Bladder Cancer Definition
Bladder cancer begins when cells that make up the urinary bladder begin to grow uncontrollably. Eventually, these cells grow into a tumor, and may even spread to other parts of the body like organs and lymph nodes.
To better understand the nature of bladder cancer and other health issues it can cause, it’s important to understand how the bladder functions. This organ is hollow and located in the pelvis. The hollow part of the bladder is surrounded by muscular, flexible walls. The primary function of the bladder is to store urine before it is purged from the body.
Urine arrives in the bladder via tubes called ureters after it leaves the kidneys. When muscles contract in the bladder, urine is forced out of the body through a tube called the urethra.
Cancer can form can start in any of the bladder’s several layers, but it most commonly forms in the innermost lining called the urothelium or transitional epithelium. As it grows, it enters other layers in the bladder wall. The more layers the cancer enters, the more difficult it becomes to treat the bladder cancer.
In many cases, the cancer eventually spreads into nearby tissues and structures like lymph nodes. If left untreated, it will likely spread to distant parts of the body like the lungs, liver, or bones.
There are several varieties of bladder cancer, and it’s important to understand the differences. They are as follows:
Urothelial carcinoma is also known as transitional cell carcinoma (TCC), and is the most common form of bladder cancer by far. If a doctor tells you that you have bladder cancer, this is most likely the form of the cancer you have. Urothelial carcinomas start in the urothelial cells that line the bladder’s interior and other parts of the urinary tract like ureters and the urethra.
Tumors may exist anywhere in these structures, so the entire urinary tract must be checked by a doctor when cancer is suspected. Urothelial carcinomas may be invasive or non-invasive, which means they have grown into deeper layers of the bladder wall, or have remained in the inner layer of cells. Invasive bladder cancer is more difficult to treat and also more likely to have spread.
This form of bladder cancer may also be described as either superficial or non-muscle invasive. These terms are used to describe non-invasive tumors and invasive tumors that haven’t grown into the bladder’s main muscle layer.
Depending on how bladder cancer grows, it may also be divided into one of two subtypes – papillary carcinomas or flat carcinomas. Papillary carcinomas grow from the inner surface of the bladder and resemble thin, finger-like projections that grow toward the hollow interior. Papillary tumors usually do not grow into the deepest layers of the bladder, and treatment is more likely to be successful. These tumors are often referred to as non-invasive papillary cancers or papillary urothelial neoplasm of low-malignant potential.
Flat carcinomas do not grow toward the hollow interior of the bladder, and sometimes remain in the bladder’s inner layer without spreading. These tumors are called non-invasive flat carcinomas.
Squamous cell carcinoma represents only 2% of bladder cancers in the United States. These cancer cells are usually invasive and resemble flat cells found on the surface of the skin.
Adenocarcinoma represents only 1% of bladder cancers in the United States. These small-cell carcinomas begin in neuroendocine cells and often grow quickly.
Sarcoma is an extremely rare form of bladder cancer that begins in the bladder’s muscle cells.
If you’ve been diagnosed with any form of bladder cancer, take a look at the information below to get a better idea of the various treatments that you could be facing.
Bladder Cancer Stages
Bladder cancers are staged according to the TNM staging system, which breaks down the cancer into three important categories. These letters stand for the following pieces of information:
• T – Tumor – This letter describes the size of the bladder tumor and where in the bladder it’s located.
• N- Nodes – This letter describes whether the bladder cancer has spread to any lymph nodes, and if so, where and how much?
• M – Metastasized – This letter describes whether the Bladder cancer has spread to distant areas (organs and lymph nodes) within the patient’s body. If so, where and how much has it spread?
Numbers (0 to 4) will appear directly after these letters. Lower numbers mean the cancer is in its earlier stages, while higher numbers mean the cancer is more advanced. These numbers are usually determined after Bladder surgery. The individual values are then combined in a process called grouping, and then an overall stage is assigned to the cancer which may be 1,2,3, or 4.
