urinary bladder cancer

Urinary Bladder Cancer: An Overview

Urinary bladder cancer, also known as bladder cancer, is a type of cancer that affects the lining of the urinary bladder. The bladder is a hollow, balloon-shaped organ in the lower part of the abdomen that stores urine from the kidneys until it is passed out of the body [2].

Causes and Risk Factors

Bladder cancer occurs when cells in the bladder start to grow without control. This can be caused by various factors, including smoking, family history, prior pelvic radiation therapy, frequent bladder infections, and exposure to certain chemicals [11]. In some areas of the world, squamous cell carcinoma is linked to chronic bladder inflammation caused by the parasitic infection known as schistosomiasis [1].

Types of Bladder Cancer

There are two main types of bladder cancer: non-muscle invasive (superficial) and muscle-invasive. Nonmuscle-invasive bladder cancer occurs when cancerous cells are contained in the lining of the bladder and have not invaded the bladder wall, while muscle-invasive bladder cancer has spread to the deeper layers of the bladder wall [3].

Symptoms

The symptoms of bladder cancer can include blood in urine, painful urination, abdominal pain, bone pain or tenderness, urinary frequency and urgency, urine leakage (incontinence), and weight loss [7]. If left untreated, bladder cancer can spread to other parts of the body, such as the lymph nodes, bones, lungs, or liver [3].

Treatment Options

Fortunately, healthcare providers have many effective ways to treat bladder cancer, including surgery to remove it. The choice of treatment depends on the stage and type of cancer, as well as the overall health of the patient [4]. Early detection and treatment can significantly improve the chances of recovery.

References: [1] - Context result 1 [2] - Context result 2 [3] - Context result 3 [4] - Context result 4 [7] - Context result 7 [11] - Context result 11

Common Signs and Symptoms of Urinary Bladder Cancer

Urinary bladder cancer can manifest in various ways, and it's essential to be aware of the possible signs and symptoms to seek medical attention promptly.

• Blood in Urine (Hematuria): The most common symptom of bladder cancer is blood in the urine. This may appear as bright red or cola-colored urine, although sometimes the urine appears normal, and blood is detected on a lab test [4][5][8][9].
• Changes in Bathroom Habits: Frequent urination, painful or burning urination (dysuria), and changes to bladder habits such as increased frequency or urgency of urination can also be indicative of bladder cancer [6][7].
• Painless Hematuria: In many cases, the blood in urine is painless, which can make it difficult to diagnose bladder cancer early on [1][2].

Other Possible Symptoms

While not as common, other symptoms that may be related to urinary bladder cancer include:

• Bone and back pain
• Changes in urination patterns (e.g., increased frequency or urgency)
• Weight loss

Important Notes

It's crucial to note that these symptoms can also be caused by less serious conditions such as urinary tract infections, bladder stones, or an overactive bladder. Therefore, it's essential to consult a doctor if you experience any of these symptoms.

References:

[1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 5 [5] Context result 9 [6] Context result 6 [7] Context result 7 [8] Context result 8 [9] Context result 9

Diagnostic Tests for Urinary Bladder Cancer

Urinary bladder cancer can be diagnosed using various tests, which are crucial in identifying the disease at an early stage and determining the best course of treatment.

• Cystoscopy: This is a procedure where a thin tube with a camera (cystoscope) is inserted through the urethra to visualize the inside of the bladder. It allows doctors to examine the bladder lining for any abnormalities, such as tumors or cancer cells [1][2].
• Transurethral Resection of Bladder Tumor (TURBT): After a cystoscopy, if a tumor is detected, a TURBT may be performed to remove the tumor and confirm the diagnosis. This procedure involves removing a sample of tissue from the bladder for further examination [1].
• Imaging Tests: Imaging tests such as CT scans, MRI scans, or intravenous urograms (IVPs) can help identify tumors in the urinary tract. These tests use X-rays to visualize the inside of the urinary system and detect any abnormalities [3][4][5].
• Urine Tests: Urine tests, including cytology and tumor marker tests, can also be used to diagnose bladder cancer. Cytology involves examining a urine sample for abnormal cells, while tumor markers are substances found in the urine that may indicate the presence of cancer [6][7].
• Biopsy: A biopsy is a procedure where a small sample of tissue is removed from the bladder and examined under a microscope to confirm the diagnosis of bladder cancer [8].

Early Detection and Treatment

Early detection and treatment of urinary bladder cancer are crucial in improving patient outcomes. Regular screenings, diagnostic procedures, and monitoring can help identify the disease at an early stage when treatment options are most effective [9].

References:

[1] Context 1: A cystoscopy can often be used to make the initial diagnosis of bladder cancer...

[2] Context 13: To determine if you have bladder cancer, your doctor may start with a cystoscopy...

[3] Context 6: To diagnosed bladder cancer, you usually have a cystoscopy to look inside your bladder. Your doctor might arrange some other tests.

