Bladder Cancer

Bladder cancer is the uncontrolled growth of abnormal cells in the bladder. The bladder is a triangle-shaped hollow organ placed in the pelvic region that stores urine. This type of cancer often begins in the urothelial cells inside the lining of the bladder. In normal conditions, the urothelial cells stretch when your bladder fills with urine and collapses when empty. The DNA mutation causes out-of-control multiplication and division of cells in the urothelial.  As a result of the abnormal mutation, bladder cancer severely impacts the urinary system. The hematuria (blood in the urine), painful urination, and frequent urge to urinate are its first visible signs and symptoms. 

Bladder cancer is the fourth most prevalent cancer that affects men the most. Most often, they recognize the signs and symptoms of bladder cancer when it is in the early stage. The early detection of symptoms leads to effective cancer treatment to kill the malignant cells. Conversely, women who do have bladder cancer recognize symptoms when the bladder cancer reaches the advanced stage. They often relate blood in pee with their gynaecological problems. The late detection of the disease leads to more complications/risk factors in the treatment.  The instances of bladder cancer are higher in Delhi, Banglore, and Mumbai. 

Surgery is the most common treatment for bladder cancer. This can help in disease reversal if detected in the early stage. However, it does not ensure that symptoms will never reoccur. In most cases, patients who have a history of bladder cancer again show signs of the cancer’s coming back. Notably, it is one of the deadliest cancers in the world. Read on the following article to learn about bladder cancer symptoms, causes, diagnosis, and treatment. This article will also help you know how to live with the bladder. And yes, do not forget to read simple preventative steps to reduce your risk of getting bladder cancer. 

Signs and Symptoms of Bladder Cancer

Blood in the urine is the first symptom of the bladder cancer. However, this is also a symptom of kidney cancer and other serious health conditions. This is less often seen in kidney cancer and the most often seen in bladder cancer. Hence, contact a healthcare professional when you first notice the blood in your pee.  Watch out for the following symptoms of bladder cancer for early detection:

• Blood in Urine (Hematuria): With microscopic hematuria, the healthcare professional detects red blood cells in the urine specimen to confirm bladder cancer. 
• Painful Urination: Also known as dysuria, the patient often experiences a burning or stinging sensation while urinating.
• Frequent Urge to Urine: The patient goes to the washroom several times a day.
• Trouble with Urination: The weak flow of urine is another symptom of the disease.  
• Untreatable Bladder Infection: A persistent bladder infection that does not go away despite taking medications. 
• Pelvic Pain: However, pelvic pain indicates a urinary tract infection or a problem with your pelvic region. It is also an indicator of bladder cancer. 

Fortunately, the early detection of bladder cancer’s symptoms is possible. Once you spot blood in your pee or any symptoms that worry you, schedule an appointment with the doctor immediately. The on-time screening tests help the doctor examine which stage of bladder cancer you have. Based on the diagnosis, the surgeon or urologist recommends the best treatment plan and ensures risk-free recovery from the disease. 

Bladder problems and bladder cancer share several similarities, including frequent need to urinate, painful urination, and burning sensation in urine. However, the key difference between bladder problems and bladder cancer is that bleeding in urine is common in bladder cancer. Conversely, patients with bladder problems never notice bleeding in their pee. Instead, they suffer from urinary incontinence or difficulty emptying the bladder which are less often seen in bladder cancer. 

Causes and Risk Factors of Bladder Cancer

DNA mutation initiates an abnormal growth of cancerous cells in the bladder. Here are some common bladder cancer causes that you should know:

•  Smoking: Smoking cigarettes doubles the risk of bladder cancer because when you smoke, they release harmful chemicals that accumulate in the urine with other organs. The toxic nature of chemicals damages the urothelial cells in the bladder and increases your risk of getting cancer. According to the ICMR (Indian Council of Medical Research) data, smoking causes 31% of bladder cancer deaths among men and accounted for 16% of deaths among women. ¹
• Chemical Exposure: Chemicals used in the manufacturing of, leather, rubber, textiles, dyes, and paint products cause bladder cancer. Exposure to harmful chemicals makes the functioning of the kidney difficult as they filter chemicals from the bloodstream before making them move into the bladder. This way, such patients are at a greater risk of developing cancer cells in the bladder.
• Chronic Bladder Irritation: Chronic or frequent urinary infections cause squamous cell bladder cancer. Also, the long-term use of a urinary catheter makes the chances of getting cancer stronger.
• Previous Cancer History: Patients who have received radiation therapy in their pelvic region because of the former cancer treatment are more prone to becoming the victim of bladder cancer. Likewise, the anti-cancer drug cyclophosphamide may also cause it.

