What is Bladder?
The bladder is an organ in your body which stores your urine before releasing out through urination. Thus, it is considered a significant part of the pelvis for functioning in the urination process. The urinary expanse also consists of kidneys, urethra, and ureters. These organs including the bladder are lined with a coating of cells called the urothelium.
What is Bladder Cancer?
When the bladder’s lining cells begin to grow out of control, bladder cancer develops. A tumour formed by growing cancer cells has the potential to eventually spread to other body regions.
Types of Bladder Cancer
Various types of bladder cancer start to grow in the lining of the bladder. These types depend on the specific cells of the organ that become cancerous. Let’s have an informed look at the types of cancer –
Urothelial (Transitional Cell) Bladder Cancer
It is the most common type of bladder cancer as it reports around 90% of all bladder cancers. It also results in 15-20 per cent of kidney cancers being found in adults. These are also called transitional cancer because they are developed in the transitional or urothelial cells of the bladder lining.
They are further classified into two classes, such as –
- Non-muscle Invasive Cancers: this means that they have not damaged the deepest layers of the bladder.
- Muscle-invasive Bladder Cancers: this means that bladder cancer has grown to the innermost layers of the walls or even beyond.
Squamous Cell Bladder Cancer
The squamous cells grow in the bladder lining as a result of a prolonged injury, infection or irritation resulting in long-standing inflammation. These cells tend to develop into cancerous cells as time passes. This type of cancer is meddlesome as it meddles with the cells in the bladder. Approximately 5% of bladder cancers are related to Squamous Cell Bladder Cancer. The plane, moist and skin-like tissues that line your body are called squamous cells. This cancer is mostly discovered in some regions of the world like Africa and Asia.
Adenocarcinoma
This comes under the rare kind of bladder cancer. Only 1 or 2% of bladder cancers are diagnosed with Adenocarcinoma. This cancer is developed in the glandular tissues which cover the particular organs of the body. These organs are often responsible for releasing substances like digestive juices, mucus, and other fluids. Breast, oesophagus, lung, colon, stomach, rectum, prostate, uterus and pancreas cancers are also referred to as adenocarcinomas.
Causes of Bladder Cancer
Numerous risk factors might lead to the growth of bladder cancer. We have created a guide to those risk factors to help you stay cautious and prevent yourself from the disease. The list suggested by cancer guidelines through medical centres is as follows –
Tobacco:
Smoking cigarettes, cigars, or pipes increases the risk factor of developing bladder cancer. It is seen that smokers tend to have a 4 to 7 times greater risk of bladder cancer than those who never smoke.
Gender:
According to the statistics reports, it is found that men are more likely to develop bladder cancer than women. But it is also accounted that women have a greater chance to die from bladder cancer than men.
Rising Age:
The risk of developing bladder cancer increases with the increase in age. The reports have discovered that most people diagnosed with bladder cancer are over 55 years old. But it is still not limited and can be discovered at any age.
Radiation:
Those individuals who have been treated with radiation therapy for their cancer are likely to get bladder cancer in the future. These radiations could be from Ultraviolet Rays through the sun or Ionizing Radiation which includes Medical radiation (such as x-rays, CT scans, or fluoroscopy) and Radon gas in our buildings.
Chemicals:
The production of textiles, dyes, rubber, paint, and leather materials include harmful chemicals which link to bladder cancer. As we all are aware that our kidneys play a vital role in cleaning the bloodstream with these toxic chemicals. Therefore, it is noted that chemicals can lead to the growth of bladder cancer.
Persistent Bladder Issues:
You might have heard of people having bladder stones. It is a massive risk of causing bladder cancer in some people if not dealt with it in time. Chronic urinary infections and people who have used urinary catheters are usually diagnosed with squamous cell bladder cancer.
Symptoms of Bladder Cancer
You must know when to visit a doctor if you notice these common symptoms of bladder cancer –
- Blood in urine
- Itching or burning while urinating
- Increased frequency of urinating
- Having the sensation to urinate but not being able to pass
- Low backache
Diagnoses for Bladder Cancer
- Cystoscopy: When your doctor inserts a cystoscope which is a narrow tube through your urethra is called a cystoscopy. This will help the doctor inspect the signs of the disease through the lens of the tube. This diagnosis can be monitored in a hospital.
