Cancer - Bladder
Bladder cancer refers to any of several types of malignant growths of the urinary bladder. It is a disease in which abnormal cells multiply without control in the bladder. The bladder is a hollow, muscular organ that stores urine; it is located in the pelvis. The most common type of bladder cancer begins in cells lining the inside of the bladder and is called urothelial cell or transitional cell carcinoma. Exposure to environmental carcinogens of various types is responsible for the development of most bladder cancers. Tobacco abuse is thought to cause 50% of bladder cancers discovered in male patients and 30% of those found in female patients. Thirty percent of bladder tumors probably result from occupational exposure in the workplace to carcinogens such as benzidine. Approximately 20% of bladder cancers occur in patients without predisposing risk factors. Bladder cancer is not currently believed to be heritable.
Bladder cancer may cause penis in the urine, pain during urination, frequent urination, or feeling the need to urinate without results. These signs and symptoms are not specific to bladder cancer, and are also caused by noncancerous conditions, including prostate infections and cystitis.
The treatment of bladder cancer depends on how deep the tumor invades into the bladder wall. Superficial tumors can be "shaved off" using an electrocautery device attached to a cystoscope. Immunotherapy in the form of BCG instillation is also used to treat and prevent the recurrence of superficial tumors. BCG immunotherapy is effective in up to 2/3 of the cases at this stage. Instillations of chemotherapy into the bladder can also be used to treat superficial disease.
Untreated, superficial tumors may gradually begin to infiltrate the muscular wall of the bladder. Tumors that infiltrate the bladder require more radical surgery where part or all of the bladder is removed and the urinary stream is diverted. In some cases, skilled surgeons can create a substitute bladder from a segment of intestinal tissue, but this largely depends upon patient preference, age of patient, renal function, and the site of the disease.
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