by Joe Harry
Dear Admin:
I am a 68-year-old man in relatively good health. I am an ex-smoker, but quit the habit years ago. Last week I was diagnosed with early stage bladder cancer. Is it true that my smoking could have caused this? How serious is bladder cancer? What are the latest treatment options?
Answer:
The good news is that bladder cancer is highly treatable when diagnosed at an early stage. Unfortunately, bladder cancer is often a repeat offender - even early-stage bladder cancer is likely to recur. For this reason, your doctor will probably schedule multiple follow-up exams even after you have had treatment.
Your bladder is a muscular, hollow organ that stores urine, which is the liquid waste filtered from your blood by your kidneys. Urine is eliminated from the body through a narrow tube called the urethra.
The bladder wall itself has multiple tissue layers. Most bladder cancers have their start in the bladder's inner lining (urothelial cells). From there, depending on the type of tumor, and the cancer's aggressiveness (grade), it may grow farther into the bladder's outer layers. Cancer in the bladder's urothelial cells is generally classified (staged) by how far it has grown into bladder tissue layers.
You mention that you have early-stage bladder cancer, which is called non-muscle invasive (superficial) cancer. This means that only the innermost surface layers of bladder tissue have tumor cells. Because the cancer hasn't extended into the muscle, successful treatment is likely.
If the tumor had invaded your bladder's muscle wall layer, it would be considered muscle invasive cancer. Even more serious, metastatic cancer, is when bladder cancer has spread beyond the outside wall of the bladder and invaded other parts of the body, such as the lymph nodes.
In the early stages of bladder cancer, it's not unusual to have no signs or symptoms. However, some patients do see blood in their urine. Other possible signs and symptoms of bladder cancer may include pain with urination, a change in bladder habits (such as increased frequency or an inability to urinate despite the urge to do so), abdominal pain and back pain.
While it's impossible to say for sure what caused your cancer, we do know that smoking is a major risk factor when it comes to bladder cancer. Compared with nonsmokers, smokers and former smokers are two to three times more likely to develop bladder cancer. That's because the body processes chemicals found in tobacco smoke and then excretes some of them in urine. The presence of these chemicals in urine may damage the bladder's lining.
Those at greatest risk of bladder cancer generally are adults over age 60. Exposure to certain chemicals also is linked to bladder cancer. These include arsenic and chemicals used in the manufacturing of dyes, rubber, textiles and leather and paint products. In addition, the use of certain anti-cancer drugs - notably high doses of cyclophosphamide (Cytoxan) - can increase bladder cancer risk, as does radiation treatment of cancers in the vicinity of the bladder.
As with other cancers, treatment options for bladder cancer are determined by the type of cancer and how far the cancer has progressed.
Because you have early-stage bladder cancer, your doctor may recommend transurethral resection of bladder tumor, or TURBT. During this procedure, a small wire loop is passed through the urethra to the bladder. The loop burns away cancer cells with an electric current.
In some special situations, it may be best to remove just the portion of your bladder (partial cystectomy) where the tumor is located by way of an open or laparoscopic surgical procedure. This procedure is done if your cancer is limited to one area of the bladder that can easily be removed without harming bladder function.
When cancer has invaded deeper layers of the bladder wall, removal of the entire bladder and other nearby tissues is commonly performed. After bladder removal, a new urinary tract is constructed by your surgeon.
Additional therapies for non-muscle invasive bladder cancer may include immunotherapy, which activates your body's own immune cells to help fight cancer cells. Chemotherapy and/or radiation therapy can also be incorporated in the overall treatment of bladder cancer.
Fortunately for you, one of the keys to successful treatment of bladder cancer is early detection. However, you will need regular and lifetime follow-ups with your doctor. Recurrence remains an ongoing concern once you've been treated for bladder cancer.
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