Staging may be pathological or clinical. The former is based on observations during surgery along with physical exams, biopsies, and imaging scans. The latter is based on biopsies, physical exams, and imaging scans.
You may also notice coding that isn’t mentioned above. These are what these values represent:
• TX – This means that the tumor can’t be accessed because there isn’t enough information
• T0 – This means that evidence of a primary tumor doesn’t exist
• NX – This means that information concerning lymph nodes is not available
• Ta – This is the code for noninvasive papillary carcinoma (see above). This cancer can usually be removed as it’s found only on a small section of tissue.
• Tis – this is the code for a flat tumor (CIS). This variety of cancer is found only on the bladder’s surface. There are other names that doctors call this cancer, including noninvasive flat carcinoma.
All of this information is then compiled to create a final staging for the bladder cancer. The earliest form of bladder cancer is Stage 0a, and the most advanced stage is Stage IVB. If the cancer is in the pelvis and/or ureter, there will be a separate staging. This cancer may be staged from Stage 0 to Stage IV.
If the cancer returns, it is said to be recurrent. Recurrent cancers receive a whole new round of tests that are similar to the ones conducted when the bladder cancer was first found.
Bladder cancer may also receive a grade from a doctor in an effort to describe how much the cancer cells resemble healthy cells. Low grade tumors look a lot like healthy cells and are less likely to be recurrent than high grade cancers. High grade cancers look very different from healthy cells, and are far more likely to be recurrent.
Obviously, bladder cancer staging is quite complex. If you’re diagnosed with cancer, take the time you need to talk to your doctor and get a complete understanding of the staging you receive. Recommended treatment may hinge on the staging of your cancer, and it will also be the basis for your prognosis. Fully explore your treatment options along with your doctor and family so that you can make the best choice concerning your personal health.
Bladder Cancer Symptoms (signs of Bladder cancer)
While there are certain symptoms associated with bladder cancer, it’s important to note that these symptoms are far more likely to be caused by some other ailment. Still, when symptoms persist or multiple symptoms manifest, it’s important to seek medical attention and get the bottom of it.
Most bladder cancers are diagnosed when patients complain to their doctor of blood in their urine. This condition is called hematuria, and it means that there is enough blood in the urine for the patient to notice it. Sometimes small amounts of blood aren’t seen and can only be detected with a urine test.
Some of the other symptoms common to bladder cancer include:
• Blood clots in the urine
• Burning sensation when urinating
• Frequent urination
• The feeling that urination is frequently necessary throughout the night
• Feeling like urination is necessary without being able to urinate
• Lower back pain on one side of the body
Sometimes symptoms don’t appear until the bladder cancer has spread to other parts of the body. This means that symptoms of bladder cancer may be unrelated to the urinary tract or bladder. For example, bladder cancer that’s spread to the lungs may cause a persistent cough or cancer that has spread to the liver may cause jaundice.
If you’re experiencing any of the aforementioned symptoms, especially blood in your urine, you should talk to your doctor as soon as you can.
Bladder Cancer Statistics
Bladder cancer statistics are used to better understand the nature of the disease. It is estimated that there will be 81,190 new cases of bladder cancer diagnosed in 2018 for the United States. This represents around 4.7% of all new cancers in the country. Of these 17,240 will die, which is about 2.8% of all cancer deaths.
The 5 year survival rate for the disease is 75.8%, which means that this percentage of patients will survive at least 5 years after their diagnosis, on average. Approximately 2.3% of men and women will be diagnosed with bladder cancer at some point in their life. There are around 708,000 people living with this disease in the United States.
Patients with bladder cancer in Situ or confined to the primary site (localized) are far more likely to survive 5 years than those with regional or distant cancer. Bladder cancer is the 6th most common cancer falling just behind melanoma of the skin and ahead of non-Hodgkin lymphoma.