Risk Factors

Now that you have learned the causes of bladder cancer. Let’s explore the risk factors that trigger the possibility of developing bladder cancer:

• Age: As your age increases, it is more likely to develop the symptoms of bladder cancer. Though it can happen at any age, most people diagnosed with this disease are older than 55 years.
• Gender: Men are more likely to get diagnosed with bladder cancer than women.
• Family History: If bladder cancer has run in your family, you are also more prone to develop cancerous cells in the bladder.

Stages of Bladder Cancer

The staging of bladder cancer helps in understanding how advanced the cancer is. As it grows more advanced, the treatment becomes more complicated. Hence, it is better to detect early signs and symptoms of bladder cancer to cure it. Let’s understand the stages of bladder cancer here:

• Stage 0:
  DNA mutation starts in the innermost lining of the bladder, known as urothelial cells or transitional epithelium. 
• Stage 1:
  The cancer is in the beginning stage. It has spread to the muscle of the wall.
• Stage 2:
  The cancerous cells start growing and invade into the deeper part of the bladder wall. 
• Stage 3:
  Over time, bladder cancer reaches into nearby tissue or organs. It may spread to lymph nodes.

Stage 4:
Also known as metastatic cancer, bladder cancer tends to reach distant lymph nodes, lungs, liver, or bones.

Bladder Cancer Diagnosis

If your healthcare provider suspects the symptoms of bladder cancer, they may recommend the following bladder cancer diagnosis tests:

• Urine Test: This test analyzes your pee or spots the traces of red blood cells (hematuria) in the urine specimen.
• Cytology: Certain cancerous cells are identified in the urine cancer.
• Cystoscopy: In this clinical test, the healthcare provider uses a thin tube and a thin camera to view the inner area of the bladder. On detecting bladder cancer with this method, the doctor moves to the next steps.
• Transurethral Resection of Bladder Tumor: This test is performed to remove cancerous cells for additional tests. It is an outpatient procedure that treats bladder tumors by removing them.
• Imaging Tests: Several imaging tests including CT Scan, MRI, and X-ray are done to get detailed and accurate images of the bladder and nearby organs. 

Bladder Cancer Treatment Options

The early stage bladder cancer is treatable and curable. Let’s understand the cancer treatment for bladder cancer here: 

1. Surgery
   In most cases, surgery is the ultimate cure for bladder cancer. The urologist recommends the best surgical option based on the patient’s cancer stage, age, medical history, and overall health conditions. The integration of cutting-edge technology has made the treatment more effective and less invasive. Researchers are trying to increase the success rate of the treatment for the advanced stage of bladder cancer. Soon, new developments in drugs or surgical methods will increase the success rate of the treatment.
   
   • TURBT: An extensive transurethral resection of bladder tumor (TURBT) surgery is conducted to remove cancer cells from the innermost lining of the bladder or nearby tissues. It is performed when the cancer is in the initial stage. In most cases, it has been observed that the second TURBT eliminates the possibility of the disease recurrence and further progression.
     
   • Cystectomy: If the cancer has invaded the muscle or there’s a risk that it would expand the muscle of the bladder, the surgeon removes all parts of the bladder. This operation is called a cystectomy. The open radical cystectomy maximizes the survival rate in patients. In contrast to radical cystectomy, the robotic-assisted laparoscopic cystectomy leads to a shorter hospital stays and less blood loss. Bladder surgery affects how you pass urine. However, this is the only way to cure bladder cancer.
     
   • Reconstruction Surgery (Urostomy): If the surgeon performs radical cystectomy, they feel the need to perform one more surgery called reconstructive surgery. It is mandatory to reconstruct a new way to pass urine. You must learn how to empty your urostomy bag or place a urinary catheter into the stomach post-operation. 

2. Chemotherapy
   Chemo drugs are cancer-killing drugs. The doctor uses intravesical therapy to provide chemotherapy drugs directly to your bladder. It only impacts the cancer cells and ensures zero risk for nearby healthy organs. However, the doctor calls the patient for periodic chemotherapy treatment, providing no side effects of drugs on healthy tissue.

3. Radiation Therapy
   Based on the tumor growth and complications, the doctor recommends radiation therapy with or without chemotherapy, targeted therapy, and surgery. In some cases, radiation therapy is an alternative to surgery. The heat X-ray waves kill the existing malignant cells in the bladder, ensuring no further progression of the cancer. 

4. Targeted Therapy
   As the name suggests, the targeted therapy targets the uncontrolled DNA mutation that turns healthy urothelial cells into cancer cells. Often, the doctor recommends it in conjunction with other treatments. 

