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Bladder Cancer

  • What is Bladder Cancer?

    The bladder is a muscular balloon-like organ that lies inside the pelvis. It collects urine from the kidneys and stores it. Bladder cancer is the abnormal growth of tissues in the bladder. When the cells in the bladder (mainly in the lining of the bladder) divide uncontrollably and produce extra tissue, they develop into a growth, also known as a tumour. Bladder cancer that is restricted only to the lining of the bladder wall is called superficial bladder cancer. Invasive cancer is when the cancer spreads to the muscle wall and to other organs including the lungs, liver and bone.

    There are 3 types of bladder cancer:

    • Adenocarcinoma (cancer that forms in mucus-secreting glands)
    • Squamous cell carcinoma (cancer that develops from cells on the lining of organs)
    • Transitional cell/urothelial carcinoma (cancer that occurs in the urinary system)
  • The specific cause of bladder cancer is unclear. However, various risk factors have been linked to bladder cancer:

    • Diet high in saturated fat and regular intake of certain Chinese herbs and painkillers
    • Chronic bladder infection and certain parasite infections, eg. schistosoma haematobium found in developing countries
    • Smoking is responsible for more than 50% of all bladder cancer cases
    • Ageing – majority of cases occur in people over the age of 70
    • Other risk factors include gender (male), race (Caucasians) and a family history of bladder cancer
    • Repeated exposure to certain chemicals in the environment, such as hair dye and aniline dyes used in textile and rubber industries
    • Treatment of other cancers, such as radiotherapy to the pelvis area or chemotherapy with a drug called cyclophosphamide
    • Blood in the urine
    • Frequent urination
    • Painful sensation while urinating

    These symptoms are also present in less serious conditions, such as urinary tract infections and urinary stones.

  • Different treatment options are available for bladder cancer, depending on the grade of the cancer and how deeply it has invaded the bladder wall.

    The treatment also depends on general health. A doctor will evaluate your condition and suggest an appropriate treatment plan that can be a single or a combination of treatment methods.

    If the bladder cancer is still in the superficial (early) stage, treatment includes:

    • Follow-ups after treatment, as superficial bladder cancers tend to relapse
    • Transurethral resection of bladder tumour (TURBT), a minimally invasive surgery that uses a resectoscope, which is inserted into the bladder through the urethra, to cut the tumour out or burn the cancer cells with an electric current
    • Intravesical chemotherapy, which can be used alone or after TURBT, whereby chemotherapy drugs are injected directly into the bladder through a catheter

    If the bladder cancer has reached an invasive (advanced) stage, the following treatment options may be advised:

    • Biological therapy – using live-attenuated (made less harmful) BCG bacteria to start an immune response against the bladder cancer cells. The bacteria is injected directly into the bladder using a catheter
    • Chemotherapy drugs – injected into the veins to circulate in the blood and reach nearly every organ in the body. They can also be taken orally
    • Radical cystectomy – a surgery that removes the entire bladder, surrounding lymph nodes and any nearby organs that have become cancerous. The doctor will create a replacement bladder by using a part of the small or large intestine
    • Radiotherapy – involves high-energy rays that destroy cancer cells to reduce symptoms caused by the disease
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