- Biopsy: The cell sample is collected by the doctor through a special tool called a scope. This cope is inserted into your bladder to get the cell sample. This process is known as a biopsy. This testing is often called Transurethral Resection of Bladder Tumour (TURBT).
- Urine Cytology: This procedure requires the examination of your urine under a microscope to analyze any cancer cells.
Preventions and Treatments for Bladder Cancer
Preventions to be considered are as follows
1. Stop smoking!
Smoking is believed to be the most injurious means of developing bladder cancer, lung cancer, or throat cancer. Consumption of tobacco through cigarettes, cigars, or pipes arises the risk factor of bladder cancer. So, consult a doctor or medical health centre for helping you quit smoking forthwith. There are numerous rehabilitation centres for you to begin the process with. This will help you in socializing with others who might be suffering from a similar situation and the groups will make you feel stronger.
2. Be careful around chemicals.
Try to limit your exposure to chemicals as they lead to the development of bladder cancer. You might be working in industries which manufacture textiles, dyes, rubber, leather, or paint products. Chemicals released from these products are often harmful to your organs. Take safety measures like wearing a mask or drinking lots of water while working in such a factory. Drinking loads of water maintain healthy body functionality.
3. Prepare yourself a healthy diet chart
You might lose your appetite and feel too exhausted to consume any food. You might not feel like eating at all. But it is suggested to eat a balanced diet to help your body fight throughout the cancer survival mission. You must have a diet chart which includes –
Eating lots of fresh vegetables and fruits:
Fruits and vegetables get you the vitamins and minerals that are essential for your body. You must eat cruciferous vegetables such as broccoli, Brussels sprouts, and kale. These vegetables are antioxidants rich. Similarly, citrus fruits like oranges, pomelo, and limes are also good for the same reason. Berries are delicious and significant at the same time.
Whole grains:
Whole grains are required for delivering fibre and nutrients to your body. When you are going grocery shopping, do look out for the “whole grain” tag in the ingredients section of your grocery.
Taking your proteins:
Proteins like eggs, fish, chicken, meat, lentils, beans, nuts, seeds, and dairy products help you gain the proteins that are much required while dealing with bladder cancer. This will help you balance muscle mass and make your immune system healthy.
Treatments required for Bladder Cancer
Surgery is the removal of the tumour along with part of the surrounding healthy tissue. For bladder cancer, there are various surgical procedures. A specific procedure will be suggested by your medical team based on the severity and stage of the condition.
- Transurethral bladder tumour resection (TURBT): Along with treating patients, this method is employed for diagnostic and staging. A cystoscope is inserted into the bladder by a surgeon during TURBT. The surgeon next performs fulguration, also known as high-energy electricity or laser surgery, to remove the tumour. Prior to the surgery, the patient is given an anaesthetic, a drug that dulls the perception of pain. TURBT might be able to eradicate bladder cancer in persons with non-muscle invasive forms of the disease. To reduce the danger of the tumour coming back, the doctor could suggest additional therapies such intravesical chemotherapy or immunotherapy following TURBT.
- Radical cystectomy and lymph node dissection: In a radical cystectomy, the entire bladder and possibly surrounding tissues and organs are removed. The prostate, a portion of the urethra or the uterus, the fallopian tubes, the ovaries, and a portion of the vagina may be among these organs.
- Urinary diversion: The doctor will devise a new method for removing pee from the body if the entire bladder is removed. One approach to achieve this is to channel urine to an aperture on the outside of the body using a portion of the small intestine or colon. To collect and drain urine, the patient must wear a bag fastened to the stoma.
Chemotherapy is the use of medications to kill cancer cells, typically by preventing the growth, division, and production of new cancer cells.
For the treatment of bladder cancer, there are two different forms of chemotherapy. The stage of cancer determines the type and timing of the medication that the doctor prescribes. Before or after surgery, discuss chemotherapy with your doctor.
