Urinary Bladder or bladder is a urinary storage organ in lower abdomen. Kidneys excrete waste products of blood in urine, which than passes through ureter to get stored in bladder, from where urine is passed out of body through urethra.
When cells of urinary bladder grow abnormally, they form bladder cancer.
Tobacco exposure
Exposure to certain chemicals or industrial compounds e.g. heavy exposure of hair dyes, diesel fumes, rubber, leather, paint, textile industries.
Chronic bladder infection
Old Age
Low intake of fluidsFamily history
Certain previous chemotherapy drugs exposure
Radiation Exposure
Bleeding while passing urine- most common symptom
Pain during urination
Frequent urination
Feeling of passing urine but not able to pass
Pelvic or back pain
Unable to pass urine when tumor grow large and cause obstruction
Urine Routine Microscopy and Examination, Urinary analysis/ cytology for malignant cells.
Cystoscopy: is endoscopic examination where a small tube with al camera is passed through urethra to look inside the urinary bladder
Cystoscopy and Transurethral Resection of Bladder tumor (TURBT): All bladder tumor is excised by cystoscopy and tissue is sent for biopsy confirmation. Deeper muscle layer biopsy is also taken.
Ultrasound: many times first investigation
MRI: Helps in understanding the proper location and depth of tumor inside bladder.
CT scan / PET CT : for local and distant spread of disease
0: Cancer superficial over lining of the bladder.
I: bladder cancer limited to inner lining and doesn’t involve the muscle layer.
II: involve muscle layer.
III: Involve tissues that surround the bladder or pelvic lymph node
IV: Spread to other organs of the body like lungs, bones, liver or distant lymph nodes.
Stage 0 and I are Non muscle invasive bladder cancer
Non Muscle Invasive Bladder cancer: -Transurethral Resection of Bladder Tumor (TURBT) with or without intravesicle (inside urinary bladder) instillation of chemotherapy or immunotherapy.
Muscle Invasive Bladder Cancer:
Surgery is most commonly performed curative treatment. Types of urinary bladder cancer surgeries include:
Radical Cystectomy :entire urinary bladder and the surrounding lymph nodes are removed.
Partial Cystectomy :only a small portion of the bladder that contains cancer is removed. A small cancer in part of urinary bladder away from ureter opening is a suitable case scenario.
Neobladder :After a radical cystectomy an option for urinary diversion/ passage is neobladder reconstruction. A reservoir is made from a segment of intestine and attached to ureters and urethra for passing urine normally. Some people may need to use a catheter to remove urine from the neobladder.
Ileal conduit : Urinary diversion is created from a small segment of intestine on which ureters are connected which drain urine from kidneys. The urine empties outside body into a pouch (urostomy bag) attached to abdomen.
Chemotherapy
Radiation Therapy
Immunotherapy
⦁ Avoid tobacco
⦁ Caution around chemicals
⦁ Drink lot of water/ fluids
⦁ Fresh fruits and vegetables
⦁ Avoid unnecessary radiation exposure
⦁ Genetic counselling and testing for at risk individuals