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Overview of Bladder Cancer: Causes, symptoms, types & treatment

Team AckoJun 20, 2024

The bladder is a hollow, muscular organ that stores urine in the lower abdomen. Most Bladder Cancers (BDC) start in the cells lining the bladder (urothelial cells). Additionally, the doctor may find urothelial cells in the kidneys and ureters, which connect the kidneys and bladder. Therefore, there is also a possibility of BDC occurring in the kidneys and ureters. In most cases, if BDC is diagnosed early, it can be treated. But despite successful treatment, it can recur even in the early stages. It is extremely important to perform follow-up tests for years after treatment to detect recurrences. Read ahead for an overview of this type of cancer.

Contents

Types of Bladder Cancer
What causes Bladder Cancer?
Bladder Cancer Symptoms
Treatment of Bladder Cancer
How to prevent Bladder Cancer
Frequently Asked Questions

Types of Bladder Cancer

The different types of Bladder Cancer are as follows.

1. Transitional Cell Carcinoma (Urothelial Carcinoma)

This type of BDC develops in the epithelium that lines the inside of the bladder. Some people with BCD may also develop tumours in these places, so a physician should scan the entire urinary tract and system.

2. Squamous Cell Carcinoma

This type of cancer occurs when the bladder is repeatedly irritated. Squamous cell carcinoma is most likely to occur in patients with a catheter for an extended period. Microscopically, the cells look similar to the flat cells on the skin's surface. Squamous cell carcinoma of the bladder is almost always invasive.

3. Adenocarcinoma

Adenocarcinomas are rare and account for only about 1% of Bladder Cancers. There is a lot of similarity between these cancer cells and the gland-forming cells of colon cancers. Bladder adenocarcinomas are almost always invasive and require extensive treatment.

4. Small-Cell Carcinoma

Small-cell carcinomas also account for less than 1% of Bladder Cancers. Nerve cells, called neuroendocrine cells, are the origin of this cancer. This cancer usually grows quickly and requires chemotherapy treatment.

According to healthcare providers, BDC may also be classified as non-invasive, non-muscle-invasive, or muscle-invasive.

Non-invasive: This can be characterised by tumours in small areas of tissue or cancer only present near the surface of the bladder.
Non-muscle-invasive: This refers to BDC that has spread deeper into your bladder without spreading to the muscles.
Muscle-invasive: Cancer that has penetrated the bladder wall muscle and the fatty layer or tissues outside the bladder.

What causes Bladder Cancer?

The exact cause of cancerous bladder cells is unknown to healthcare providers and researchers. As abnormal cells grow in the bladder, cancer usually spreads to other areas of the body. The cause of this cancer can be attributed to factors such as gene mutations. RB1 and TP53 genes are known to be associated with BDC.

Cancer suppressor genes such as FGFR and RAS are also associated with BDC. You may be at greater risk, if you have certain risk factors, such as follows.

Cigarette smoke: Smoking cigarettes increases your risk of BDC by more than double. You may also be at risk if you smoke pipes and cigars and are exposed to second-hand smoke.
Radiation exposure: You may be at higher risk of BDC if you get radiation treatment for cancer.
Chemotherapy: There is a risk associated with certain chemotherapy drugs.
Exposure to certain chemicals: Research shows that people who work with leather, paint, dyes, rubber, some textiles and hairdressing supplies are at greater risk.
Frequent bladder infections: The risk of squamous cell carcinoma increases if a person has frequent bladder infections and bladder stones.
Chronic catheter use: People who use catheters in their bladders for a long time may develop squamous cell carcinoma.
Personal or family history of cancer: You will likely develop BDC again if you have previously had it. Also, you may be more likely to develop BDC if one of your blood relatives has a history of the disease.

Bladder Cancer Symptoms

Bladder Cancer is primarily characterised by blood in the urine (haematuria), which is usually painless and occurs suddenly. There are also less common symptoms such as follows.

Having trouble emptying your bladder
When passing urine, you feel a burning sensation
Frequently need to pass urine
Having pain when urinating
Pain in the lower abdomen or back (less common)

Treatment of Bladder Cancer

Bladder Cancer can be treated in four different ways. The treatment provider may use one or more of these treatments, or they may combine them.

1. Surgery

BDC is commonly treated with surgery. Based on the cancer stage, providers decide which surgical options to use. When BDC hasn't spread, TURBT, the procedure used to diagnose the disease, can often be used to treat it. In a process called fulguration, high-energy electricity is used to remove or burn away tumours.

Another treatment option is a Radical Cystectomy. Patients will have your bladder and surrounding organs removed during this surgery. People with cancer that has spread outside their bladder or have several early-stage tumours on their bladder undergo this procedure.

When men and people undergo DMAB surgery, their prostates and seminal vesicles are removed. Women and people undergoing DFMB may have their ovaries, uterus, and part of their vagina removed. Additionally, providers perform a procedure called urinary diversion so that people can still pass urine.

Chemotherapy or radiation therapy may be used following surgery to kill cancer cells that may have been missed by surgery. It is an adjuvant treatment.

2. Chemotherapy

Essentially, these are cancer-fighting drugs. Chemotherapy drugs can be delivered directly to your bladder through an intravenous tube inserted into your urethra using intravesical therapy. An intravenous treatment targets cancer without harming healthy tissue.

3. Immunotherapy

The immune system is used to attack cancer cells during immunotherapy. Immunotherapy comes in different forms such as the following.

Vaccines such as Bacillus Calmette-Guérin (BCG) boost your immune system.
PD-1 and PD-L1 inhibitor therapy: These proteins are found on certain cells. T-cells carry PD-1 on their surfaces, which aids in regulating the immune system. Some cancer cells display PD-L1 proteins on their surface. These two proteins connect and prevent T-cells from killing cancer cells when they connect. The two proteins cannot bind during inhibitor therapy, which allows T-cells to attack cancer cells.

4. Radiation Therapy

Surgery may be substituted with radiation therapy. Radiation therapy can be combined with TURBT and chemotherapy by healthcare providers. It is an alternative to the surgery of removing the bladder. The type of treatment recommended depends on factors such as the size of the tumour and the characteristics of the tumour.

5. Targeted Therapy

The targeted therapy focuses on genetic changes that lead to cancer cells developing. FGFR gene inhibitors, for example, target cells with gene changes that promote the growth of cancer cells.

How to prevent Bladder Cancer

A definite method of preventing BDC does not exist. However, the risk of this cancer can be reduced by practising certain behaviours.

By quitting smoking, you will reduce the risk of developing urinary Bladder Cancer since chemical residue will not be present.
Maintaining a healthy diet and reducing junk food consumption
Continuing to be active
Get frequent health check-ups

Frequently Asked Questions

Here’s a list of common questions and answers related to Bladder Cancer.

What are the warning signs of Bladder Cancer?

One of the most common warning signs of BDC is blood in your urine. If you see blood in your urine, you should see a doctor.

Is Bladder Cancer a fatal illness?

Leaving BDC untreated can cause it to spread to other parts of the body. Metastasized cancer, or cancer that has spread, may shorten your life expectancy. When BDC is detected and treated early, the chance of living longer increases.

Is there a difference in Bladder Cancer symptoms between women versus men?

It’s possible that blood in the urine can be considered a part of menstruation by women. In this regard, men are more likely than women to notice blood in the urine, so BDC is more likely to be diagnosed early in men.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions. Bladder Cancer is written as BDC in this article.