- Intravesical chemotherapy: A urologist typically administers intravesical, or local, chemotherapy. Drugs are injected into the bladder during this sort of therapy using a catheter that has been placed through the urethra. Only superficial tumour cells that come into touch with the chemotherapy solution are eliminated by local therapy. The bladder wall tumour or tumour cells that have metastasized to other organs are inaccessible to it. The most often prescribed medications for intravesical chemotherapy are gemcitabine (Gemzar), docetaxel (Taxotere), valrubicin (Valstar), and mitomycin-C (which is accessible as a generic medicine). Additionally, mitomycin (Jelmyto) has been given FDA approval for the treatment of low-grade upper tract urothelial carcinoma.
- Systemic chemotherapy: The major regimens for systemic, or whole-body, chemotherapy to treat bladder cancer include:
- Gemcitabine
- Carboplatin (available as a generic drug) and gemcitabine
- MVAC, which combines 3 drugs: (Rheumatrex, Trexall), vinblastine (Velban), doxorubicin
- Dose-dense (DD)-MVAC with growth factor support: This is the same regimen as MVAC, but there is less time between treatments and has mostly replaced MVAC
- Docetaxel or paclitaxel (available as a generic drug)
Immunotherapy strengthens your immune system’s capacity to attack cancer cells in order to combat the disease. It may be administered locally or systemically.
- Local Immunotherapy
- Bacillus Calmette-Guerin (BCG): A weakened mycobacterium known as BCG, which is identical to the bacteria that causes tuberculosis, is the conventional immunotherapy treatment for bladder cancer. Through a catheter, BCG is inserted directly into the bladder. The term for this is intravesical treatment. BCG adheres to the bladder’s interior lining and activates the immune system to eliminate the tumour cells. Flu-like symptoms, fevers, chills, exhaustion, a burning feeling in the bladder, and bladder haemorrhage are just a few of the side effects that BCG can bring on.
- Interferon (Roferon-A, Intron A, Alferon): Another immunotherapy that is occasionally administered intravenously is interferon. Occasionally, it is used in conjunction with BCG to treat cancer if BCG alone is ineffective. Nowadays, interferon therapy is rather unusual.
- Denvax Immunotherapy
Denvax is cancer immunotherapy. It works to boost the immune system against cancer, mostly solid tumours. Denvax is targeted therapy and comes under the 4th modality of cancer treatment called cancer Immunotherapy.
Dendritic cells are cells of the immune system that help in the fight against cancer. Denvax treatment is customized dendritic cell-based cancer immunotherapy.
- Systemic Immunotherapy
Drugs that block PD-1 and PD-L1 are the subject of active immunotherapy research. T cells, a subset of white blood cells that directly support the body’s immune system in the battle against disease, have PD-1 on their surface. Stopping PD-1 from operating enables the immune system to more effectively eradicate cancer because PD-1 prevents the immune system from eliminating cancer cells.
- Avelumab (Bavencio): If chemotherapy has deferred advanced urothelial cancer, the PD-L1 inhibitor avelumab can be provided after chemotherapy, regardless of whether the tumour expresses PD-L1, since it has been shown to lengthen life and lower the risk ofthe cancer worsening. Switch maintenance therapy is the name given to this type of care.
- Nivolumab (Opdivo): A PD-1 inhibitor called nivolumab can be used to treat metastatic or advanced urothelial cancer that has not responded to platinum treatment. Adjuvant therapy, which is often administered after a patient has had their cancer completely surgically removed, can reduce the likelihood of the disease returning in those with advanced cancers who are at a high risk of recurrence.
- Pembrolizumab (Keytruda): A PD-1 inhibitor called pembrolizumab can be used to treat bladder cancer in the following circumstances:
- Unaffected by platinum treatment, advanced or metastatic urothelial cancer. It is the only immunotherapy that has been demonstrated to extend patients’ lives in this circumstance.
- Non-muscle-invasive bladder cancer (Tis) that has not been cured by BCG treatment in people who cannot receive or choose not to have radical cystectomy.
Keeping your lifestyle healthy while maintaining a balanced diet is
recommended for surviving any type of cancer. You must keep your
body active physically and mentally. Be prepared for any obstacle that
may or may not come. This way you will be motivated to search for solutions.
Keeping a positive mindset is compulsory while battling with cancer.
What is Bladder?
