By Dr. Abhay Kumar, Urology
Bladder cancer can be caused by a variety of factors which include genetic factors, inheritance, drugs, chemicals, environment-related factors and smoking. In fact, smoking tobacco is one of the major causes of bladder cancer around the world. The chemicals present in tobacco can irritate the bladder lining which ultimately leads to bladder cancer. Besides smoking other important environmental factors might be chemotherapy, exposure to chemicals from newspaper, dye, leather, paints industries.
Symptoms of bladder cancer are as follows:
Most often it occurs in people more than 50 years of age. It can present in different ways but common symptoms being :
- Painless hematuria – reddish or brownish coloured urine with or without clots Increased frequency of urination Pain while passing urine.
- Difficulty in passing urine
The diagnosis requires a proper imaging workup including ultrasound, CT scan and urine examinations. Following the initial imaging, a biopsy is required to confirm the diagnosis and stage of the disease. This is done by cystoscopy under anaesthesia.
Treatments for bladder cancer depend on the stage of cancer. Broadly bladder cancers can be categorised into Non-invasive and Invasive cancers.
- For non-invasive cancers: It requires recurrent cystoscopic surveillance and resection. For those with a high risk of tumour recurrence or progression, intravesical chemotherapy or immunotherapy might be required.
- For invasive cancers the various treatment choices are:
- Surgery: For localised tumour which is amenable to resection perhaps surgery is the best possible treatment. This is a major undertaking where in the whole of the bladder along with accessory organs is removed. The surgeon may offer choices for reconstruction between neobladder (refashioning bladder with patient’s gut) or ileal conduit (fashioning a stoma over which bag can be worn to collect urine). Following surgery, a regular follow up is required and the prognosis is good.
- Chemotherapy: This modality is reserved for patient’s where surgery is not possible or they have metastatic disease (disease spread to other body parts).In this method, medications are used to target and destroy cancer cells.
- Radiation Therapy: This might be an option for patient’s that are not suitable for surgery. Radiation therapy uses gamma rays to destroy cancer cells in the body The key to good prognosis in bladder cancers is early detection of timely intervention and good follow up.