to small cell carcinoma of the lungs.
Sarcoma
Sarcomas begin in the muscle cells of the bladder, making them some of the most difficult types of bladder cancer to treat. However, bladder sarcomas are extremely rare.
Bladder cancer can be further divided into two different subtypes. These classifications refer to how the cancer grows and can either be papillary carcinomas or flat carcinomas. Papillary carcinomas tend to grow in finger-like projections from the inner surface of the bladder towards the center, often without reaching deeper layers of the bladder. They’re usually considered non-invasive and slow growing. Flat carcinomas do not grow towards the center, hollow part of the bladder. Instead, they spread over the plane of the inner lining. Your doctor can discuss the differences between papillary and flat bladder cancer with you in more detail.
Risk Factors for Bladder Cancer
While most bladder cancer diagnoses occur in older individuals, it can affect people of all ages. Some of the biggest risk factors for bladder cancer include the following:
- Over the age of 65
- Men
- Smoking
- Family history
- Genetic mutations
- Pelvic radiation exposure
- Recurrent bladder infections
- Neurogenic bladder
- Overuse of indwelling catheters
- Exposure to certain medications
- Occupational exposure to chemicals
There are several ways to reduce your risk of developing bladder cancer, but it’s also important to understand warning signs so you can seek treatment as soon as possible. Since there are currently no preventative screening processes available, detecting abnormalities is the best option for a positive prognosis.
Bladder Cancer Symptoms
The most common symptom of bladder cancer is hematuria, or blood in the urine. While this doesn’t necessarily mean that you have bladder cancer, it should not be ignored. If you have any signs of hematuria, it’s important to schedule an appointment with your urologist as soon as possible. This will help you determine the underlying cause and ensure the appropriate treatment is taken in a timely manner.
In addition to hematuria, symptoms of bladder cancer include:
- Increased urgency
- Nocturia
- Pain or burning with urination
- Increased frequency of urination
- Urinary blockages
- Infection
- Kidney damage
- Pain in the lower back or abdomen
If there are any changes in your bathroom habits that can’t be associated with other lifestyle alterations, contact your urologist for a health assessment as soon as possible.
Diagnosing Bladder Cancer
Individuals who show symptoms of bladder cancer should schedule an appointment with their urologist to undergo diagnostic testing. During this time, your doctor will ask you a series of medical questions, record your family history, and discuss any symptoms you may be experiencing. After the initial screening, your doctor will likely perform one or more tests. These include the following:
Cystoscopy
During a cystoscopy, your doctor will enter a small, narrow tube that has a lens attached to one end into your bladder. This tube (cystoscope) can be maneuvered around the interior walls of your urethra and bladder to look for signs of damage or disease. It is a minimally invasive test that can be done either in your urologist’s office or in a hospital.
Biopsy
A biopsy is performed to test the cells of the bladder and examine them under a microscope to identify the progression of cancer. A specialized tool will be used to minimize invasiveness and maximize post-biopsy healing. This procedure, also referred to as a transurethral resection of bladder tumor (TURBT) can also be used to treat small tumors present.
Urine Cytology
A urine cytology will test a sample of your urine to check for the presence of any cancer cells. The sample is collected in the same manner as a urinalysis.
Imaging
Imaging tests like CT scans, X-rays, or ultrasounds can also be used to help assess structures of your urinary tract for damage or signs of cancer cells.
Bladder Cancer Prognosis
During diagnostic testing, your doctor will get a better understanding of the severity, progression, and aggressiveness of your bladder cancer. This may lead to additional tests to better understand the extent or stage of the cancer cells present. Lower stages of cancer indicate that the cells affected are confined to the inner layers of the bladder, which is much easier to treat. When cancer has spread to the highest stage—stage IV—it has reached the lymph nodes and becomes harder to treat. Your treatment plan will depend on the stage and aggressiveness of the cancer.
While bladder cancer has a high survival rate when caught early, later stages can be more difficult to treat. The best way to be proactive about your bladder health is to live a healthy lifestyle and see your urologist regularly. If you’re diagnosed with bladder cancer, your doctor will work with you to create a customized treatment plan that’s specific to your needs. If you have any questions, don’t hesitate to ask your doctor. Regardless of if you experience a bladder cancer diagnosis or are suffering from another urologic condition, Byram Healthcare provides supportive products to help you manage your symptoms.
Byram Healthcare is a member of the National Association for Continence’s Trusted Partners Program, whose mission is to provide quality continence care through education, collaboration and advocacy. We continue to build partnerships in the clinical community to ensure we focus on what’s best for the patient.