The bladder is an organ in your body which stores your urine before releasing out through urination. Thus, it is considered a significant part of the pelvis for functioning in the urination process. The urinary expanse also consists of kidneys, urethra, and ureters. These organs including the bladder are lined with a coating of cells called the urothelium.
What is Bladder Cancer?
When the bladder’s lining cells begin to grow out of control, bladder cancer develops. A tumour formed by growing cancer cells has the potential to eventually spread to other body regions.
Types of Bladder Cancer
Various types of bladder cancer start to grow in the lining of the bladder. These types depend on the specific cells of the organ that become cancerous. Let’s have an informed look at the types of cancer –
Urothelial (Transitional Cell) Bladder Cancer
It is the most common type of bladder cancer as it reports around 90% of all bladder cancers. It also results in 15-20 per cent of kidney cancers being found in adults. These are also called transitional cancer because they are developed in the transitional or urothelial cells of the bladder lining.
They are further classified into two classes, such as –
- Non-muscle Invasive Cancers: this means that they have not damaged the deepest layers of the bladder.
- Muscle-invasive Bladder Cancers: this means that bladder cancer has grown to the innermost layers of the walls or even beyond.
Squamous Cell Bladder Cancer
The squamous cells grow in the bladder lining as a result of a prolonged injury, infection or irritation resulting in long-standing inflammation. These cells tend to develop into cancerous cells as time passes. This type of cancer is meddlesome as it meddles with the cells in the bladder. Approximately 5% of bladder cancers are related to Squamous Cell Bladder Cancer. The plane, moist and skin-like tissues that line your body are called squamous cells. This cancer is mostly discovered in some regions of the world like Africa and Asia.
Adenocarcinoma
This comes under the rare kind of bladder cancer. Only 1 or 2% of bladder cancers are diagnosed with Adenocarcinoma. This cancer is developed in the glandular tissues which cover the particular organs of the body. These organs are often responsible for releasing substances like digestive juices, mucus, and other fluids. Breast, oesophagus, lung, colon, stomach, rectum, prostate, uterus and pancreas cancers are also referred to as adenocarcinomas.
Causes of Bladder Cancer
Numerous risk factors might lead to the growth of bladder cancer. We have created a guide to those risk factors to help you stay cautious and prevent yourself from the disease. The list suggested by cancer guidelines through medical centres is as follows –
Tobacco:
Smoking cigarettes, cigars, or pipes increases the risk factor of developing bladder cancer. It is seen that smokers tend to have a 4 to 7 times greater risk of bladder cancer than those who never smoke.
Gender:
According to the statistics reports, it is found that men are more likely to develop bladder cancer than women. But it is also accounted that women have a greater chance to die from bladder cancer than men.
Rising Age:
The risk of developing bladder cancer increases with the increase in age. The reports have discovered that most people diagnosed with bladder cancer are over 55 years old. But it is still not limited and can be discovered at any age.
Radiation:
Those individuals who have been treated with radiation therapy for their cancer are likely to get bladder cancer in the future. These radiations could be from Ultraviolet Rays through the sun or Ionizing Radiation which includes Medical radiation (such as x-rays, CT scans, or fluoroscopy) and Radon gas in our buildings.
Chemicals:
The production of textiles, dyes, rubber, paint, and leather materials include harmful chemicals which link to bladder cancer. As we all are aware that our kidneys play a vital role in cleaning the bloodstream with these toxic chemicals. Therefore, it is noted that chemicals can lead to the growth of bladder cancer.
Persistent Bladder Issues:
You might have heard of people having bladder stones. It is a massive risk of causing bladder cancer in some people if not dealt with it in time. Chronic urinary infections and people who have used urinary catheters are usually diagnosed with squamous cell bladder cancer.
Symptoms of Bladder Cancer
You must know when to visit a doctor if you notice these common symptoms of bladder cancer –
- Blood in urine
- Itching or burning while urinating
- Increased frequency of urinating
- Having the sensation to urinate but not being able to pass
- Low backache
Diagnoses for Bladder Cancer
- Cystoscopy: When your doctor inserts a cystoscope which is a narrow tube through your urethra is called a cystoscopy. This will help the doctor inspect the signs of the disease through the lens of the tube. This diagnosis can be monitored in a hospital.
