The Truth About Bladder Cancer

by Alisha Dhamani

To begin with, each year, about 67,000 new cases of bladder cancer are expected, and about 13,000 people will die of the disease in the U.S. Bladder cancer affects three times as many men as women. Women, however, often have more advanced tumors than men at the time of diagnosis.

Bladder cancer can occur at any age, but it is most common in people older than 50 years of age. The average age at the time of diagnosis is in the 60s. However, it clearly appears to be a disease of aging, with people in their 80s and 90s developing bladder cancer as well.

Firstly, the bladder is a hollow organ in the lower abdomen (pelvis). It collects and stores urine produced by the kidneys. Cancer occurs when normal cells undergo a transformation whereby they grow and multiply without normal controls.

As the cells multiply, they form an area of abnormal cells. Medical professionals call this a tumor. As more and more cells are produced, the tumor increases in size. Tumors overwhelm surrounding tissues by invading their space and taking the oxygen and nutrients they need to survive and function.

Of all types of cancer, bladder cancer has an unusually high propensity for recurring after treatment. Bladder cancer has a recurrence rate of 50%-80%. The recurring cancer is usually, but not always, of the same type as the first (primary) cancer. It may be in the bladder or in another part of the urinary tract (kidneys or ureters).

Bladder cancer is most common in industrialized countries. It is the fifth most common type of cancer in the United States the fourth most common in men and the ninth in women.

Important to mention, Tumors are cancerous only if they are malignant. This means that, because of their uncontrolled growth, they encroach on and invade neighboring tissues. Malignant tumors may also travel to remote organs via the bloodstream or the lymphatic system.

This process of invading and spreading to other organs is called metastasis. Bladder cancers are most likely to spread to neighboring organs and lymph nodes prior to spreading through the blood stream to the lungs, liver, bones, or other organs.

Bladder cancers are classified (staged) by how deeply they invade into the bladder wall, which has several layers. Many physicians subdivide bladder cancer into superficial and invasive disease. Superficial bladder cancer is limited to the innermost linings of the bladder (known as the mucosa and lamina propria). Invasive bladder cancer has at least penetrated the muscular layer of the bladder wall.

Nearly all adenocarcinomas and squamous cell carcinomas are invasive. Thus, by the time these cancers are detected, they have usually already invaded the bladder wall.

Many urothelial cell carcinomas are not invasive. This means that they go no deeper than the superficial layer (mucosa) of the bladder.

Of the different types of cells that form the bladder, the cells lining the inside of the bladder wall are most likely to develop cancer. Any of three different cell types can become cancerous. The resulting cancers are named after the cell types.

In the United States, urothelial carcinomas account for more than 90% of all bladder cancers. Squamous cell carcinomas make up 3%-8%, and adenocarcinomas make up 1%-2%.

Urothelial carcinoma (transitional cell carcinoma) is by far the most common type of bladder cancer in the United States. The so-called transitional cells are normal cells that form the innermost lining of the bladder wall.

In transitional cell carcinoma, these normal lining cells undergo changes that lead to the uncontrolled cell growth characteristic of cancer.

Squamous cell carcinoma originate from the thin, flat cells that typically form as a result of bladder inflammation or irritation that has taken place for many months or years.

Adenocarcinoma cancers form from cells that make up glands. Glands are specialized structures that produce and release fluids such as mucus.

These three types of cancer can develop anywhere in the urinary tract. If abnormal cells are found anywhere in the urinary tract, a search for other areas of abnormal cells is warranted. For example, if cancerous cells are found in the bladder, an evaluation of the kidneys and ureters is essential.

Furthermore, a tumor grade is based on the degree of abnormality observed in a microscopic evaluation of the tumor. Cells from a high-grade cancer have more changes in form and have a greater degree of abnormality when viewed microscopically than do cells from a low-grade tumor.

