October 24, 2014
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Cancer of the Bladder

(Bladder Cancer)

The Facts on Cancer of the Bladder

In cancer of the bladder, certain harmful cells invade the bladder and destroy healthy cells, which cause the bladder not to function properly.

The bladder is a hollow organ that stores urine as it is filtered from the kidneys. The flexible bladder wall is made up of three layers, allowing the bladder to expand and contract as needed. 90% of bladder cancers are found in the epithelial lining, the innermost layer of the wall.

Bladder cancer is the sixth leading cause of new cancer cases in Canada each year. It is diagnosed 2 to 3 times more often in men than in women, and it is seen in Caucasians twice as often as those of African descent. It's the fourth most common cancer among American men, the ninth most common in women.

Because of early diagnosis and better treatments, the mortality rates for this disease have been falling significantly over the last 25 years.

Causes of Cancer of the Bladder

The actual cause of bladder cancer is unknown, but there are some proven risk factors. They include:

  • smoking - smokers are twice as likely to develop bladder cancer than non-smokers
  • chemical exposure - certain chemicals, such as those used in the following professions, can become concentrated in the urine, creating a risk factor for cancer:
    • hairdressers
    • painters
    • textile workers
    • dye, leather, and rubber workers
  • race - Caucasians have twice as high a risk of developing this cancer as people of African descent; Asians have the lowest risk
  • gender - men have a 2 to 3 times higher risk than women of developing bladder cancer
  • age - most cases of bladder cancer are diagnosed in people over the age of 40 years
  • previous use of certain chemotherapy medications, such as cyclophosphamide* (often used in breast cancer and lymphoma treatment), can significantly increase the risk of later developing bladder cancer
  • previous radiation to the pelvic area
  • family or personal history of bladder cancer




Symptoms and Complications of Cancer of the Bladder

The symptoms of bladder cancer are easily confused with those of a bladder or urinary tract infection, kidney stones, or prostate problems. They are:

  • blood in the urine (most common)
  • pain or burning sensation while urinating
  • a feeling of urgency or needing to urinate immediately
  • the feeling of not having emptied the bladder completely after urinating
  • pain in the lower back

If any of these symptoms are present, it's important to get them checked by your doctor to get a diagnosis of what's causing the symptoms.

It is important to catch bladder cancer early. This increases the chance that treatment will be successful. Complications from bladder cancer occur more from the treatment (such as surgery) rather than the cancer itself. However, if the cancer is left untreated and allowed to grow, it will eventually cause even greater complications. Cancer that has spread from the bladder is more difficult to treat.

Complications from surgery depend on the type of surgery. If a partial cystectomy (removal of part of the bladder) takes place, the bladder can still collect urine, but will be quite a bit smaller. This means the person will have to urinate much more often. As well, cancer can return, and frequent checkups are necessary so that any cancerous cells can be found as early as possible.

After a full cystectomy (removal of the entire bladder and prostate), there's no bladder to hold the urine, so another way to hold and eliminate urine must be made. In some cases, a new bladder can be created by using a small section of bowel tissue. This new bladder has to be regularly emptied manually, usually by using a tube or a catheter (a thin, flexible tube inserted into the body that permits the introduction or withdrawal of fluids).

Or, a urostomy may be necessary, in which a surgeon connects the ureters (tubes that drain the urine from the kidneys to the bladder) to the abdominal wall to create a stoma (opening). A plastic bag is externally attached to the stoma, acting like a bladder to collect urine. The bag must be emptied regularly.

Other complications from bladder cancer surgery may include infertility for women (if the uterus is removed), menopause (if the ovaries are removed), and possibly some sexual dysfunction if the vagina has been made smaller or shorter.

Men can also experience sexual dysfunction and infertility due to the removal of the prostate and the seminal vesicles (the glands that make semen).

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