Bladder Cancer

Bladder Cancer

Overview

The urinary bladder is a muscular organ in the lower abdominal cavity and its function is to store urine.

The most common type of bladder cancer is urothelial carcinoma, which accounts for approximately 85% of all bladder cancers.

Other types of bladder cancer include squamous cell carcinoma and adenocarcinoma. These types of cancer only account for a small percentage of bladder cancers (1-2%), but are aggressive (grow quickly).

Bladder cancer can be either:

Non-muscular-invasive bladder cancer – where cancer cells are only found in superficial inner layers

Muscular-invasive bladder cancer – where cancer cells have spread beyond the first two layers of the bladder into the muscle layer or into nearby tissue.

Risk Factors

  • Smoking is the leading modifiable risk factor for bladder cancer, causing approximately 50% of all bladder cancers in both men and women.
  • Exposure to chemicals in the workplace such as aromatic amines, used in the dye, paint and textile industry increase the risk of bladder cancer.
  • Age – bladder cancer risk increases with age, with most people being over 60 years of age when diagnosed.
  • Repeated urinary infections– such as a urinary tract infection (UTI), bladder stones or kidney infections can increase the risk, as well as long-term use of catheters.
  • Previous chemotherapy or radiation therapy – certain chemotherapy drugs and radiation to the pelvis area can increase the risk for bladder cancer.

What are the signs and symptoms?

  • Gross Painless haematuria in 80-90% patients. Painless haematuria must be treated as malignancy of the urinary tract until proved otherwise.
  • Advanced disease may cause urine voiding related symptoms
  • Lower abdominal pain in advanced cancers
  • Patients with metastatic disease may present with symptoms related to organs involved

Evaluation

  • Urine analysis to look for microscopic hematuria
  • Complete blood panel evaluation
  • Renal function tests
  • Urine for malignant cells
  • CECT or Whole-Body PET CT or MRI as needed
  • Cystoscopy and biopsy of any suspicious lesions

Treatment options

  1. Treatments for non-muscle-invasive bladder cancer include:
  2. Surgery – transurethral resection of bladder tumour (TURBT) can be done which removes or destroys the tumour. This procedure is done under general anaesthetic and takes approximately 30 minutes.

    Chemotherapy – uses drugs to kill the cancer cells by inserting a catheter (soft tube) directly into the bladder via the urethra (called intravesical chemotherapy).

    Immunotherapy – via the use of a vaccine (known as Bacillus Calmette-Guérin (BCG)) which was once used to treat tuberculosis, can increase the body’s natural immune system to stop the growth of the cancer cells in the bladder.

  3. Treatments for muscle-invasive bladder cancer include:
  4. Surgery – the removal of the whole bladder is a common surgical treatment in cases where the cancer has spread to the muscle.

    Chemotherapy – Systemic Chemotherapy to treat muscle-invasive bladder cancer usually involves intravenous therapy (drugs given by injection into the vein).

    Radiation therapy – can be used instead of surgery to treat muscle-invasive bladder cancer. It can also be used at the same time as chemotherapy to help maximise treatment outcomes.

    Immunotherapy – is a treatment option for muscle-invasive bladder cancer which has metastasised (spread to distant areas of the body)

What we offer in our centre?

All the above evaluation and treatment options are available in our centre for treating bladder cancer.

The surgical options available in our centre are -

  • Transurethral resection of bladder tumour TURBT
  • Transurethral biopsy of bladder tumour
  • Cystoscopy and DJ stenting for bladder tumours if necessary
  • Partial cystectomy with bladder augmentation
  • Lap/open Radical cystectomy with continent diversion for bladder cancer

Chemotherapy /Radiotherapy/ Immunotherapy based on the stage of disease being offered for the patient.

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