Urinary Bladder Cancer

The bladder is a balloon-shaped organ in the pelvis which stores the  urine. When cells that line the inner part of bladder turn malignant, the resulting condition is called cancer of bladder.

Bladder cancer is common in elderly , though it can occur at all ages.Common type of tumor is called transitional cell carcinoma (Urothelial Cancer) that arises cells that line the renal calyces, renal pelvis, ureter, bladder , the urethra up to urethral meatus. This cancer has the highest risk of recurrence and demands very close follow up.Tumor types less often seen are called Squamous cell and Adenocarcinoma .

Symptoms

• Blood detected in urine
• Frequent and painful urination
• Lower abdominal pain

Risk Factors

• Smoking due to presence of Nitrosamine, naphthylamine carcinogens present in smoke
• Common in males
• Exposure to aromatic amines and aniline dyes
• Previous Radiotherapy, Chemotherapy
• Long term catheter drainage in neuropathic bladder

DiagnosisUltrasound, CT scan usually will detect the tumour size in the bladder and presence of similar tumour in other part of urinary passageEndoscopic examination of the bladder usually confirms the diagnosisTreatmentBladder tumour starts in the lining of bladder and can grow deep in to the bladder. Endoscopic resection of tumour can be done and the raw area heals well. Additional chemotherapy may be required in certain situations. Careful follow up endoscopy is important to check tumour recurrence and extension of tumour in to bladder muscle layer

• If the tumour has spread in to the bladder muscle or there is development of Cancer in situ removal of entire urinary bladder ( Radical cystectomy  Surgery) will be required.
• Sometimes radiation therapy to reduce the tumour bulk can be given before radical cystectomy and artificial new urinary bladder has to be reconstructed to provide urine drainage.