Bladder Cancer: The Facts

What is it?

As the name implies, Bladder Cancer originates in the bladder, which is part of the urinary tract. The bladder is a balloon-like sac in the body that stores urine. Urine is a toxic waste material that is produced by the kidneys as they filter the blood. After being produced in the kidneys, urine passes to the bladder by way of thin hollow tubes called ureters. During urination, urine stored in the bladder passes through the urethra and out of the body.

There are several different layers of tissue that make up the bladder. A muscular wall surrounding the bladder contracts and relaxes to accommodate different volumes of urine. The inner lining of the bladder is composed of layers of tissue known as transitional cells. The kidneys, ureters and urethra are also lined with these types of transitional cells.

Transitional cell carcinoma (TCC) accounts for about 9 out of 10 cases of Bladder cancer. This type of Bladder Cancer begins in the transitional cells that line the bladder. Many cases of TCC tend to remain confined to this lining for long periods of time only superficially affecting the function of the bladder. A more invasive stage occurs when TCC spreads to the deeper layers of the bladder. Metastases can then follow, in which cells from the tumor can break off, enter the lymphatic system, and travel to other parts of the body. TCC is very treatable when it is diagnosed at the stage where it is still isolated in the bladder lining.

Squamous cell carcinoma is a less common form of Bladder Cancer, making up about 8% of all cases. This type of Bladder Cancer begins in a different type of bladder tissue than in TCC. Almost all cases of squamous cell carcinoma become located invasively in deeper layers of the bladder.

Adenocarcinoma is a rare form of Bladder Cancer, making up 2% of all cases, and almost always involves deeper layers of the bladder.

Who gets it?

Next year in the U.S., about 55,000 people are expected to be newly diagnosed with Bladder Cancer. It is the 4th most common cancer among males and the 9th most common among females. In general, about three times as many males are diagnosed as are females. Race also seems to be a factor in determining the likelihood of developing Bladder Cancer. Two to three times as many Caucasians are diagnosed than are African-Americans. Rhode Island has the HIGHEST bladder cancer incidence rate in the country.

It is NOT KNOWN EXACTLY how Bladder Cancer begins, but there are certain risk factors that have been attributed to a higher chance of developing it. The primary risk factors include:

• Smoking - More than doubles your odds of developing Bladder Cancer
  
• Occupational Hazards - Good safety practices are critical in workplaces with toxic chemicals such as analine dyes
  
• Chronic bladder problems
  
• Family history of Bladder Cancer
  
• Personal history of previous Bladder Cancer
  
• Over 55 years of age
  

How is it detected?

There are several different tests that can be performed by a doctor to determine the actual cause of the symptoms and whether or not it is cancer. Each patient's individual case determines which tests are appropriate for him or her. The following descriptions are meant to provide patients with information to aid them in discussing their options with their physician.

Diagnostic Tests:

• Urine culture: A urine sample is analyzed for signs of infection
  
  
• Urine cytology: Urine or cells are examine in the lab for signs of cancer
  
  
• Flow Cytometry: Urine sample, bladder washings, or tissue samples, are analyzed to determine the amount of DNA present; provides information on cancer reoccurrences
  
  
• Bladder tumor marker studies: Urine is examined for "markers" associated with cancer
  
  
• Cystoscopy: A cystoscope ,a slender tube with a lens and a light, is placed into the bladder through the urethra. Anything unusual can be removed for a biopsy
  
  
• Biopsy: Tissue samples are removed and examined to determine cancerous state of the cells
  
  
• Intravenous pyelogram (IVP): A special dye is put in the blood stream and X-rays are taken to obtain a picture of the bladder and urinary tract
  
  
• CT, MRI and other imaging studies: Used to determine if the cancer had spread to other organs
  

Screening for Bladder Cancer in asymptomatic patients who have no personal history of the disease is not routine. However, even very early stage Bladder Cancer is normally associated with recognizable symptoms. These symptoms can be a result of a number of different things and should not automatically be assumed to be cancer. It is important to report any of these conditions to your doctor so that the appropriate diagnostic tests can be performed.

Symptoms:

• Blood in the urine – a rusty or red color
  
• Change in bladder habits – Frequent need to urinate or delay when trying to urinate
  
• Pain when urinating
  

Is it curable?

More than 94% of people with Bladder Cancer survive if it is diagnosed at an early stage. If treatment doesn't begin until after the cancer has spread to nearby organs, the survival rate drops to 50%. Like most other cancers, the survival rate for Bladder Cancer greatly diminishes if the cancer has spread throughout the body to distant organs. Don't hesitate to report any symptoms to your doctor! Early detection and treatment are essential.

It's easier to prevent cancer than to treat it....

Certain lifestyle and dietary habits can greatly reduce your risk of developing Bladder Cancer (as well as other cancers). Some of these include:

• Not smoking
  
• Regular exercise
  
• Moderate, if any, consumption of alcohol
  
• Low fat, high fiber diet
  

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