- Biopsy: The cell sample is collected by the doctor through a special tool called a scope. This cope is inserted into your bladder to get the cell sample. This process is known as a biopsy. This testing is often called Transurethral Resection of Bladder Tumour (TURBT).
- Urine Cytology: This procedure requires the examination of your urine under a microscope to analyze any cancer cells.
Preventions and Treatments for Bladder Cancer
Preventions to be considered are as follows
1. Stop smoking!
Smoking is believed to be the most injurious means of developing bladder cancer, lung cancer, or throat cancer. Consumption of tobacco through cigarettes, cigars, or pipes arises the risk factor of bladder cancer. So, consult a doctor or medical health centre for helping you quit smoking forthwith. There are numerous rehabilitation centres for you to begin the process with. This will help you in socializing with others who might be suffering from a similar situation and the groups will make you feel stronger.
2. Be careful around chemicals.
Try to limit your exposure to chemicals as they lead to the development of bladder cancer. You might be working in industries which manufacture textiles, dyes, rubber, leather, or paint products. Chemicals released from these products are often harmful to your organs. Take safety measures like wearing a mask or drinking lots of water while working in such a factory. Drinking loads of water maintain healthy body functionality.
3. Prepare yourself a healthy diet chart
You might lose your appetite and feel too exhausted to consume any food. You might not feel like eating at all. But it is suggested to eat a balanced diet to help your body fight throughout the cancer survival mission. You must have a diet chart which includes –
Eating lots of fresh vegetables and fruits:
Fruits and vegetables get you the vitamins and minerals that are essential for your body. You must eat cruciferous vegetables such as broccoli, Brussels sprouts, and kale. These vegetables are antioxidants rich. Similarly, citrus fruits like oranges, pomelo, and limes are also good for the same reason. Berries are delicious and significant at the same time.
Whole grains:
Whole grains are required for delivering fibre and nutrients to your body. When you are going grocery shopping, do look out for the “whole grain” tag in the ingredients section of your grocery.
Taking your proteins:
Proteins like eggs, fish, chicken, meat, lentils, beans, nuts, seeds, and dairy products help you gain the proteins that are much required while dealing with bladder cancer. This will help you balance muscle mass and make your immune system healthy.
Treatments required for Bladder Cancer
Surgery is the removal of the tumour along with part of the surrounding healthy tissue. For bladder cancer, there are various surgical procedures. A specific procedure will be suggested by your medical team based on the severity and stage of the condition.
- Transurethral bladder tumour resection (TURBT): Along with treating patients, this method is employed for diagnostic and staging. A cystoscope is inserted into the bladder by a surgeon during TURBT. The surgeon next performs fulguration, also known as high-energy electricity or laser surgery, to remove the tumour. Prior to the surgery, the patient is given an anaesthetic, a drug that dulls the perception of pain. TURBT might be able to eradicate bladder cancer in persons with non-muscle invasive forms of the disease. To reduce the danger of the tumour coming back, the doctor could suggest additional therapies such intravesical chemotherapy or immunotherapy following TURBT.
- Radical cystectomy and lymph node dissection: In a radical cystectomy, the entire bladder and possibly surrounding tissues and organs are removed. The prostate, a portion of the urethra or the uterus, the fallopian tubes, the ovaries, and a portion of the vagina may be among these organs.
- Urinary diversion: The doctor will devise a new method for removing pee from the body if the entire bladder is removed. One approach to achieve this is to channel urine to an aperture on the outside of the body using a portion of the small intestine or colon. To collect and drain urine, the patient must wear a bag fastened to the stoma.
Chemotherapy is the use of medications to kill cancer cells, typically by preventing the growth, division, and production of new cancer cells.
For the treatment of bladder cancer, there are two different forms of chemotherapy. The stage of cancer determines the type and timing of the medication that the doctor prescribes. Before or after surgery, discuss chemotherapy with your doctor.
