(1) Overview: –
The bladder is a hollow organ in the lower part of the abdomen; it is shaped like a small balloon and has a muscular wall that stores urine until it is passed out of the body. Urine is the liquid waste that is made by the kidneys when they clean the blood. The urine passes from the two kidneys into the bladder through two tubes called ureters. When the bladder is emptied during urination, the urine goes from the bladder to the outside of the body through another tube called the urethra.
Types of Bladder cancers
(1) Transitional cell carcinoma or urothelial carcinoma.
Sub-types of urothelial carcinoma.
(i) Non-Invasive urothelial tumors: – These tumors are limited to the bladder only.
(ii) Invasive urothelial tumors: – The cancer may have spread from the urothelium to the deeper layers of the bladder.
(iii) Papillary urothelial tumors.
(2) Squamous cell carcinoma: – Cancer that begins in squamous cells, which are thin, flat cells that may form in the bladder after long-term infection or irritation.
(3) Adenocarcinoma: – Cancer that begins in the glandular cells. Glandular cells in the lining of the bladder produce and release fluids such as mucus.
(4) Cancer that is confined to the lining of the bladder is called superficial bladder cancer. Cancer that begins in the transitional cells may spread through the lining of the bladder and invade the muscle wall of the bladder or spread to nearby organs and lymph nodes this is called invasive bladder cancer.
(2) Risk factors: –
(b) Occupational exposure: – Exposure to certain chemicals at work, such as rubber, certain dyes used in textiles, paint and certain chemicals in hairdressing and perfume industry.
(c) A diet in fried meats and fat.
(d) Age factor.
(e) Being male.
(g) Bladder infection and inflammation for long duration.
(3) Signs and Symptoms: –
(i) Blood in the urine.
(ii) Frequent urination, or feeling the need to urinate without being able to do so.
(iii) Pain during urination.
(iv) Lower back pain.
(4) Diagnosis as per modern science: –
(a) CT scan
(b) Urine analysis
(c) Internal examination of vagina and rectum.
(d) Intravenous pyelogram.
(g) Urine cytology.
(5) Staging: –
(i) Stage 0: – The cancer is non-invasive papillary carcinoma. It has not grown into the muscles or connective tissues of the bladder wall or spread to lymph nodes or distant sites.
(ii) Stage I: – The cancer has grown to the connective tissues under the layer of the bladder wall. The cancer has not spread to lymph nodes or to distant sites.
(iii) Stage II: – The cancer has spread to the thick muscle layer of the bladder wall, but, it has not passed completely through the muscles to reach the layer of fatty tissues that surrounds the bladder. The cancer has not spread to lymph nodes or to distant sites.
(iv) Stage III: – The cancer has grown completely through the bladder into the layers of fatty tissues that surrounds the bladder. It may have spread into prostate, uterus, or vagina. The cancer has not spread to lymph nodes or to distant sites.
(v) Stage IV: – The cancer has spread through the bladder wall to the pelvic or abdominal wall and/or has spread to lymph nodes and/or distant sites, such as bones, liver or lungs.