What Is Bladder Cancer?

Bladder cancer is one of the most common types of cancer in the United States, with an estimated 74,000 people receiving diagnoses this year and another 15,000 patients dying from bladder cancer. Medical professionals predict an increase in the number of bladder cancer cases in the coming years.
Cigarette smoking and chemical exposure are among the leading causes of bladder cancer, the second-most common urological cancer in adults. Bladder cancer is more common among men than women, and afflicts more Caucasians than African-Americans. It is also known for its high recurrence rate.

But for patients diagnosed with bladder cancer, the silver lining comes in the form of statistics and new medical procedures:

• About 80 percent of bladder cancer patients are diagnosed in the earliest stages.
• The overall five-year survival rate is more than 90 percent.
• Innovative techniques allow an increasing number of patients to keep their bladder rather than having it removed.

Bladder Cancer Causes

Among the risk factors for bladder cancer are advanced age, chronic bladder infections and treatment with certain types of medications. Those medications include cyclophosphamide, a common chemotherapy drug, and pioglitazone, the active ingredient in the type 2 diabetes drug Actos. Studies show that Actos increases the risk of bladder cancer by as much as 80 percent.
Researchers say that because the leading cause of bladder cancer is smoking, it is one of the most preventable types of cancer. Studies show that cigarette smoking raises the risk for bladder cancer fourfold. In addition, some occupations pose a stronger risk of daily exposure to workplace chemicals, which can lead to bladder cancer.

Among them are:

• Hairdressers
• Machinists
• Printers
• Painters
• Medical workers
• Truck drivers

There are also some lesser-known causes, including arsenic and chlorine compounds found in drinking water and sexually transmitted diseases, such as gonorrhea and human papilloma virus (HPV).

Symptoms of Bladder Cancer

Symptoms of bladder cancer develop quietly in a majority of people with the disease. Hematuria, also known as bloody urine, is typically the first sign of the disease. But because this symptom is usually painless and fleeting, most patients are either unaware of it or ignore it. Although the blood could be visible, it is most often undetectable unless under a microscope.
For this reason, many patients don’t learn of their diagnosis until after a urine analysis. Frequent bladder infections, frequent urination, back pain and painful urination are among the warning signs. While these are less common, they should not be ignored.

Diagnosing Bladder Cancer

Because of the stealthy nature of bladder cancer, most patients are taken by surprise by a bladder cancer diagnosis. It often comes after testing for recurrent urinary tract infections (UTIs) or during a routine medical visit.
Once tumor markers are found in the urine, doctors order a series of other tests. These include an intravenous pyelogram (IVP), the standard imaging test for bladder cancer. Through this test, physicians can view the bladder and surrounding organs for evidence of cancer. Doctors also use CT scans, MRI scans and bone scans, as well as ultrasounds, for a more complete look at the bladder.
For a closer look at the inside of the bladder, doctors may perform a bladder biopsy. This is done with a long, flexible device called a cystoscope that is inserted into the bladder through the urethra. Small tissue samples are removed for laboratory examination.
Once bladder cancer is diagnosed, oncologists will stage the cancer using the tumor, node and metastases (TNM) system. With this, medical professionals can determine the extent of the cancer and the best course of treatment.

Bladder Cancer Treatment

While surgery, either alone or in combination with other treatments, is the standard for managing bladder cancer, researchers are finding innovative ways to treat it.

Overall, treatment depends on the stage, or progress, of the disease:

• Stage 0 through 1 treatments (non-muscle invasive):
• Transurethral Resection (TUR or TURBT) – With the use of a cystoscope, surgeons are able to cauterize, or burn away, the destructive cancer cells.
• Segmental cystectomy – In some early-stage patients, surgeons will remove a portion of the diseased bladder. The remaining bladder is sewn together.
• Chemotherapy and immunotherapy – To ensure the cancer is killed, sometimes oncologists will order several rounds of chemotherapy or immunotherapy to impede the early-stage disease.
• Stage II, III and IV treatments (muscle invasive)
• Radical cystectomy – In this procedure, a surgeon removes the entire diseased bladder and replaces it with one of several urinary diversions. These include creating a new bladder from the intestines or creating a new urinary elimination system.
• Chemotherapy and immunotherapy – Unless the patient is sickly or elderly, oncologists will prescribe either or both of these treatments to further destroy this spreading disease.
• Clinical trials – Many oncologists will recommend that advanced-stage patients seek clinical trials for new and inventive ways to battle bladder cancer.
• Dr. Arkady Mandel, Chief Scientific Officer of Theralase Technologies Inc. stated, “Commercialization of any new anti-cancer medicine depends upon the safe and effective destruction of all cancerous tumours, while upholding the patient’s quality of life. We are excited that our leading patented photo dynamic compound effectively destroyed a human urinary bladder carcinoma cell line (HT-1376) when activated by our proprietary light system. We are confident that as we complete our preclinical research and prepare for human trials in 2013, we will demonstrate to the medical community that we possess a highly effective, safe and efficient alternative treatment option to current bladder cancer patients.”

Incidence Rates of Bladder Cancer

For unknown reasons, the incidence of bladder cancer is higher in New England than the rest of the United States. While Caucasians have a higher incidence of the disease than African Americans, the mortality rate is in Caucasians is only slightly higher. That’s because African Americans tend to be diagnosed at a later disease stage, according to the National Cancer Institute.
Despite the best efforts of medical professionals, bladder cancer is known to reoccur in most cases. For this reason, medical professionals recommend that patients have check-ups every three months for the first three years after diagnosis and then every year thereafter.