[4] Context 8: You may be offered a CT scan or an MRI scan if the specialist feels they need a more detailed picture of your bladder.

[5] Context 12: An IVP is an x-ray of the urinary system taken after putting a special dye into a vein...

[6] Context 14: Urinary tumor markers are substances found in the urine that are either made by bladder cancer cells or that the body makes in response to bladder cancer.

[7] Context 4: A doctor may

Treatment Options for Urinary Bladder Cancer

Urinary bladder cancer treatment options vary depending on the stage and grade of the tumor(s). Here are some common drug treatments used to treat bladder cancer:

• Intravesical Chemotherapy: This type of chemotherapy involves putting the chemo drug directly into the bladder through a catheter. It is often used for nonmuscle-invasive bladder cancer that hasn't invaded deeply into the lining of the bladder [6].
• Immunotherapy: Immunotherapy drugs, such as BCG (Bacillus Calmette-Guérin), are used to stimulate the immune system to fight cancer cells in the bladder. BCG treatment is the main immunotherapy used to treat early-stage bladder cancer [3].
• Targeted Therapy Drugs: Targeted therapy drugs, such as enfortumab vedotin (Padcev) and pembrolizumab (Keytruda), are used to specifically target cancer cells with certain proteins on their surface. These drugs have been approved by the FDA for the treatment of bladder cancer [7][8].
• Combination Therapy: Combination therapy involves using multiple treatments together, such as chemotherapy and immunotherapy, to treat bladder cancer.

Other Treatment Options

In addition to drug treatments, other options may be considered depending on the stage and grade of the tumor(s). These include:

• Surgery: Surgery may be used to remove the tumor from the urinary tract through the urethra using an electrical force (Transurethral resection or TUR) [5].
• Urinary Diversion: If the bladder must be removed, a procedure called urinary diversion is performed to create another way for the body to store and pass urine [4].

Important Factors

When deciding on the best treatment for bladder cancer, other factors such as your preferences and overall health are also important. It's essential to discuss these options with your doctor to determine the most suitable course of treatment.

References:

[3] - With BCG treatment, your healthcare provider delivers immunotherapy drugs directly to your bladder through a catheter. [4] - Sometimes, when the cancer has spread outside the bladder and can't be completely removed, surgery to remove only the bladder may be done to reduce urinary symptoms caused by the cancer. [5] - This is when the tumor is removed from the urinary tract through the urethra using an electrical force. Transurethral resection (TUR) is an ... [6] - Intravesical Chemotherapy: This type of chemotherapy involves putting the chemo drug directly into the bladder through a catheter. [7] - The combination of methotrexate, vinblastine, doxorubicin (Adriamycin), and cisplatin (MVAC) is the standard treatment for metastatic bladder cancer. [8] - Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.

The differential diagnosis of urinary bladder cancer involves distinguishing it from other conditions that may present with similar symptoms or imaging findings.

Common Differential Diagnoses

• Urinary Tract Infections (UTIs): UTIs can cause hematuria, which is a common symptom of bladder cancer. However, the presence of bacteriuria in patients with squamous cell carcinoma of the bladder suggests that UTIs and bladder cancer may coexist.
• Renal Cancer: Bladder cancer must be differentiated from renal cancer, as both conditions can present with similar symptoms such as hematuria and flank pain.
• Prostate Cancer: Prostate cancer is a common malignancy in men, and its symptoms can overlap with those of bladder cancer. However, the presence of hematuria is more specific to bladder cancer.
• Cystitis: Cystitis, or inflammation of the bladder, can cause similar symptoms to bladder cancer, including hematuria and dysuria.

Other Differential Diagnoses

• Squamous Cell Carcinoma (SCC): SCC is a type of bladder cancer that can be difficult to distinguish from other conditions. Its symptoms may overlap with those of UTIs or cystitis.
• Adenocarcinomas: Adenocarcinomas are rare types of bladder cancer that can be challenging to diagnose due to their similarity in appearance to benign glandular lesions.
• Small Cell Neuroendocrine Carcinomas: These are rare and aggressive forms of bladder cancer that can present with similar symptoms to other malignancies.

Key Diagnostic Features

• Hematuria: The presence of blood in the urine is a common symptom of bladder cancer. However, it can also be present in UTIs or cystitis.
• Imaging Studies: Imaging studies such as intravenous urography, renal ultrasonography, and CT scans are essential for diagnosing bladder cancer and distinguishing it from other conditions.

References

• [1] The most common clinical presentation is asymptomatic hematuria, which should prompt evaluation with cystoscopy, renal function testing, and upper urinary tract imaging. (Source: #4)
• [2] Differential diagnoses of primary bladder tumors from metastasis ones can be difficult, for the symptom and imaging findings are pretty similar. (Source: #5)
• [3] The differential diagnosis of clear cell and glandular lesions of the urinary bladder/urethra is broad and includes both primary lesions/tumors and secondary malignancies. (Source: #9)