BLADDER CANCER

What Is Bladder Cancer ?

The bladder is a hollow organ in the lower abdomen. It stores urine, the liquid waste produced by the kidneys. Urine passes from each kidney into the bladder through a tube called a ureter.

An outer layer of muscle surrounds the inner lining of the bladder. When the bladder is full, the muscles in the bladder wall can tighten to allow urination. Urine leaves the bladder through another tube, the urethra.

Understanding bladder cancer

Cancer is a group of many related diseases. All cancers begin in cells, the body's basic unit of life. Cells make up tissues, and tissues make up the organs of the body.

Normally, cells grow and divide to form new cells as the body needs them. When cells grow old and die, new cells take their place.

Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

Tumors can be benign or malignant:

Benign tumors are not cancer. Usually, doctors can remove them. Cells from benign tumors do not spread to other parts of the body. In most cases, benign tumors do not come back after they are removed. Most important, benign tumors are rarely a threat to life.

Malignant tumors are cancer. They are generally more serious. Cancer cells can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or the lymphatic system. That is how cancer cells spread from the original (primary) tumor to form new tumors in other organs. The spread of cancer is called metastasis.

The wall of the bladder is lined with cells called transitional cells and squamous cells. More than 90 percent of bladder cancers begin in the transitional cells. This type of bladder cancer is called transitional cell carcinoma. About 8 percent of bladder cancer patients have squamous cell carcinomas.

Cancer that is only in cells in the lining of the bladder is called superficial bladder cancer. The doctor might call it carcinoma in situ. This type of bladder cancer often comes back after treatment. If this happens, the disease most often recurs as another superficial cancer in the bladder.

Cancer that begins as a superficial tumor may grow through the lining and into the muscular wall of the bladder. This is known as invasive cancer. Invasive cancer may extend through the bladder wall. It may grow into a nearby organ such as the uterus or vagina (in women) or the prostate gland (in men). It also may invade the wall of the abdomen.

When bladder cancer spreads outside the bladder, cancer cells are often found in nearby lymph nodes. If the cancer has reached these nodes, cancer cells may have spread to other lymph nodes or other organs, such as the lungs, liver, or bones.

When cancer spreads (metastasizes) from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if bladder cancer spreads to the lungs, the cancer cells in the lungs are actually bladder cancer cells. The disease is metastatic bladder cancer, not lung cancer. It is treated as bladder cancer, not as lung cancer. Doctors sometimes call the new tumor "distant" disease.

The most common symptoms of bladder cancer include the following:

• Blood in the urine (hematuria)
  
  
• Pain or burning during urination without evidence of urinary tract infection
  
  
• Change in bladder habits, such as having to urinate more often or feeling the strong urge to urinate without producing much urine

These symptoms are nonspecific. This means that these symptoms are also linked with many other conditions that have nothing to do with cancer.

• Having these symptoms does not necessarily mean you have bladder cancer.
  
  
• If you have any of these symptoms, you should see your health care provider right away. People who can see blood in their urine, especially older males who smoke, are considered to have a high likelihood of bladder cancer until proven otherwise.

Blood in the urine is usually the first warning sign of bladder cancer.

• Unfortunately, the blood is often invisible to the eye. This is called microscopic hematuria, and it is detectable with a simple urine test.
  
  
• In some cases, enough blood is in the urine to noticeably change the urine color. The urine may have a slightly pink or orange hue, or it may be bright red with or without clots.
  
  
• If your urine changes color, you need to see your health care provider.

Bladder cancer often causes no symptoms until it reaches an advanced state that is difficult to cure. Therefore, you may want to talk to your health care provider about screening tests if you have risk factors for bladder cancer. Screening is testing for disease in people who have never had the disease and have no symptoms but who have one or more risk factors.