Men are 4 times as likely to develop bladder cancer than females. White men are twice as likely to develop the disease as black men, but white and black women are nearly equal in this regard. The vast majority of patients are between the age of 65 and 85, but bladder cancer can effect much younger people.
The rate of bladder cancer in America has been dropping by about one percent every year.
Causes of Bladder Cancer
Why people develop this common cancer is currently unknown. For various reasons, cells in the bladder start to grow abnormally after developing mutations. Instead of growing and dividing as intended, they out of control and won’t die. When enough of these cells form, a tumor develops.
There are certain risk factors that can cause cancer cells to grow, although some people who develop the disease may have no obvious risk factors, and some who have multiple risk factors never develop bladder cancer. Some of the risk factors associated with bladder cancer include:
• Smoking tobacco or other forms of tobacco use
• Exposure to certain chemicals, which is sometimes job-related
• Past exposure to radiation
• Chronic irritation of the bladder’s lining
• Parasitic infections
• Being male
• Previous cancer treatment
• Personal history of cancer
• Family history of cancer
Obviously some of these risk factors are controllable, like smoking tobacco, but other are not controllable, like being a male. For risk factors that are controllable, it’s important to consider taking steps to prevent the onset of bladder cancer.
Bladder Cancer Screening and Prevention
Screening is the process by which routine testing is done in an effort to ascertain whether cancer has developed in a patient. The goal of screening is to find cancer in its earliest stages so that successful treatment is more likely.
Currently, there are no screening measures used to look for bladder cancer in patients who are exhibiting no symptoms. The reason is because there are no tests that are able to accomplish this goal. However, some doctors may prescribe certain tests to patients at very high risk of developing bladder cancer. This includes:
• Patients who have previously had bladder cancer
• People with birth defects affecting the bladder
• People who have been exposed to certain chemicals, usually at their place of work
Tests commonly used to detect bladder cancer include the following…
Urinalysis is done by checking for small amounts of blood in a person’s urine. This test can be readily performed during an annual physical or other routine health checkup. Urinalysis can sometimes detect cancer in its earliest stages, but it’s not capable of being used as an accurate screening test.
Urine cytology is test where a doctor uses a microscope to find cancer cells in the patient’s urine.
Urine tests for tumor markers are a series of newer tests that look for evidence of bladder cancer in the actual bladder. These tests can find cancer is its earliest stages but they’re not perfect. For the most part, these tests are used on patients showing symptoms that may be related to bladder cancer, but they aren’t quite capable of being used for screening purposes.
Prevention of bladder cancer is only possible by reducing risk factors associated with the disease. The best means of protection are as follows:
• Stop smoking and don’t start smoking – Smoking tobacco is linked to many cancers. If you smoke, quit. If you haven’t ever smoked, don’t start.
• Use caution around chemicals – If you work with chemicals at work or at home, use the proper safety equipment and avoid exposure.
• Eat plenty of fruits and vegetables – Diets rich in vegetables and fruits are full of vitamins and antioxidants that have been clinically shown to reduce the risk of cancer.
If you are at high risk of developing bladder cancer, you should arrange routine tests with your doctor as a means of prevention. While this method isn’t perfect, it could save your life.
Bladder Cancer Treatments
There are multiple treatment options for patients with bladder cancer, but the choice of treatment often depends on the cancer’s staging and whether it’s spread to other parts of the body.
Surgery is often used to remove bladder cancer tumors and some of the healthy surrounding tissue in an effort to prevent the return of the cancer. There are different surgeries used for different situations based on the size and stage of the cancer.
Transurethral bladder tumor resection, also known as TURBT, is used for bladder cancer treatment, staging, and diagnosis. The cancer tumor is removed using a tool that is inserted through the urethra and into the bladder. For patients with non muscle invasive bladder cancer, this surgery may be able to completely eliminate the cancer. Follow-up treatments may be used to minimize the risk of the cancer returning.
