×

Bladder Cancer

kidney-overview

Overview

Urinary bladder is a part of the urinary system and its main function is to store urine passed down from the kidneys. The bladder is made up of 4 layers. These are

  • Transitional epithelium
  • Lamina propria
  • Muscularis propria
  • Fatty connective tissue

Bladder cancer starts developing in the inner lining of the urinary bladder. According to the Globocan 2018 report, the incidence rate and mortality rate for bladder cancer was found to be 1.6% and 1.3% respectively in India.

Types of Bladder Cancer

Transitional cell carcinoma

Transitional cell carcinoma, also known as urothelial carcinoma, begins in the urothelial cells that line the inner layer of the urinary bladder. It is the most common form of bladder cancer.

Squamous cell carcinoma

These types of bladder cancer are usually invasive and are less likely to occur than transitional cell carcinoma. It accounts for 1-2% of bladder cancers.

Adenocarcinoma

This is an invasive carcinoma and it accounts for only 1% of bladder cancers.

Small cell carcinoma

This type of bladder cancer usually begins in neuroendocrine cells. It accounts for less than 1% of bladder cancers.

Sarcoma

This type of bladder cancer is rare and it originates in the muscle cells of the urinary bladder.

Causes

Acquired (somatic) genetic mutation in genes such as TP53or RB1 tumor suppressor genes and FGFR and RAS oncogenes are responsible for development of bladder cancers. Sometimes, exposure to radiation or cancer inducing chemicals leads to acquired gene mutations. Inherited (germline) gene mutations are not generally a major cause of bladder cancer.

Risk Factors

Smoking

This is one of the major risk factor which increases the risk of bladder cancer. The risk is much higher in people who are smoking from a long time or if they have started it at a younger age. A chemical named arylamines in cigarette smoke is responsible for increased risk of bladder cancer.

Exposure to hazardous chemicals at work

Exposure to chemicals such as arylamines and polycyclic aromatic hydrocarbons (PAH) for a long period of time increases the risk of developing bladder cancer.

Bladder infections and irritation

Certain disease conditions such as gonorrhea and bladder stones increases the risk of developing bladder cancer.

Family history

If any relative in the family has a history of bladder cancer you may also be at a higher risk of developing it.

Previous history of bladder cancer

If a person has a previous history of bladder cancer he is more likely to develop cancer in other parts of the urinary tract.

Signs & symptoms

Detection of blood in the urine

Frequent urination

Loss of weight

Tiredness

Burning sensation or irritation while urinating

Back pain or pain in the bones

Diagnosis

Cystoscopy: A cystoscope is used to examine the inner part of the bladder and urethra.

CT urogram: This procedure mainly helps in staging of cancer and also identify the causes of the symptoms. It makes use of a CT scan and a dye to visualize the urinary system.

Ultrasound scan: It is performed to check any other complications such as blockages in the ureters, and its spread.

Intravenous pyelogram (IVP): It is a test performed to examine the urinary system as a whole. This will help in determining the health of urinary tract, spread of bladder cancer or blockages in the ureter.

diagnosis-image

References