5. Immunotherapy
   Based on the patient’s preferences, the doctor combines immunotherapy with other treatments. Intravesical immunotherapy intends to boost the immune system to attack early-stage bladder cancer cells. It includes the Bacillus Calmette Guerin (BCG) vaccine, Nadofaragene firadenovec (Adstiladrin) protein, and Nogapendekin alfa inbakicept receptor agonist to attack the bladder cancer cells. The BCG is usually given to patients with high-risk bladder cancer.

Prognosis and Recovery 

According to the present ICMR (Indian Council of Medical Research) data, around 50% of bladder cancers recur post-operative treatment in India.¹ However, the mortality rate and complications are lower in hospitals with experienced surgeons. The open radical cystectomy is a cost-effective and efficient treatment for bladder cancer.  Let’s understand the 5-year survival rate for the bladder cancer through the following pointers:

• Patients with stage 1 bladder cancer have around 88% of the 5-year survival rate²
• People suffering from stage 2 bladder cancer have around a 63% 5-year survival rate
• People diagnosed with stage 3 bladder cancer have an approximately 46% 5-year survival rate
• Patients suffering from stage 4 bladder cancer have about a 15% 5-year survival rate.

Here, the noteworthy point is that patients diagnosed with bladder cancer live for 5 years or more. The factors that impact life expectancy are the surgeon’s performance, recovery period, lifestyle adjustments, and follow-up procedures. 

Living with Bladder Cancer

Post-cancer treatment, people begin a new chapter of their lives. Hence, taking care of their emotional health and mental health should be the top priority of their family members. For some people, anxiety, depression, and fear that were once inside during the bladder cancer treatment start to recur. Sometimes, the lingering side effects trigger this emotional disturbance while in some cases, the fear of the symptoms’ reoccurrence disturbs the peace of mind. This time, the family and friends play a crucial role in making them see the positive aspects of life. The fear of the cancer reversal may grip them even after years of treatment. Here are some self-care tips that can help you live with a history of bladder cancer:

• Learn how you can avoid the risk of a second cancer
• Be aware of the fact that second-time reoccurrence is a matter of chance only that you should accept with confidence 
• Accept your fears and rewire them into positive thoughts
• Live in the present moment and find how you can be happier, more peaceful, and more energetic than before
• Use your energy to focus on mental wellness
• Be more physically active
• Set a self-care routine to make yourself empowered. 

Prevention and Reducing Risks

You can avoid the risk of second bladder cancer or any other form of cancer only with a few simple preventative measures. Here are some essential preventative measures for you to know:

• Go to all your follow-up appointments 
• Attend all screening tests to cooperate with your doctor in catching up on the recurrence of symptoms in the early stage
• Know possible long-term side effects after treatment
• Set reminders to remind yourself of medical appointments with your primary care provider. 

Take a look at the following steps you should follow to lower the risk of second cancer:

• Quit smoking and say no to tobacco
• Regular exercise to stay at a healthy weight
• Eat the right food
• Avoid nutritional supplements; If it is necessary to take them, first seek the doctor’s recommendation. 

Why Choose Dr. Prabhudev Salanki for bladder cancer treatment?

Dr. Prabhudev Salanki is a highly esteemed urologist in Bangalore, boasting an impressive educational background with degrees such as MBBS, MS, FRCS, DNB (Urol), FRCS (Urol), FEBU, and a Diploma in Laparoscopic Urology. He is also a Fellow of the International College of Robotics Surgeons, highlighting his advanced expertise in cutting-edge urological procedures.

Dr. Salanki specializes in treating a wide range of conditions, including uro-oncology, male and female urology, pediatric urology, prostate enlargement, urinary tract infections, urinary incontinence, and more complex diseases like bladder, prostate, and other urological cancers.

With a focus on utilizing advanced technologies, Dr. Salanki performs surgeries such as laparoscopic procedures, RIRS (Retrograde Intrarenal Surgery) with intracorporeal lasers, and PCNL (Percutaneous Nephrolithotomy), all with precision and personalized care. He is also a pioneer in robotic-assisted laparoscopic cystectomy, performing radical cystectomy to improve survival rates for bladder cancer patients in Bangalore. Known for his compassionate and attentive approach, Dr. Salanki is highly recommended for his expertise, high success rates, minimal complications, and commitment to holistic patient care.

Struggling with the symptoms of bladder cancer? Fear not! Schedule a consultation with Dr. Prabhudev Salanki to get the best bladder cancer diagnosis and treatment, supported by personalized care and treatment. 

Medically Reviewed by Dr. Prabhudev Salanki