Cystectomy and lymph node dissection is a radical removal of the entire bladder, which may even include the removal of nearby tissues and organs. This surgery requires a qualified surgeon.
Urinary diversion is surgery to create a new means of passing urine after the bladder is surgically removed. There are few different methods doctors use to accomplish this task.
There are side effects associated with surgery that should be fully understood before agreeing to any procedure. Some of the possible side effects include:
• Longer time needed to heal
• Discomfort or minor bleeding
• Urine leakage
• Inability to empty the bladder (if a neobladder is created)
• Erectile dysfunction
• Loss of sexual feeling (this can often be repaired)
Obviously, there is a lot to consider when contemplating surgery for bladder cancer. Be sure to get the facts from your doctor.
Chemotherapy is a process where drugs are taken orally or injected into the bloodstream to kill cancer cells. Invasive chemotherapy is a process where the drugs are delivered to the bladder through a catheter inserted through the urethra. Systematic chemotherapy is accomplished via medication taken orally or intravenously.
Side effects caused by chemotherapy may include loss of appetite, diarrhea, hair loss, nausea, vomiting, and tiredness. They often go away after some time. It’s important to understand the risks associated with chemotherapy, and be prepared to endure the many side effects common to the treatment.
Immunotherapy is designed to boost the body’s natural ability to fight cancer using materials made by the body or produced synthetically in a lab. The goal is to restore immune system function to fight the bladder cancer.
A drug called Bacillus Calmette-Guerin (BCG) is often used for this purpose. The drug is interted into the bladder using a catheter where it attaches to the interior lining and stimulates the immune system to kill the cancer cells. There are side effects associated with this treatment that include fever, fatigue, and headaches, among others.
Interferon and immune checkpoint inhibitors are also used for this purpose. These too cause side effects that your doctor can explain in full.
Radiation therapy is a process where high energy x-rays are used to kill cancer cells. This treatment is almost always used in tandem with other bladder cancer treatments, but some patients unable to endure chemotherapy may be prescribed radiation therapy only.
Radiation therapy is most often used to kill cancer cells that may remain after surgery, to relieve symptoms caused by tumors, or treat cancer that has spread to one area, like the liver or the brain.
Side effects of radiation therapy include skin rashes, loose bowel movements, and fatigue. Patients may also feel the need to urinate frequently or bleeding from the bladder, but they usually go away after some time.
In some situations, treatment doesn’t work. In these situations the cancer may be referred to as either advanced or terminal. This is a difficult thing to hear and even harder to talk about for many people. In these situations, it’s important to talk to your doctor, and family members who can offer support. It’s also important to ensure comfort and minimize pain in whatever way possible.
Alternative Treatments Used for Bladder Cancer
If a cancer treatment falls outside of the mainstream medical treatments outlined above, it is considered “alternative.” The goal with many alternative bladder cancer treatments is to encourage the body to maximize its self healing potential by boosting the immune system through natural means. Every person has unique cancer cells in their body that the immune system attempts to keep in check, so the idea behind alternative treatments is to reinforce the body’s natural healing systems to get the cancer under control.
Sometimes patients seek alternative treatments to support a more traditional treatment protocols, while others use alternative remedies to help alleviate the side effects of treatments like surgery, radiation therapy, and chemotherapy. Others patients may seek an entirely naturopathic approach to treatment.
Some alternative approaches to treatment focus on understating the nature of the cancer in the individual patient, and then developing a specific treatment protocol based on that information. Every patient’s cancer is unique to their body, which explains why mainstream treatments work for some patients and not for others, even though they have the same stage of bladder cancer.
Doctors using this methodology will do in-depth testing on their patient’s cancer in an effort to understand how best to control it, kill it,and keep it from recurring. In the meantime, the patient’s immune system is enhanced through diet, exercise, and other holistic methods. Treatment for one patient may be vastly different than another patient because their cancers respond differently to similar treatment protocols.
