Bladder cancer increases with age and is four times more common in men than women and twice as high in Caucasian men than African-American men.
80% of newly diagnosed individuals are 60 years of age or older.
Except for skin cancer, bladder cancer is the most frequently recurring cancer, with up to 70% of patients experiencing a recurrence.
When the disease is diagnosed and treated in early stages, the chances of survival are excellent, highlighting the importance of a timely and accurate diagnosis.
Causes of Bladder Cancer
Most diagnosed bladder cancer cases occur in industrialized and polluted nations.
Tobacco is the greatest risk factor for bladder cancer, accounting for half of all cases. Even if one stopped smoking years ago, the risk is related to the quantity of tobacco smoked over the years.
Occupational exposure to cancer-causing chemicals (carcinogens) is another risk factor: dye, rubber, leather, aluminum, paint, and arsenic in drinking water.
Occupations at higher risk for bladder cancer because of chemical exposure include: hairdressers, painters, machinists, printers, and those who work with dyes, textiles, rubber, leather, and petrochemicals.
The Relationship Between Tobacco and Bladder Cancer
Bladder cancer is the second most common tobacco-related malignancy (#1 is lung cancer).
Tobacco is the leading risk factor for bladder cancer and most newly diagnosed bladder cancer patients are smokers or former smokers. About 20% of newly diagnosed bladder cancer patients are current smokers.
Cancer causing chemicals (carcinogens) in tobacco are absorbed through the lungs into the bloodstream, circulate throughout the body, filter through the kidneys (causing kidney cancer or RCC) into the urine and have prolonged contact time with the bladder as urine is stored in the bladder.
There is a long lag time between carcinogen exposure and the development of bladder cancer, often more than twenty years, similar to the relationship between sun exposure and skin cancer.
The health benefits of stopping smoking are considerable, decreasing the chances of bladder cancer recurrence, progression and development of another tobacco-related cancer. Those smokers diagnosed with bladder cancer have a window of opportunity where a lifestyle change to quit smoking occurs.
Continuing to smoke after diagnosis is associated with worse disease outcomes compared to those who quit.
The Relationship Between Kidney and Bladder Cancer
Bladder and kidney cancers are both diseases of the urinary tract.
The causes of both are primarily the same, and therefore it is possible that both types of cancer may be present at the same time.
Human internal organ with kidneys and bladder illustration Image by brgfx on Freepik
Symptoms
Blood in the urine is something you need to get checked out, although it can be caused by something other than bladder cancer.
Other signs include an irritating lower urinary tract and urgency, frequency, discomfort with urinating, and urinary leakage.
The Doctor will carry out a number of non-invasive tests to check your bladder. The final check though is done by visual inspection of the lower urinary tract (bladder and urethra) using a tiny, flexible, lighted instrument attached to a camera and monitor. Sometimes a small sample (biopsy) of bladder wall is taken if a cancer tumour is suspected.
The Stages of Bladder Cancer
The suspect tissue sample is examined and information regarding type and malignancy are determined.
The majority of bladder cancer tumours are those in the cells that line the bladder. A minority of bladder tumours are squamous cell cancers. Squamous cell cancers are flat and scale like.
Depth refers to the degree that the cancer is growing into the bladder wall. Bladder cancers are broadly categorized into superficial and deep. Superficial tumours are largely confined to the bladder lining and superficial layers and do not penetrate the muscle layer of the bladder. Deep tumours have “roots” that penetrate the muscular wall of the bladder.
Tumour grade refers to how much the microscopic appearance of the cancer deviates from the microscopic appearance of healthy bladder cells. Low-grade cancers are similar in cellular appearance to normal bladder cells and generally behave in an slow fashion. High-grade cancers often behave aggressively. Other factors of prognostic importance are the number of tumours present, the size of the tumours, and their physical characteristics.
4 Stages of Bladder Cancer
In general, the best prognosis is for a solitary, small, superficial, low-grade tumour.
The the worst prognosis is for many tumours originating from many different areas of the bladder, and/or large, invasive (deep), high-grade tumours.
Diagnostic Statistics
The majority of patients with newly diagnosed bladder cancer have superficial cancer that only involves the inner layers of the bladder wall.
20% have invasive disease that involves the deeper layers of the bladder wall, and 5% present with metastatic disease, defined as spread beyond the confines of the bladder.
Treatment options
The treatment selected for your particular tumour is dependent on the type and placement of that (those) tumours.
Superficial (surface only) the treatment is mainly wait and see with regular inspections or tests.
The next step is to inject a chemical or BCG vaccine into the bladder. This attacks the tumour directly while the chemical is retained in the bladder.
When the tumour(s) have grown into the muscle and fat of the bladder then surgery to remove some or all of the bladder may be required. This may then require an external urine collection bag needs to be used for the rest of your life.
When the bladder cancer spreads to other organs then chemotherapy and/or irradiation will be recommended.
Prevention
Prevention is a lot better than the "cure".
A number of studies have shown that a phyto-chemical called Isothiocyanates does kill bladder and kidney cancer cells.
This chemical is found in naturally occurring foods, namely Cruciferous vegetables. These include cabbage, Brussels sprouts, brocolli with the outstanding vegetable being Wasabia japonica, which is 40 times more potent than its nearest rival.
Eating your greens is actually good for you and may keep you cancer free.
