Bladder cancer is the fourth most common cancer in men and the tenth most common cancer in women. Bladder cancer is more common in older adults. Less than one percent of people with this disease are under the age of forty. You can find more information below.

What is bladder cancer?

Bladder cancer is a malignant tumor located in the mucosa of the bladder in almost all cases . Here, cells that have been modified to divide faster than healthy and normal cells are formed. The greatest danger is that the replaced cells can be expelled and form secondary tumors in other parts of the body.

The most important symptoms in recognizing bladder cancer are painful urination and blood in the urine . Patients should always consult a doctor if such changes are noticed.

Who is it seen in?

Bladder cancer usually only occurs in old age. Men get sick at an average of 74 years, and women at an average of 76 years. Bladder cancer is rare in middle or young adulthood. Also, men are more affected by bladder cancer than women.

What causes bladder cancer?

It is still unclear why tumors develop in the bladder and urinary tract. Many international community and scientific studies have shown some factors that increase the risk of developing bladder cancer.

The biggest risk factor for bladder cancer is smoking. Passive smoking also increases the risk, because carcinogens of cigarette smoke are filtered from the blood by the kidneys and enter the bladder with urine, where they damage the mucous membrane. Experts estimate that about 30 to 70 percent of all bladder cancer can be attributed to smoking.

Things that trigger bladder cancer

Workers in some occupational activities are exposed to certain chemicals, such as aromatic amines and aniline dyes, that may increase the risk of bladder cancer. In this case, the following are at risk:

  • chemical workers
  • painters
  • auto painters
  • Employees in rubber processing
  • Those working in the steel and leather industry
  • hairdressers
  • dental technicians
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In these industries, bladder cancer is recognized as an occupational disease. Today, there are improved safety measures for the transport of such substances in the workplace.

However, even in daily life, many people come into contact with carcinogenic substances. For example, chemical hair dyes are suspected to increase the risk of bladder cancer.

Other risk factors include:

  • Cystitis : Cystitis can increase the risk of bladder cancer if it lasts for years and goes untreated.
  • Radiation : A radiotherapy can increase the risk of cancer of the bladder area.
  • Some drugs : Some drugs, such as cancer drugs containing the active ingredient cyclophosphamide, are considered a risk factor.
  • Hereditary predisposition : Bladder cancer is common in some families. Researchers therefore hypothesize that genetic makeup may play a role.
  • Bladder stone : Those with bladder stones are at more risk than other people.

What are the symptoms of bladder cancer?

In bladder cancer, there are almost no symptoms at first, and even if symptoms do occur, they are more general in nature. The first sign of bladder cancer is usually blood in the urine . This means that the urine is reddish or brownish in color.

In addition to blood in the urine , other symptoms such as increased urge to urinate can be seen in bladder cancer. However, although there is a request, urine may not come out, it comes in drops. Similar to a bladder infection, a feeling of pressure on the bladder can also be a symptom.

Care should also be taken when there is pain in the kidney area for no apparent reason , the person concerned should see a doctor. Pain usually only occurs in advanced stages of bladder cancer.

Chronic cystitis can be a sign of bladder cancer, especially if antibiotic therapy for the cystitis has failed.

How is bladder cancer diagnosed?

The first point of contact to clarify whether you have bladder cancer is the family doctor. If there is no evidence of a harmless trigger for the symptoms (such as an acute urinary tract infection), he or she will refer the person to a urologist.

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The urologist can then use special diagnostic procedures to rule out or confirm the suspected cancer. These are some procedures that are usually done without hospitalization.

So what are these procedures? How is bladder cancer diagnosed in men and women?

1- Patient-doctor dialogue

The doctor will ask the patient about his or her exact symptoms, especially about blood in the urine, increased urge to urinate, or problems with urination. He or she will usually want to know if there are other known illnesses and if the person concerned is taking medication regularly.

2- Physical examination

The doctor examines the kidney area and abdomen. In men it also probes the prostate, in women it checks whether the bladder can be felt through the vagina.

3- Can test

If bladder cancer is suspected, checking blood values ​​for abnormalities is also usually part of the medical examination.

4- Urine examination

The doctor asks the patient for a urine sample to be given to the laboratory. In the laboratory, it is learned whether there is a urinary tract infection and whether the possible red color of the urine is actually caused by blood. The doctor can also determine if there are tumor cells in the urine.

5- Ultrasound

Using sonography, the doctor can see the kidneys, renal pelvis, and bladder. This way, he or she can recognize if there are other causes other than bladder cancer that are triggering the symptoms. For example, it may detect kidney or bladder stones. If there is still no definitive diagnosis after this examination, the doctor may recommend or perform a bladder examination.

6- Bladder mirroring

Examination of the urethra and bladder as cystoscopy also provides important information for the diagnosis of bladder cancer. Allows the doctor to evaluate the mucous membrane of the bladder wall; can take tissue samples from suspicious spots if necessary. This often happens during an outpatient examination, where the doctor inserts a tubular instrument into the urethra and bladder. This method is almost painless for women, men are mostly anesthetized locally.

7- Other examinations

In some cases, doctors must check to see if bladder cancer or tumors have spread beyond the bladder. This is done using imaging processes that produce images of the inside of the body. Besides ultrasound, it also includes computed tomography , magnetic resonance imaging , and x-ray scanning.

Bladder cancer stages

The bladder consists of four separate layers. Inside is outside and these are; uroelium (mucosa) – internal muscles – external muscles – external bladder limitation. Bladder tumors are divided into stage 1 to 4 categories (T1 to T4) based on the involvement of the individual layers.

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A distinction is made between superficial bladder carcinomas, which are limited to the inner tissue layers of the bladder, and infiltrating or invasive bladder carcinomas that also attack the bladder muscles, bladder wall, or other organs.

Dividing into stages is important because it helps to decide on the next treatment. About 80 percent of those affected have superficial bladder cancer, which means that the bladder can be treated with an endoscopic procedure (through the urethra) to prevent bulging.

How is bladder cancer treated?

If the tumor is limited to the bladder mucosa, it can be removed by transurethral resection . To do this, the surgeon inserts a tube with an electrical loop into the bladder and removes the affected tissue through the urethra.

To reduce the risk of recurrence, a medication is placed into the bladder, usually through a catheter ( instillation therapy ). The treatment is repeated at certain intervals, depending on the medicinal product.

If the tumor has already grown into the muscle layer, but the tumors show no signs of spreading (metastasis), the carcinoma should be completely removed by surgery. In addition to the entire bladder, the surgeon must also remove the prostate and seminal vesicles in men. In women, the procedure involves the bladder, uterus, ovaries, fallopian tubes, and part of the vaginal wall. In any case, an artificial urinary drainage should be created.

If the patient’s general condition does not allow for surgical removal of the bladder or the patient refuses, radiation therapy may be considered. If the cancer is in an advanced stage, radiation therapy relieves symptoms.

Chemotherapy can reduce the likelihood of recurrence. It can be done before or after surgery. Doctors discuss with the patient which procedure is better. Chemotherapy may also be considered if the disease has progressed further or has recurred. Usually, several drugs are combined over a period of time.

Another relatively new therapeutic approach for advanced bladder cancer is immunotherapy with immune checkpoint inhibitors . They ensure that the body’s own immune cells, which are active against the tumor, do not slow down in their activities. Since recurrence may occur after treatment, patients should be followed up regularly.

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