Many alternative treatment methods view chemotherapy and radiation therapy as detrimental to the patient, not only because of side effects, but because the patient is left in weakened state. If the treatment fails to kill the patient’s cancer, it may not be possible to pursue other forms of treatment.
As with any treatment for any cancer, patients should be fully aware of their options. Be sure you trust your doctor, and then get the information you need to make an informed choice. Talk to other specialists about alternative treatments, and talk to other patients. Talk to your family members for emotional support and loving advice. Ultimately, the choice for bladder cancer treatment is yours alone, so explore every option before you take the first step toward recovery.
Vitamins and Supplements Used in the Treatment of Bladder Cancer
In an effort to prevent and treat cancer, vitamins and supplements often play a key role, especially with bladder cancer. Vitamin deficiencies have been linked to the onset of cancer, yet there is still a great deal of controversy surrounding the role vitamins play in regards to cancer treatment. This is odd, because multiple sources recommend a healthy diet to maintain a strong immune system resistant to cancer, but abandon this philosophy when it comes to cancer treatment.
Alternative treatments that focus on enhancing the immune system often utilize vitamin and supplement therapies, and other techniques. Some of the more common vitamins used in alternative cancer treatments include:
• Vitamin B6 – This vitamin supports the normal function of the bladder glands, and also makes antibodies that help the immune system fight disease.
• Vitamin C – Another immune system booster, this natural vitamin also helps repair and regenerate tissue in the body, an essential process for many on cancer treatment protocols.
• Vitamin D – There are studies that prove a link between vitamin D deficiencies and higher risk of cancer. While usually absorbed through the skin by exposure to natural sunlight, some people require supplements to maintain proper levels of vitamin D. If you live in a northern latitude, you should have your vitamin D levels routinely checked to be sure you’re getting the proper dosage.
• Vitamin E – This vitamin helps the body fight infection, which is a powerful tool during cancer treatment.
• Vitamin A – This is yet another vitamin that boosts the immune system while creating a barrier against infection.
• Selenium – Aggressive forms of cancer like bladder cortical cancer can overwhelm the body, but selenium has been shown to slow down this reaction.
There are many other supplements and vitamins commonly used during cancer treatment. Be sure to talk to your doctor before using any supplement or vitamin to be sure it fits into your treatment protocols.
Natural Remedies that May Help Bladder Cancer
There are a number of natural remedies that bladder cancer patients use either to treat the disease, symptoms associated with the disease, or side effects caused by cancer treatment. What follows is a breakdown of some of the more common natural remedies used by patients suffering from bladder cortical cancer.
• Massage – Not only can massage help with pain, it’s also a powerful tool to help cancer patients relax and relieve stress.
• Herbal Preparations – These often take the form of extracts, teas, and tinctures that can be taken orally to relieve pain or boost the body’s metabolism.
• Dietary supplements – As mentioned above, there are many vitamins and supplements thought to help prevent cancer and boost the body’s natural ability to combat cancer.
• Physical therapy – Join and muscle pain are common during cancer treatment, and physical therapy often helps relieve this pain while building overall strength.
• Hydrotherapy – Large water basins, spas, swimming pools, and even hot and cold body wraps are capable of offering real relief from stress and pain often associated with cancer and its treatments.
• Acupuncture – Many people swear by the healing and pain relieving abilities of acupuncture. It can be especially helpful for patients suffering from insomnia, nausea, and hot flashes.
• Counseling – There are many forms of counseling that can help with emotional stress or assist patients to adopt healthier lifestyles.
• Diet and Exercise – Eating healthy and remaining active are two of the best ways to maintain a healthy body and strong immune system. Nutrition plays a proven role in cancer prevention, so it’s important to eat plant-based foods with the nutrients that body needs to operate at its best
As with any form of cancer treatment, be sure to talk to your doctor before pursuing any natural remedy.
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