- Intravesical chemotherapy: A urologist typically administers intravesical, or local, chemotherapy. Drugs are injected into the bladder during this sort of therapy using a catheter that has been placed through the urethra. Only superficial tumour cells that come into touch with the chemotherapy solution are eliminated by local therapy. The bladder wall tumour or tumour cells that have metastasized to other organs are inaccessible to it. The most often prescribed medications for intravesical chemotherapy are gemcitabine (Gemzar), docetaxel (Taxotere), valrubicin (Valstar), and mitomycin-C (which is accessible as a generic medicine). Additionally, mitomycin (Jelmyto) has been given FDA approval for the treatment of low-grade upper tract urothelial carcinoma.
- Systemic chemotherapy: The major regimens for systemic, or whole-body, chemotherapy to treat bladder cancer include:
- Cisplatin and gemcitabine
- Carboplatin (available as a generic drug) and gemcitabine
- MVAC, which combines 4 drugs: methotrexate (Rheumatrex, Trexall), vinblastine (Velban), doxorubicin, and cisplatin
- Dose-dense (DD)-MVAC with growth factor support: This is the same regimen as MVAC, but there is less time between treatments and has mostly replaced MVAC
- Docetaxel or paclitaxel (available as a generic drug)
Immunotherapy strengthens your immune system’s capacity to attack cancer cells in order to combat the disease. It may be administered locally or systemically.
- Local Immunotherapy
- Bacillus Calmette-Guerin (BCG): A weakened mycobacterium known as BCG, which is identical to the bacteria that causes tuberculosis, is the conventional immunotherapy treatment for bladder cancer. Through a catheter, BCG is inserted directly into the bladder. The term for this is intravesical treatment. BCG adheres to the bladder’s interior lining and activates the immune system to eliminate the tumour cells. Flu-like symptoms, fevers, chills, exhaustion, a burning feeling in the bladder, and bladder haemorrhage are just a few of the side effects that BCG can bring on.
- Interferon (Roferon-A, Intron A, Alferon): Another immunotherapy that is occasionally administered intravenously is interferon. Occasionally, it is used in conjunction with BCG to treat cancer if BCG alone is ineffective. Nowadays, interferon therapy is rather unusual.
- Denvax Immunotherapy
Denvax is cancer immunotherapy. It works to boost the immune system against cancer, mostly solid tumours. Denvax is targeted therapy and comes under the 4th modality of cancer treatment called cancer Immunotherapy.
Dendritic cells are cells of the immune system that help in the fight against cancer. Denvax treatment is customized dendritic cell-based cancer immunotherapy.
- Systemic Immunotherapy
Drugs that block PD-1 and PD-L1 are the subject of active immunotherapy research. T cells, a subset of white blood cells that directly support the body’s immune system in the battle against disease, have PD-1 on their surface. Stopping PD-1 from operating enables the immune system to more effectively eradicate cancer because PD-1 prevents the immune system from eliminating cancer cells.
- Avelumab (Bavencio): If chemotherapy has deferred advanced urothelial cancer, the PD-L1 inhibitor avelumab can be provided after chemotherapy, regardless of whether the tumour expresses PD-L1, since it has been shown to lengthen life and lower the risk ofthe cancer worsening. Switch maintenance therapy is the name given to this type of care.
- Nivolumab (Opdivo): A PD-1 inhibitor called nivolumab can be used to treat metastatic or advanced urothelial cancer that has not responded to platinum treatment. Adjuvant therapy, which is often administered after a patient has had their cancer completely surgically removed, can reduce the likelihood of the disease returning in those with advanced cancers who are at a high risk of recurrence.
- Pembrolizumab (Keytruda): A PD-1 inhibitor called pembrolizumab can be used to treat bladder cancer in the following circumstances:
- Unaffected by platinum treatment, advanced or metastatic urothelial cancer. It is the only immunotherapy that has been demonstrated to extend patients’ lives in this circumstance.
- Non-muscle-invasive bladder cancer (Tis) that has not been cured by BCG treatment in people who cannot receive or choose not to have radical cystectomy.
Keeping your lifestyle healthy while
maintaining a balanced diet is recommended
for surviving any type of cancer. You
must keep your body active physically
and mentally. Be prepared for any
obstacle that may or may not come.
This way you will be motivated to search
for solutions. Keeping a positive mindset
is compulsory while battling with cancer.
