Bladder Cancer

The bladder is a hollow, muscular organ in the pelvic region that stores urine before it is expelled from the body through the urethra.

Bladder cancer occurs due to an abnormal growth of tissues within the bladder. This growth or tumour typically develops when the cells in the lining of the bladder replicate rapidly and produce additional tissue.

When confined to the bladder wall's lining, it is termed superficial bladder cancer. However, if the cancer extends to the muscle wall and spreads to distant organs, such as the lungs, liver, and bones, it is classified as invasive bladder cancer.

There three types of bladder cancer are adenocarcinoma, squamous cell carcinoma, and transitional cell or urothelial carcinoma.

Risk Factors of Bladder Cancer

The exact cause of bladder cancer is not very clear. However, there are various risk factors that have been linked to bladder cancer.

Bladder cancer is most commonly diagnosed in individuals aged 70 and above. Being male and having a family history of bladder cancer are identified as risk factors for bladder cancer as well.

Other factors that contribute to the risk of bladder cancer include high intake of saturated fat, regular consumption of specific herbs and painkillers, chronic bladder infections, certain parasitic infections, and smoking. In fact, smoking is the leading cause, accounting for more than 50% of bladder cancer cases.

Regular exposure to certain workplace chemicals, including those found in hair dye and aniline dyes used in textile and rubber industries, is linked to an elevated risk of bladder cancer.

Symptoms of Bladder Cancer

The following are symptoms that can be attributed to bladder cancer:

• Blood in urine
• Loss of appetite and weight loss
• Having to urinate more than usual
• Painful urination
• Feeling the urge to urinate even if the bladder is not full
• Lower back pain on one side
• Weak urine stream
• Fatigue and weakness

Diagnosis of Bladder Cancer

Your doctor would first question your general health and symptoms before conducting a thorough physical examination. Diagnosis is made based on your reported symptoms, physical examination, and investigations.

1. Cystoscopy is a procedure that involves the use of a lens on a thin, long tube to allow for a clearer and more detailed examination of the urethra and bladder.
2. During cystoscopy, the doctor will collect a cell sample from the bladder for biopsy. This procedure is known as transurethral resection of the bladder tumour (TURBT), which can also serve as a therapeutic measure for managing bladder cancer.
3. Urine sample is collected to be analysed to detect the presence of cancer cells.
4. Imaging tests such as computed tomography (CT) scan.

Treatment Options for Bladder Cancer

Treatment options for bladder cancer will depend on the grade of the cancer, how deeply it has invaded the bladder wall, and the patient’s general health. Your doctor will assess your condition and suggest an individualised plan that may involve a single method or a combination of treatments.

For superficial bladder cancer (early stage), treatment includes:

1. Follow-ups after treatment as superficial bladder cancers tend to re-occur.
2. Intravesical chemotherapy, whereby chemotherapy drugs are injected directly into the bladder through a catheter. This treatment can be used alone or after TURBT.
3. Trans-urethral resection of bladder tumour (TURBT) is a minimally invasive surgery that uses a resectoscope instrument, which is inserted into the bladder through the urethra, to remove the tumour or burn away bladder cancer cells with an electric current.

For invasive bladder cancer (advanced stage), treatment includes:

1. Biological therapy that uses live-attenuated Bcg bacteria, to trigger an immune response against the bladder cancer cells. The bacteria are injected directly into the bladder using a catheter.
2. Chemotherapy drugs are injected intravenously to kill cancer cells. These can also be given orally.
3. Radiotherapy is used to kill cancer cells by using high-energy rays and to relieve symptoms caused by bladder cancer.
4. Radical cystectomy, a surgery that removes the whole bladder, surrounding lymph nodes and any neighbouring organs that have become cancerous. If this is necessary, a section of the intestines will be used to create a new way to pass urine. The urine is diverted to an opening on the outside of the body and the patient will be required to wear a bag attached to this opening to collect and drain urine. This is referred to as an ostomy bag.

Make an Appointment at Gleneagles Hospitals 

If you are experiencing any of the symptoms of bladder cancer, get in touch with us to find out more about our Oncology Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with gynae-oncologists to assist patients through cancer treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.