Getting diagnosed with bladder cancer can be a life-changing experience. May that be any cancer, that of the bladder or otherwise. Cancer can be difficult to deal with, especially if it is in a late stage. The later it is caught, the more life-changing its effects and the more difficult its treatment. Hence, it is imperative to get tested for bladder cancer and catch it early. Read on to know more.
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The stress a patient feels when observing the initial symptoms of a life-changing disease can be extremely demotivating. Imagine a situation, where suddenly one day in the bathroom, you notice that you’re urinating blood, or experience sudden bladder pain. You visit your local oncologist and get a stressful diagnosis. Well, what now?
The first step you can take is to prepare and inform yourself. That is the purpose of this blog.
I Have Bladder Cancer: What Is It?
Have you been diagnosed with bladder cancer? It is a type of cancer that begins in the urothelial cells that line the inside of the bladder. The bladder is a muscular organ responsible for storing urine before excretion.
Urothelial cells are a fine layer of cells that line the inside of the bladder. During cancer, the body overproduces mutated versions of these cells, leading to tumors and eventually cancer. These same urothelial cells are also present in the kidney and the ureters (tubes that carry urine). Therefore it is possible to contract cancer there too, but it is significantly more common for cancer to originate in the bladder.
Of course, bladder cancer if it mutates enough, can progress to the rest of the organs eventually.
What Kind of Bladder Cancer?
Your bladder is made up of a series of different cells important for a series of different functions. The bad news is, bladder cancer can originate in any one of these cells. To make matters worse, your cancer may even be a combination of these cell-based cancers. Below are the types of bladder cancers based on the cells that are infected.
Urothelial carcinoma, or urothelial cancer, was once also known as transitional cell carcinoma, based on the transitional property of urothelial cells. What that means is, urothelial cells have the property to expand or contract based on the urine content in the bladder. To accommodate enough urine, this gives the bladder and the ureters the property to be elastic. Urothelial carcinoma is the most common kind of bladder cancer.
Squamous Cell Carcinoma
Chronic inflammation, irritation, or infections such as urinary tract infections in chronic cases, are associated with squamous cell carcinoma. It is common in parts of the world where schistosomiasis, a parasitic infection, is common. Due to chronic irritation, flat squamous cells begin forming in the bladder, leading to this form of cancer.
Paraurethral glands are small mucus-secreting glands that form a thin layer of mucus over the epithelial layer of bladder skin. Adenocarcinoma is a cancerous mutation of the cells that make up these glands. Adenocarcinoma is rare, and can also be caused by long-term irritation or inflammation in the bladder.
What Are The Signs & Symptoms I Can Expect With Bladder Cancer?
So far, you’ve read nothing but grim news about what to expect with bladder cancer. But here’s the positive:
Most bladder cancers can be diagnosed early when they’re significantly more treatable.
However, even stage 1 bladder cancer can reoccur post-treatment. That’s why bladder cancer patients require following up with tests for pretty much years or even the rest of their life, after the first diagnosis and treatment.
Here are a few signs and symptoms that patients can expect to see. In the case of these symptoms, patients must get themselves tested for bladder cancer immediately.
- Hematuria (bloody urine)
- Frequent urination
- Pain during urination
- Lower back pain
- Abdominal pain
- Urinary incontinence (no or less control over urination)
It is worth noting, however, that certain cases can have blood in the urine but no pain during urination. Other cases may see pain during urination, but no visible blood. In the latter case, however, blood in the urine often presents itself in test results.
Diagnosing Bladder Cancer
So you’re suspecting bladder cancer, and you go to consult your urologist or oncologist. But you’re not sure what to expect, or what tests to undergo. Consider this your guide!
Your doctor might use one or multiple of these procedures, methods, and tests to diagnose the presence of cancer in the patient.
A sample of urine is analyzed under a microscope. This allows the doctors to check for the presence of cancerous cells in the urine and diagnose bladder cancer.
The doctor may conduct a physical examination. In this test, the doctor will insert fingers into the patient’s vagina or rectum to check the presence of any lumps, while wearing gloves of course. Lumps may suggest a cancerous growth.
A camera and tube will be used to view the inside of the bladder. A small and narrow tube, with a camera on one end, will be inserted into the patient’s urethra. The scope is fed through the urethra, into the bladder to check for signs of cancer or disease on the lining.
In tandem with a cystoscopy, if the doctor finds abnormal growths within the bladder or urethra, a tissue sample may be needed for testing. This tissue sample is extracted by feeding specialized surgical tools through the cystoscope. While using the view from the camera of the cystoscope, the doctor may conduct this procedure on the spot. This procedure is also known as Transurethral Resection of Bladder Tumor (TURBT), and can also be used as a treatment option for bladder cancer.
A CT scan is an imaging test to get a proper image of the bladder. A contrast dye injected into the bloodstream may be used to help provide clearer images.
X Ray/ Retrograde Pyelogram
A retrograde pyelogram is a variation of the standard X-Ray imaging test. In this test, the doctor will thread a thin tube or catheter into the bladder through the urethra. The tube will then be filled with contrast dye, to make the urethra more visible in the x-ray.
Based on the results of these tests, the doctor will diagnose the patient with bladder cancer and assign the patient a stage. The aggression and the spread of the cancer are determined by this stage number.
- Stage 0: Cancer hasn’t spread past the epithelial lining of the bladder
- Stage 1: Bladder cancer has spread past the bladder lining but hasn’t reached muscle
- Stage 2: Bladder cancer has spread to the muscle
- Stage 3: Bladder cancer has spread to the surrounding tissue
- Stage 4: Bladder cancer has spread and reached other parts of the body
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Bladder Cancer Treatment: What to Expect
The intensity of the treatment and subsequent treatment options will be decided majorly based on the stage of cancer. However, the doctor will work with the patient to decide the best possible course of treatment. However, the following are the treatment options that will usually be considered.
Tumor removal surgery, along with certain aspects of radiation therapy may be used for treatment. However, this surgery is best suited to lower grades of cancer. A higher grade of cancer may warrant this surgery in tandem with another treatment, or stronger treatments in general.
Treatment options are divided into two types of treatment, intravesical chemotherapy or systemic chemotherapy. Intravesical chemotherapy is a good option to treat lower grades of cancer. This means that cancer must be still limited to the bladder lining. However, cancer may be aggressive enough to progress to higher stages.
On the other hand, systemic chemotherapy is the most appropriate treatment for higher grades of bladder cancer. This treatment aims to increase the chance of recovery in a patient whose cancer has progressed too high for surgery.
Treatment for higher cancer stages, radiation therapy may be used as a treatment on its own or in tandem with surgery. Radiation will help to shrink the cancerous growth prior to surgical removal.
This treatment uses medication to trigger the body’s immune system to fight cancer cells.
In case of highly advanced cancer, the bladder may be removed and replaced with a ‘neobladder’ made from tissue from the patient’s bowel. This removal of the bladder (along with surrounding lymph nodes) is known as a radical cystectomy.
It is more than likely that in the case of bladder cancer, more than one treatment might be used in tandem by your healthcare team. This will help to shrink cancer prior to surgery, or treat it without surgery, etc. Depending on the patient’s condition, the treatment may vary slightly.
Advanced bladder cancer may demand radical treatment procedures that aggressively change a patient’s way of life. However, bladder cancer can be detected and treated early with high rates of success. Therefore, it is imperative that patients get themselves tested early for bladder cancer if noticing any signs or symptoms. As it is said, prevention is indeed better than a cure!
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