Urinary bladder cancer is a condition in which there is an abnormal growth of cells around the bladder.
The urinary bladder is part of the excretory system of the human body. The kidneys make urine, a liquid waste product while they purify the blood. This urine is then carried from the kidneys via the narrow tubes called ureters into the bladder. The urinary bladder stores the urine until there is an urge to urinate. Another tube called urethra carries the urine from the lower part of the bladder outside during urination.
The urinary bladder is a hollow triangular organ situated in the pelvis. It has a thick wall with a muscle coating due to which it contracts while eliminating urine and relaxes while urine enters it. The lower opening into the urethra is surrounded by a muscular band called sphincter which prevents urine from trickling into the urethra.
The inner part of the bladder is lined by a tissue called transitional cell epithelium or urothelium. About 95% of the cancers are transitional cell cancer (TCC) while the remaining 5% are either squamous cell cancers (due to chronic irritation by stone or infection) or adenocarcinoma.
Causes of urinary bladder cancer
- The most common cause of cancer of the urinary bladder is a long term history of smoking and/or using tobacco products. Chronic smokers are twice as more likely to develop this cancer than non-smokers.
- It is an occupational hazard for those working with chemicals in rubber and textile industries and dyes for e.g. aniline dyes. It is also present in people working in factories where rope and fabric are made.
- It is more common in men than in women and racially, whites are affected more than dark skinned people. It is generally seen in the elderly after 60 years of age.
- Heredity plays a role in this cancer. Persons with a condition called Balkan nephropathy which affects the kidneys are more likely to suffer from bladder cancer.
- Drugs like cyclophosphamide, NSAID’s and others may be triggers for developing cancer of the urinary bladder.
- If the drinking water contains a high level of arsenic, it may predispose to this cancer.
- Having frequent infections of the bladder for e.g. schistosomiasis or having a kidney or bladder stone can cause irritation of the lining of the bladder and may in the future cause bladder cancer.
- People who have urinary catheters for a long time such as those confined to bed are more at risk.
Symptoms and signs of cancer of the urinary bladder
Cancer of the urinary bladder may occur at more than one location in the bladder, hence called a multi-focal tumour.
The earliest and most common sign is passing blood in the urine which is painless, this is called painless hematuria. This is generally intermittent i.e. it may be there for one or two days and then stop and start again.
Sometimes, when infection is also present, there will be symptoms of cystitis (infection of the bladder) such asurge to pass urine, burning sensation while passing urine and increased frequency of passing urine.
There may be a lump in the lower abdomen if the tumour is large or if the kidney is enlarged as a secondary effect of the tumour.
There may be flank pain at the location of the kidneys.
Anaemia may be a sign.
Bone pain may be present in the pelvic region in advanced cancers.
In the next article, we will tell you in detail about the diagnosis and treatment of cancer of the urinary bladder.
Photograph via Creative Commons
Written by Dr Nisreen Nakhoda, General Physician
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