Bladder Cancer
What is Bladder Cancer?
Bladder cancer occurs when abnormal cells grow within the bladder, the organ responsible for storing urine. It is one of the most common cancers affecting the urinary system. Although more often diagnosed in older adults, bladder cancer can occur in anyone and is more frequent in men than women.
There are two broad categories. Non muscle invasive bladder cancer is confined to the inner lining of the bladder. Muscle invasive bladder cancer has grown into the bladder wall or surrounding tissues. Early diagnosis is important because treatment is most effective when the cancer is detected before it spreads.
What causes bladder cancer?
The exact cause is not always known, but several factors increase risk. Smoking is the most significant contributor because chemicals from tobacco enter the bloodstream, are filtered by the kidneys and collect in the bladder, where they can damage the lining over time.
Age and gender also play a role, with most cases occurring in people over 55 and more commonly in men. Chronic bladder irritation from repeated infections, kidney stones or long-term catheter use can contribute.
Exposure to certain industrial chemicals used in dyes, rubber and textiles has been linked to bladder cancer. Family history and genetic factors may also increase risk. Individuals who have previously received chemotherapy or pelvic radiation for other cancers may have a higher likelihood of developing bladder cancer. Other contributing factors can include diabetes and long-standing infections from parasitic diseases such as schistosomiasis.
Who is affected?
Bladder cancer primarily affects older adults, although it can occur in younger individuals. Men are affected more often than women. People who smoke, work in industries with known chemical exposures or have long term bladder conditions may be at higher risk.
Common symptoms
Bladder cancer symptoms can overlap with other urinary conditions, and persistent signs should always be evaluated. Many people experience blood in the urine, which may appear pink, red or dark brown, or may only be visible on urine testing. Frequent urination, urgency or pain during urination may occur. Some individuals feel lower abdominal or pelvic discomfort.
Less commonly, people may experience incontinence or difficulty controlling urine. Persistent symptoms or recurrent episodes should prompt medical assessment.
What are the possible complications of bladder cancer?
If bladder cancer is not diagnosed early, it can become more difficult to treat and may progress beyond the bladder.
How is bladder cancer diagnosed?
Diagnosis usually begins with a detailed medical history and physical examination. Urine tests may be performed to check for blood, infection or abnormal cells.
A cystoscopy is one of the most important diagnostic tools. This involves inserting a small camera through the urethra to examine the inside of the bladder. If suspicious areas are seen, a tissue sample, biopsy, may be taken.
Imaging studies such as ultrasound, CT or MRI can help evaluate the bladder, kidneys and surrounding tissues, and determine whether cancer has spread.
Stages of bladder cancer
Bladder cancer is staged according to how deeply it has grown and whether it has spread.
- Stage zero disease is confined to the bladder lining.
- Stage one has grown beneath the lining but not into the muscle.
- Stage two has invaded the bladder muscle.
- Stage three has grown into surrounding tissues.
- Stage four indicates spread to distant organs such as the lungs, liver or bones.
Staging helps guide treatment and predict outcomes.
How do you treat bladder cancer?
Treatment depends on the stage, location of the tumour and the person’s overall health.
Surgery is often the first step for non muscle invasive disease. Transurethral resection of bladder tumour, TURBT, removes tumours through the urethra using a cystoscope. Muscle invasive cancer may require partial or complete removal of the bladder, cystectomy, and sometimes nearby organs such as the prostate, uterus or ovaries.
Chemotherapy may be delivered directly into the bladder, intravesical chemotherapy, for early stage disease or through the bloodstream, systemic chemotherapy, for more advanced cancer.
Immunotherapy including BCG treatment can stimulate the immune system to target cancer cells in non muscle invasive disease. Checkpoint inhibitors may be used for advanced cancers.
Radiation therapy may be used to shrink tumours before surgery or to treat cancer that cannot be removed surgically. Targeted therapy may also be recommended, which focuses on specific cancer cell pathways.
For advanced or incurable cancer, palliative care aims to manage symptoms, maintain comfort and support quality of life.
Preventing bladder cancer
Although bladder cancer cannot always be prevented, risk can be reduced by avoiding smoking, minimising exposure to harmful workplace chemicals, staying well hydrated and eating a diet rich in fruits, vegetables and fibre.
When should you see a doctor?
You should seek medical advice if you notice blood in your urine, pain during urination or persistent pelvic discomfort or urinary frequency. Although these symptoms are not always caused by cancer, early assessment is important. Early diagnosis and treatment improve outcomes and increase the likelihood of successful treatment.
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