This information is provided by the pathologist, a physician trained in the science of tissue diagnosis. Low-grade tumors are less aggressive, whereas high-grade tumors are more dangerous and have a propensity to become invasive.

Papillary tumors are urothelial carcinomas that grow narrow, finger-like projections. Benign (noncancerous) papillary tumors (papillomas) grow projections out into the hollow part of the bladder. These can be easily removed, but they sometimes grow back.

These tumors vary greatly in their potential to come back (recur). Some types rarely recur after treatment; other types are very likely to do so. Papillary tumors also vary greatly in their potential to be malignant (invasive). A small percentage (15%) do invade the bladder wall. Some invasive papillary tumors grow projections both into the bladder wall and into the hollow part of the bladder.

In addition, bladder cancer can develop in the form of a flat, red (erythematous) patch on the mucosal surface. This is called carcinoma-in-situ (CIS).

Although these tumors are superficial, they are high-grade and have a high risk for becoming invasive.
Interesting fact about bladder cancer is that, white men and women, develop bladder cancers twice as often as other ethnic groups. In the United States, African Americans and Hispanics have similar rates of this cancer. Rates are lowest in Asians.

Lastly, because of its high recurrence rate and the need for lifelong surveillance, bladder cancer is the most expensive cancer to treat on a per patient basis.

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Bladder Cancer

Cruciferous Vegetables, Cancer Beater - A Real Cancer Prevention Diet

By Kirsten Whittaker Posted: December 07, 2008

If you smoke, or ever have, and you eat lots of broccoli (or other cruciferous veggies such as cabbage, cauliflower, kale, turnip greens, mustard greens or collard greens), you might be doing yourself a great favor in terms of lung cancer. This according to research just presented at the American Association of Cancer Research meeting held last week in Washington D. C. by a team from Roswell Park Cancer Institute of Buffalo, NY when they concluded cruciferous vegetables can helpful as part of a cancer prevention diet.

Li Tang, Ph. D. , a post-doctoral fellow at Roswell Park Cancer Institute and colleagues conducted a hospital-based, case-controlled study of lung cancer cases matched with smoking status controls.

The study wasn't focused on broccoli alone, but allowed for eating all the commonly consumed cruciferous vegetables - in either their raw or cooked forms. The study found that among smokers - and especially former smokers - higher intake of cruciferous vegetables was associated with a lower risk of lung cancer. Smokers who ate raw veggies saw the most benefit.

Researchers divided their findings into four subtypes of lung cancer. The strongest risk reduction was seen among subjects with squamous or small-cell carcinoma, the two types most strongly associated with heavy smoking.

"Broccoli is not a therapeutic drug, but for smokers who believe they cannot quit nor do anything about their risk, this is something positive, " Tang said. “People who quit smoking will definitely benefit more from intake of cruciferous vegetables. "

The percentage of Americans who smoke has fallen below 20% for the first time since the mid 1960s. If you smoke and you're concerned about lung cancer risk, first and foremost, you need to stop. Get help quitting from support groups, nicotine replacement therapy, hypnosis or the variety of medications now available. If you have the will (or even if you're not sure you do) getting cigarettes out of your life for good can save you not only money, but help you take solid, real-world steps to improve your health, today and over the long haul as well.

When you do quit, your lung capacity goes up and your bronchial tubes relax which makes breathing easier. Not only this, the poisonous carbon monoxide in your blood goes down so that your blood can carry more oxygen. Of course your sense of smell, the discoloration of your teeth, fingers and clothing will also improve noticeably. Best of all, the second hand smoke you're sending into the environment will be eliminated - a healthy gift to everyone around you.

If you're trying to quit, or can't quite get there yet. . . eat as many of the cruciferous veggies as you enjoy from the list above, especially in their raw state as heating damages an important enzyme thought to activate the cancer fighting properties.

