Bladder cancer occurs when cells in the bladder, the muscular sac that stores urine, divide without control or order. Bladder cancer sometimes spreads to other parts of the body.
The bladder is the hollow muscular sac in the lower abdomen *
Each year about 74,000 Americans—56,000 men and 18,000 women—learn that they have bladder cancer. Among men, it is the fourth-leading cause of cancer. In women, it ranks eighth. Bladder cancer usually strikes between the ages of 50 and 70. Early symptoms typically include blood in the urine and frequent or painful urination. Other conditions can also cause these symptoms, making a visit to a doctor necessary. There are about 16,000 deaths from bladder cancer each year.
Cigarette smoking is most commonly associated with lung cancer, but smokers are also two to three times more likely than nonsmokers to develop bladder cancer. Cigarette smoke contains harmful cancer-causing chemicals called carcinogens * . People can greatly reduce their risk for bladder cancer by quitting smoking or not starting in the first place.
That does not mean that workers in these professions will develop cancer. In fact, most will not. They should, however, be aware of their risk and take precautions to decrease their exposure to chemical carcinogens.
In many cases, though, bladder cancer seems to develop without an apparent specific cause.
When medical professionals want to evaluate someone for bladder cancer, they usually perform a physical exam and test a urine sample to check for blood and cancer cells. They also can insert a thin, lighted tube called a cystoscope (SIS-tuh-skope) through the urethra * to examine the lining of the bladder. If cancer is a possibility, they typically perform a biopsy. A biopsy is the removal of a tissue sample, which is then examined under a microscope. The presence of cancer cells indicates the disease is present.
If cancer is found, doctors typically want to know the depth of penetration, which is a measure of how far the cancer has moved beyond the surface of the bladder; they also want to know whether the cancer has spread to other locations in the body. Both findings have an impact on prognosis, as well as on treatment options. To determine depth of penetration and cancer spread, medical professionals may perform tests that create images of the inside of the body. These include:
The usual treatments for bladder cancer are surgery, radiation therapy, chemotherapy *
If the tumors are only on the surface of the bladder wall, the doctor can burn them away through a process called fulguration (ful-gu-RAYshun), which involves inserting a tool with a small wire loop on the end through the urethra.
If the cancer has grown into or through the bladder's muscular wall, a surgeon will remove part or all of the organ in a procedure called cystectomy (sis-TEK-tuh-mee). Sometimes nearby reproductive organs need to be removed as well.
Radiation therapy is another common treatment for bladder cancer. Internal radiation involves placing a small container of radioactive material, called a radiation implant, directly into the bladder to destroy the cancer cells. Radiation also can come from a machine outside the body that focuses high-energy rays on the affected area to kill cancer cells. A patient may receive radiation before or after surgery or along with anticancer drugs called chemotherapy.
Biological therapy, also known as immunotherapy, is a form of treatment that attempts to trigger the body's own disease-fighting immune system against the cancer.
People who have part or all of their bladder removed often have to make some adjustments in their activities of daily living. When people lose just part of the bladder, they may find that they need to go to the bathroom more frequently. When the entire bladder is taken out, they must learn a new way of emptying the urine from their bodies.
Upon removing the bladder, surgeons construct a new passageway to take over the bladder's function in a procedure called a urostomy (ur-OS-tuh-mee). They might use a piece of the small intestine to create a tube that carries the urine to an opening, called a stoma (STOma), in the stomach area where the urine can drain into an attached bag. The patient must empty the bag periodically. Another method uses part of the small intestine to create a storage pouch inside the body, collecting the urine there. Patients learn to use a tube called a catheter to drain the urine through either a stoma or the urethra. In some cases, patients may receive a replacement bladder called a neobladder, which is a pouch made out of intestinal tissue that patients can empty through muscular control. The surgery for neobladders is complex and may result in side effects, including incontinence (the inability to control urination).
Special therapists work with bladder cancer patients to teach them to care for themselves and their stomas after surgery. These therapists can answer questions, address emotional and physical concerns, and suggest sources of additional information about a urostomy. People who have a urostomy usually can resume all the activities they enjoyed before the operation.
See also Cancer: Overview • Tumor
Fischer, Kristen.“Half of U.S. Cancer Deaths Linked to Smoking in New Study.” Healthline News, June 15, 2015. Available at: http://www.healthline.com/health-news/half-of-us-cancer-deaths-linkedto-smoking-in-new-study-061515 (accessed November 21, 2015).
American Cancer Society. “What Are the Key Statistics about Bladder Cancer?” Cancer.org . http://www.cancer.org/cancer/bladdercancer/detailedguide/bladder-cancer-key-statistics (accessed November 21, 2015).
American Cancer Society. “What Is a Urostomy?” http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/ostomies/urostomyguide/urostomy-what-is-urostomy (accessed November 21, 2015).
National Cancer Institute. “Bladder Cancer—for Patients.” http://www.cancer.gov/types/bladder (accessed November 21, 2015).
American Cancer Society. 250 Williams St. NW, Atlanta, GA 303031034. Toll-free: 800-227-2345. Website: http://www.cancer.org (accessed November 21, 2015).
American Urological Association. 1000 Corporate Blvd., Linthicum, MD 21090. Toll-free: 866-RING-AUA. Website: https://www.auanet.org (accessed November 21, 2015).
National Cancer Institute. BG 9609 MSC 9760, 9609 Medical Center Dr., Bethesda, MD 20892-9760. Toll-free: 800-4-CANCER. Website: http://www.cancer.gov (accessed November 21, 2015).
* abdomen (AB-do-men), commonly called the belly, is the portion of the body between the thorax (THOR-aks) and the pelvis.
* carcinogens (kar-SIH-no-jenz) are substances or agents that can cause cancer.
* urethra (yoo-REE-thra) is the tube through which urine passes from the bladder to the outside of the body.
* chemotherapy (KEE-mo-THER-apee) is the treatment of cancer with powerful drugs that kill cancer cells.