Bladder Cancer

Bladder cancer:

Bladder cancer is a cancer that starts in the bladder. The bladder is the body part that holds and releases urine. It is in the center of the lower belly area.
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Causes, incidence, and risk factors
In the United States, bladder cancers usually start from the cells lining the bladder (called transitional cells).
These tumorsare classified based on the way they grow:
* Papillary tumors have a wart-like appearance and are attached to a stalk.
* Nonpapillary (sessile) tumors are flat. They are much less common. However, they are more invasive and have a worse outcome.
The exact cause of bladder cancer is uncertain. However, several things may make you more likely to develop it:
* Cigarette smoking. Smokinggreatly increases the risk of developing bladder cancer. Up to half of all bladder cancers in men and several in women may be caused by cigarette smoke.
* Chemical exposure at work. About one in four cases of bladder cancer is caused by coming into contact with to cancer-causing chemicals at work. These chemicals are called carcinogens. Dye workers, rubber workers, aluminum workers, leatherworkers, truck drivers, and pesticide applicators are at the highest risk.
* Chemotherapy: The chemotherapy drug cyclophosphamide (Cytoxan) may increase the risk of bladder cancer. Your doctor may prescribe a medicine to reduce this risk.
* Radiation treatment: Women who had radiation therapy to treat cervical cancer have an increased risk of developing bladder cancer.
* Bladder infection:A long-term (chronic) bladder infection or irritation may lead to a certain type of bladder cancer.
Some research has suggested a link between artificial sweeteners and bladder cancer. The evidence is weak.
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Symptoms
Symptoms of bladder cancer can include:
* Abdominal pain
* Blood in the urine
* Bone pain or tenderness if the cancerspreads to the bone
* Fatigue
* Painful urination
* Urinary frequency
* Urinary urgency
* Urine leakage (incontinence)
* Weight loss
Note: Other diseases and conditions can cause similar symptoms. It is important to see a doctor to rule out all other possible causes.
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Signs and tests
The health care provider will performa physical examination, including a rectal and pelvic exam.
Tests that may be done include:
* Abdominal CT scan
* Abdominal MRI scan
* Bladder biopsy (usually performed during cystoscopy)
* Cystoscopy (examining the inside of the bladder with a camera)
* Intravenous pyelogram - IVP
* Pelvic CT scan
* Urinalysis
* Urine cytology
If tests confirm you have bladdercancer, additional tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future.
The TNM (tumor, nodes, metastatis) staging system is used to stage bladder cancer:
* Ta: The cancer is in the lining of the bladder only and has not spread
* T1: The cancer goes through thebladder lining, but does not reach the bladder muscle
* T2: The cancer spreads to the bladder muscle
* T3: The cancer spreads past the bladder into the fatty tissue surrounding it
* T4: The cancer has spread to nearby structures such as the prostate gland, uterus, vagina, rectum, abdominal wall, or pelvic wall
Tumors are also grouped based on how they appear under a microscope. Thisis called grading the tumor. A high-grade tumor is fast growing and more likely to spread. Bladder cancer can spread into nearby areas, including the:
* Lymph nodes in the pelvis
* Bones
* Liver
* Lungs
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Treatment
Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health.
Stage 0 and I...