Earlier work released in February 2008 backed up these findings with results showing that compounds called isothiocyanates from these veggies could have cancer fighting properties. The research was on bladder cancer and supported animal studies that suggest broccoli and the other cruciferous vegetables have some cancer protecting abilities. Another study, out in July 2008, suggested a link between men who ate broccoli four times a week and a protective effect against prostate cancer.

So the real story here is that we should all try to increase our consumption of cruciferous vegetables whether we smoke or not as part of a cancer prevention diet.

Next just head on over to the Daily Health Bulletin for more health tips including information on following a cancer prevention diet and get 5 free revealing health reports.

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Bladder Cancer

Cancer In The Bladder: Symptoms, Causes and Treatment

Bladder cancer is a type of cancer that occurs in your bladder, a balloon-shaped organ in your pelvic area that stores urine. It is the fourth most common type of cancer in men and the eighth most common type in women. Tumors can develop on the surface of the bladder wall or in more severe cases, within the wall and into the underlying muscles. Cancer in the bladder typically affects older adults, though it can occur at any age. Bladder tumors are 2 to 3 times more common in men.

Causes of Bladder Cancer
Smoking, gender, and diet can affect the risk of developing bladder cancer. Bladder carcinomas are also associated with industrial exposure to aromatic amines in dyes, paints, benzedine, nitrates, solvents, leather dust, inks, combustion products, rubber, and textiles. The period between exposure to the carcinogen and development of symptoms is about 18 years.

There is currently limited evidence that diet plays a part in the development of bladder cancer, but a diet high in fruit and vegetables and low in fat may help reduce the risk. Urinary infections, kidney and bladder stones, and other causes of chronic bladder irritation have been linked with bladder cancer (especially squamous cell carcinoma of the bladder), but they do not necessarily cause bladder cancer.

Signs of Bladder Cancer
In early cases around 25% of patients have no symptoms. Commonly the first sign of bladder tumours is blood in the urine, pain after urination, urinary frequency and dribbling. However, these signs and symptoms are not specific to bladder cancer, and may also be caused by non-cancerous conditions, including prostate infections and cystitis.

Types of Bladder Cancer
Cancers are divided into superficial and invasive disease. Superficial bladder cancer is limited to the innermost linings of the bladder. Invasive bladder cancer has at least penetrated the muscular layer of the bladder wall. Less than 5% of bladder cancers in the United States are squamous cell carcinomas, however, worldwide this is the most common form, accounting for 75% of bladder carcinoma in underdeveloped nations. Urothelial carcinoma (transitional cell carcinoma) is by far the most common type of bladder cancer in the United States.

Diagnosis of Bladder Cancer
Cancer in the bladder is usually curable if it is diagnosed while the cancer is still contained in the bladder, and up to 80% of tumors are diagnosed at this early stage. A biopsy for bladder cancer is usually done during cystoscopy. CT and Ultrasound scans, urinalysis and arteriography may also be done.

Treatment for Bladder Cancer
Treatments include bladder cancer surgery, radiation, chemotherapy and biologic therapy. The stage and grade of the cancer provides important information and can help guide treatment. Superficial bladder tumors are surgically removed with chemotherapy being added to the treatment regime to help prevent recurrence. Radical cystectomy and urinary diversion (an external bag) is usually undertaken for invasive bladder cancer.

Several new compounds have shown activity against transitional cell bladder cancer and are now being tested in combination chemotherapy trials. BCG immunotherapy is the most effective intravesical therapy and involves a live attenuated strain of Mycobacterium bovis. Immunotherapy in the form of BCG instillation is also used to treat and prevent the recurrence of superficial tumors. Alternative bladder cancer treatments such as herbal treatment may also be of some benefit.

Risk Reduction
Stopping smoking can reduce the risk of getting bladder cancer and if you have been diagnosed with superficial bladder cancer, stopping smoking will reduce the risk of developing more tumours in the future. Bladder cancer has a recurrence rate of 50%-80% and therefore, doctors recommend cystoscopy screening every three months for the first two years after treatment. People who drink a lot of fluids each day have a lower rate of bladder cancer.

