Urinary Bladder  Cancer Urinary Bladder  Cancer Urinary Bladder  Cancer

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What is Urinary Bladder Cancer?
Urinary Bladder Cancer is a type of cancer that begins in the cells of the bladder, the organ that stores urine. It’s most commonly seen in the inner lining of the bladder, called the urothelium, and is often detected at an early stage. However, bladder cancer has a high recurrence rate and can be aggressive, especially if it spreads beyond the bladder. Bladder cancer can significantly impact daily life, especially if surgery involves bladder removal. Patients often need to adapt to urinary diversions or lifestyle changes to manage their condition. Support groups, counseling, and rehabilitation services can help patients and their families navigate these changes.

Symptoms of Bladder Cancer

Bladder cancer often presents with several symptoms that may vary depending on the cancer’s stage and progression. One of the most common early signs of bladder cancer is hematuria, or blood in the urine, which may appear bright red or rust-colored. Sometimes, blood in the urine might only be detectable under a microscope during a lab test, so it’s important to pay attention to routine medical checkups. Frequent or painful urination and a persistent feeling of urgency are other symptoms. These can be mistaken for urinary tract infections (UTIs) but may indicate an underlying issue if they persist.

In addition to these symptoms, some patients experience pelvic pain or pain in the lower back, especially if the cancer has spread to nearby areas. Loss of appetite and unexplained weight loss are other symptoms that may appear in later stages of the disease, as the body expends energy fighting cancer cells. Fatigue is also common in advanced cases, where the cancer interferes with the body’s normal functions.

While these symptoms may raise concern, they are not exclusive to bladder cancer and can be associated with other conditions, such as infections or kidney stones. Therefore, if symptoms are persistent, it’s essential to seek medical advice. Early detection is crucial, as bladder cancer is generally more treatable in its early stages. A healthcare provider may conduct tests such as urine cytology, imaging scans, and cystoscopy (where a small camera is used to inspect the bladder) to confirm the diagnosis. 

Diagnosis of Bladder Cancer

Diagnosing bladder cancer typically involves several steps:

Urinalysis: A simple urine test can detect blood in the urine, although this alone doesn’t confirm cancer.

Cystoscopy: A scope with a camera is inserted into the bladder through the urethra, allowing doctors to visualize the bladder’s inner lining and check for tumors.

Biopsy (Transurethral Resection of Bladder Tumor – TURBT): During cystoscopy, tissue samples or the entire tumor may be removed for examination. TURBT is the primary method for diagnosing and staging bladder cancer.

Imaging Tests: CT scans, MRIs, or ultrasounds help determine if the cancer has spread to nearby tissues or lymph nodes.

Urine Cytology and Biomarker Tests:
Urine cytology looks for cancer cells in the urine, while biomarker tests identify molecular changes associated with bladder cancer.

Treatment Options for Bladder Cancer

Treatment depends on the stage and grade of cancer, patient health, and treatment goals. Common options include:

Surgery:

TURBT: Used for early-stage, non-muscle-invasive bladder cancer, TURBT removes the tumor via the urethra.

Cystectomy:
Involves partial or complete removal of the bladder, especially in muscle-invasive cancer cases.

Urinary Diversion:
When the bladder is removed, a new way to store and pass urine is created, either using a stoma or a neobladder.

Intravesical Therapy: For non-muscle-invasive cancer, medications are directly delivered to the bladder to prevent recurrence:

BCG (Bacillus Calmette-Guerin): An immunotherapy that stimulates the immune system to attack cancer cells.

Intravesical Chemotherapy:
Drugs like mitomycin are introduced into the bladder to target cancer cells.

Chemotherapy: Used to treat advanced or muscle-invasive cancer, chemotherapy can be given before surgery (neoadjuvant) to shrink the tumor or after surgery (adjuvant) to reduce recurrence risk. Common drugs include cisplatin and gemcitabine.

Radiation Therapy: Used when surgery isn’t an option or as part of bladder preservation therapy, radiation aims to destroy cancer cells in the bladder. It’s often combined with chemotherapy to increase effectiveness.

Immunotherapy: Immunotherapy drugs like pembrolizumab and atezolizumab are used for advanced bladder cancer, especially for patients who can’t undergo chemotherapy.

Targeted Therapy: Erdafitinib is a targeted therapy for bladder cancers with specific genetic mutations, such as FGFR3 or FGFR2 mutations. This therapy blocks proteins that help cancer cells grow.

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