Bladder Cancer: Causes and Symptoms

Bladder Cancer (Bladder Tumor)

Bladder cancer is the growth of abnormal tissue on the inner lining of the bladder. In some cases, the tumor also grows into the muscles of the bladder wall.

The most common symptom of bladder cancer is blood in the urine, which is usually painless. If someone notices blood in the urine, even if it occurs only from time to time, they should see a urologist for further evaluation.

What Is Cancer?

Cancer occurs when the structure of genes inside cells changes in the DNA. These changes can alter how fast the cells grow, meaning the cells begin to grow and multiply uncontrollably and form masses called tumors.

Causes of Bladder Cancer

Most cases of bladder cancer appear to be caused by exposure to harmful substances that can produce abnormal changes in bladder cells over many years.

• Tobacco and smoking:This is one of the common causes, and it appears that more than 1 in every 3 people with bladder cancer developed it because of smoking or inhaled substances such as opium.

Exposure to certain chemicals:Exposure to chemicals in factories is another cause of bladder cancer, although the use of such substances in factories is now limited. Exposure to some specific industrial chemicals is the second underlying risk factor for bladder cancer and accounts for about 25 percent of cases.

Occupations with greater exposure to bladder cancer risk include:

• Paint manufacturing

• Textile work

• Painting

• Plastic manufacturing

• Leather production

• Rubber manufacturing

Non-industrial occupations are also associated with bladder cancer, such as:

• Drivers, including taxi and bus drivers, because they have prolonged exposure to diesel exhaust.

Other Predisposing Causes of Bladder Cancer

Other predisposing factors that increase the risk of bladder cancer include:

• • A history of radiotherapy to areas near the bladder, such as for bowel cancer

  • Previous exposure to certain chemotherapy drugs such ascyclophosphamide and cisplatin

  • Diabetes

  • People who have used a urinary catheter for years.

  • Recurrent and long-lasting urinary tract infections

  • Long-standing bladder stones

  • Early menopause (before age 45)

• Untreated schistosomiasis infection, which is very rare in Iran.

Types of Bladder Cancer

Bladder tumors are classified as follows based on how far they have spread in the body:

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  Non-muscle-invasive bladder tumors:

  
  

If a bladder tumor is limited to the inner surface of the bladder wall, it is called a non-muscle-invasive tumor. This is the most common type of bladder tumor.

People who see a physician with this type of bladder tumor usually have a life expectancy similar to that of the general population if they continue regular follow-up.

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  Muscle-invasive bladder tumors:

  
  

If bladder tumors extend beyond the inner surface of the bladder and reach the muscles of the bladder wall, they are called muscle-invasive bladder tumors. These tumors are less common, but they are more likely to spread to other parts of the body and involve other areas.

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  Advanced or metastatic tumor:

  
  

If a bladder tumor spreads to parts of the body outside the bladder, it is called advanced bladder cancer or metastatic disease.

How Bladder Cancer Spreads

• Bladder cancer begins in the superficial layer of the bladder wall and, in some cases, may reach the muscular wall of the bladder. In that situation, it may spread to other parts of the body through the lymphatic vascular system; this is called metastatic disease.

Who Is Affected?

• This disease is more common in older adults, and most bladder cancer cases are diagnosed at age 60 or older.

• This cancer is more common in men, because men generally smoke more and, because of their presence in industrial workplaces, are more likely to be exposed to high-risk chemicals.

Symptoms:

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  The most common symptom of bladder cancer:

  
  

• Blood in the urine is the most common symptom of bladder cancer (hematuria). It is usually painless, and a person may see streaks of blood in the urine, or the urine may become completely brown.

• Blood in the urine is not always visible and may occur intermittently.

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  Less common symptoms of bladder cancer include the following:

  
  

• Frequent urination or needing to use the restroom more often

• A sudden urgent need to empty the bladder

• Burning sensation during urination

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  If bladder cancer reaches an advanced stage and spreads, symptoms may include the following:

  
  

• Pelvic pain

• Bone pain

• Unintentional weight loss

• Swelling of the legs

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  Blood in the urine can also have other, more common causes, including:

  
  

• Urinary tract infections, also called cystitis

• Kidney infections

• Kidney stones

• Enlarged prostate in men

• Urethral infection

Seeing a Urologist

At a visit with a urologist, a complete medical history is taken first. Previous illnesses, current medications, and any prior surgeries are then reviewed. The person may be referred for laboratory urine tests to check for blood, bacteria, or abnormal cells.

A physical examination is also performed to check for any possible mass in the body.

Hospital Referral

Hospital evaluation is used for the following:

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  Cystoscopy:

  
  

Cystoscopy is initially recommended for people with bladder cancer. Cystoscopy, or bladder endoscopy, allows the urologist to look inside the bladder using a thin tube with a camera and light at its tip. Before cystoscopy, local anesthesia is usually applied inside the urethra using gels, which helps the cystoscope pass into the bladder easily and without pain. This method takes about 5 minutes.

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  Imaging tests

  
  

The person may be prescribed a CT scan or MRI, or contrast imaging with a contrast agent (IVP) may be used to evaluate the urinary system.

During this imaging, contrast material is injected into the bloodstream, and X-rays are used to image the urinary tract.

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