Survival Rates
The prognosis depends on the stage of the cancer, whether it is superficial or invasive bladder cancer, and whether it has spread to other places in the body. Superficial bladder cancer has a good prognosis, with 5-year survival rates of 82-100%. If a tumor has grown into the wall of the bladder but has not spread to other organs, treatment usually involves surgical removal of the tumor, or combined chemotherapy and radiation therapy, with a five-year survival rate of 60% to 75%. Patients with more deeply invasive tumors,which are also usually less well differentiated, and those with lymphovascular invasion experience 5-year survival rates of 30% to 50% following radical cystectomy.

About the Author

Dick Aronson has a background of over 35 years in various facets of the Healthcare industry. He set up and ran clinical trials in more than 20 countries and he has also founded a number of small private health related businesses. Dick now runs a number of informative health websites Go to Health Innovations Online and Go to Cancer Information Online

Bladder Cancer

Bladder Cancer Prevention and Control

When you think about cancer prevention and control, the bladder is probably an organ that does not come to mind immediately. This is because bladder cancer is often overlooked due to the surge in information regarding cancers of the breast and prostate. But there is a breadth of information available which focuses on preventing and treating this form of the disease.

Because bladder cancer usually attacks you later in life, it is important to maintain a healthy lifestyle today. Poor habits and family history can play a large role in your efforts at bladder cancer control.

The American Cancer Society discusses four types of bladder cancer people can develop. They are urothelial carcinoma, squamous cell carcinoma, adenocarcinma, and small cell cancer. Each type of bladder cancers is treated differently; and patients are urged to consult with their doctors before beginning any regimen.

Cancer of the bladder can be detected early by recognizing certain symptoms such as blood in the urine or a sudden change in your bladder habits. If you are experiencing any other abnormalities, such as excessive pain, you should see your doctor immediately. If you are having trouble with bladder pain control, it could be a warning sign of a growing tumor.

If you are a smoker, then it is important to stop this habit as part of your cancer prevention and control regiment. Smoking is a leading culprit in many kinds of cancers, especially when it involves the bladder.

Doctors also urge patients to practice healthy habits such as eating a well-balanced diet full of fruits, vegetables, lean proteins and hearty grains. Exercising is another key to warding off bladder cancer because being active can help your body maintain its natural defenses.

Sometimes it is impossible to avoid cancer if you have defective genes inherited from your family. To help you in this fight, consult with family members to learn of their history and inform your doctor of your findings. These are just a few of the ways to lower your risks for developing cancer of the bladder.

If you do develop bladder cancer, there are options for treating this disease. You can choose from several different surgeries, depending on the aggression and stage of your cancer. These can range from a partial removal of the bladder to having the entire organ extracted from the body.

If you are in the earlier stages of this type of cancer, you could opt for immunotherapy, chemotherapy or radiation therapy treatments. After receiving your initial treatment, it is important to receive follow-ups to ensure the cancer does not return.

If you do have a relapse of your cancer, there are new tests and treatments out to help determine the stage and severity of it. The American Cancer Society discusses on the web site two new tests able to detect tumor cells by using urine samples.

A new treatment for cancer relapses is a PDT, or photodynamic therapy test. This method involves injecting a chemical into the body which clings to tumor cells in the bladder. A laser is then used to kill the tumor cells and eliminate the cancer. As research continues for this disease, better advancements in treatments and early detections will be released to help fight this deadly killer.

With all the information available to day about cancer, there is good reason why you should advocate cancer prevention and control in your life. This is especially true for cancers that are not discussed frequently in the news, such as bladder cancer. Preventing any kind of cancer involves maintaining a healthy lifestyle with plenty of exercise, a well-balanced diet and avoiding habits such as smoking.

About the Author

Andi Michaels has worked in healthcare and now runs health related websites on topics including treating cancer as well as sites on lung conditions

Bladder Cancer