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Bladder Cancer

Definition

The bladder is located in the lower abdomen. It is a hollow organ with flexible muscular walls. It stores urine until a person is ready to urinate. Bladder cancer is a disease in which cancer cells grow in the bladder.
Cancer occurs when cells in the body, in this case bladder cells, divide without control or order. Sometimes, cells divide uncontrollably when new cells are not needed. A mass of tissue called a growth or tumor can form. The term cancer refers to malignant tumors. Malignant tumors can invade nearby tissue and spread to other parts of the body.
Three main types of cancer affect the bladder. They are named for the type of cell that becomes cancerous:

Causes

The cause of bladder cancer is unknown. However, several risk factors have been identified.

Risk Factors

This condition is more common in adults between 65 and 85 years old. It is also more common in men and people who are Caucasian. Factors that may increase your chance of developing bladder cancer include:

Symptoms

Symptoms include:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will feel the abdomen and pelvis for abnormalities. The physical exam may include a rectal or vaginal exam.
Staging tests are done after bladder cancer is found. These tests find out if the cancer has spread and, if so, to what parts of the body. Treatments for bladder cancer depend on the stage of the cancer. The stages of bladder cancer are:
Stages of Bladder Cancer
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Treatment

Treatment options depend on the stage and may include one of more of:

Surgery

Surgery involves removing cancerous cells and nearby tissue. Types of surgery to treat bladder cancer include:
  • Transurethral resection—This is done for early stage or superficial bladder cancer. A cystoscope is placed into the bladder through the urethra. A small wire loop at the end of the cystoscope is used to remove cancer cells. Fulguration can be done during this procedure. It uses electrical current to burn away remaining cancer cells.
  • Cystectomy is the surgical removal of all or part of the bladder—This is done when bladder cancer is invasive. Segmental or partial cystectomy is the removal of part of the bladder. Radical cystectomy is the removal of the entire bladder and nearby lymph nodes. In men, the prostate is usually also removed. In women, the uterus, ovaries, part of the vagina, and the fallopian tubes might also be removed. A form of urinary diversion must be created to store the urine if the bladder is removed.

Radiation Therapy

Radiation Therapy is the use of radiation to kill cancer cells and shrink tumors. Radiation may be:
  • External radiation therapy—Radiation is directed at the tumor from a source outside the body.
  • Internal radiation therapy—Radioactive materials are placed near the cancer cells in the bladder through the urethra or through an incision in the abdomen.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms, including pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. For bladder cancer, chemotherapy is often given directly into the bladder. This is called intravesical chemotherapy.

Biologic Therapy (Immunotherapy)

Biologic therapy is the use of the body’s immune system to fight cancer. Substances made by the body or in a laboratory are given directly into the bladder to help boost, direct, or restore the body’s defenses against the cancer. This type of therapy is used only for superficial low-grade cancers that have been resected transurethrally.

Prevention

The following steps can reduce your risk of getting bladder cancer:

RESOURCES

American Cancer Society http://www.cancer.org

National Cancer Institute http://www.cancer.gov

CANADIAN RESOURCES

BC Cancer Agency http://www.bccancer.bc.ca

Canadian Cancer Society http://www.cancer.ca

References

Bladder cancer. American Cancer Society website. Available at: http://www.cancer.org/cancer/bladdercancer. Accessed June 11, 2015.

Bladder cancer. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/bladder-cancer. Accessed June 11, 2015.

Torpy JM. Bladder cancer. JAMA. 2005;293(7):890. Available at: http://jama.ama-assn.org/cgi/content/full/293/7/890. Accessed June 11, 2015.

What you need to know about bladder cancer. National Cancer Institute website. Available at http://www.cancer.gov/cancerinfo/wyntk/bladder. Accessed June 11, 2015.

7/21/2015 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Sun JW, Zhao LG, et al. Obesity and risk of bladder cancer: a dose-response meta-analysis of 15 cohort studies. PLoS One. 2015 Mar 24;10(3).

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