Bladder Cancer

Cancer of the bladder occurs when cells in the bladder grow and divide in an abnormal way.1

What is bladder cancer?

The bladder is a muscular balloon-shaped organ that can expand and contract (get smaller) depending on how much urine is in the bladder. 1 ,2

The bladder is made up of four layers of tissue:1

  • Urothelium – this layer consists of cells that keep the urine in the bladder and prevent it being absorbed into the body. It is the first layer inside of the bladder.
  • Lamina propria – is next to the urothelium layer and consists of blood vessels.
  • Muscularis propria – this is the thickest of all layers, and it is responsible for contracting the bladder to empty urine.
  • Perivesical tissue – surrounds all the other layers of the bladder and consists mainly of fatty tissue to help protect the bladder.

Cancer of the bladder occurs when cells in the bladder grow and divide in an abnormal way.1

The most common type of bladder cancer is urothelial carcinoma, which accounts for approximately 85% of all bladder cancers.3

Other types of bladder cancer include; squamous Cell Carcinoma and adenocarcinoma. These types of cancer only account for a small percentage of bladder cancers (1-2%), however they tend to be aggressive (grow quickly).3

Bladder cancer can be either;

  • Non-muscular-invasive bladder cancer – where cancer cells are only found in either of the first two layers of the bladder; the urothelium cells (the innermost cells of the bladder) or the next layer of tissue called the lamina propria.1,3
  • Muscular-invasive bladder cancer – where cancer cells have spread beyond the first two layers of the bladder into the muscle layer and in some cases, into nearby tissue.1,3

Is bladder cancer hereditary?

It is not common for bladder cancer to be passed down from generation to generation, although people can inherit genetic mutations from their parents which increase the risk of bladder cancer. 15

Additionally, people can inherit impairments in removing waste products (such as toxins) from the body, making them more exposed to environmental cancer-causing toxins such as tobacco and industrial chemicals, increasing their cancer risk. 15

Signs and symptoms of bladder cancer

The most common symptom of bladder cancer is having blood in your urine (known as haematuria).6

The blood can be small amounts and can be brownish or red in colour. Blood in your urine tends to come on quickly, and it can come and go.6

Additional symptoms can include;

  • Changes in urinating such as feeling the need to urinate more often or pain (such as a burning sensation) when urinating.6,7
  • Pain in the pelvis or lower back, usually on one side.

There are a number of conditions that can cause these symptoms besides bladder cancer. However, it is important if you are experiencing any of the above symptoms that you talk to your doctor. 7

Stages of bladder cancer

The most common system used to stage bladder cancer is called the TNM system, which stands for:5

  • Tumour (T) – which describes how big the tumour is and how much of the bladder and surrounding tissue has been affected.
  • Nodes (N) – describes how many lymph nodes have been affected by the cancer.
  • Metastasis (M) – describes if the cancer has spread to other parts of the body.

A biopsy of the tumour will also provide information and a ‘grade’ of the cancer such as how quickly it will grow and the chance of it coming back.5

  • Low grade – most tumours in the bladder are considered low grade, which means the cancer cells are slow growing and tend not to spread and look like bladder cells.5
  • High grade – cancer cells look very different to bladder cells and tend to grow quickly and spread to other tissues in the body.5

Bladder cancer research at Icon

Our research centre at Icon offers Australia the largest private clinical trials programme in cancer research, with over 35 clinical trials currently open for recruitment.  Clinical trials specific to bladder cancer research can be found here.

Icon’s collaborative approach to clinical trial research not only enables continual advancement and breakthroughs in bladder cancer research, but also enables the most up to date treatment options are available to all patients regardless of health insurance.

Treatment for bladder cancer

Treatment for bladder cancer will depend on a number of things such as; your type of bladder cancer, your medical history and personal preferences for treatment.

Treatment for non-muscle-invasive bladder cancer include; 8

  • Surgery – a procedure known as a transurethral resection of bladder tumour (TURBT) can be done which removes or destroys the tumour via inserting a tube with a camera in the urethra (where your urine comes out). This procedure is done under general anaesthetic and takes approximately 30 minutes. 10
  • Immunotherapy – via the use of a vaccine (known as Bacillus Calmette-Guérin (BCG)) which was once used to treat tuberculosis, can increase the body’s natural immune system to stop the growth of the cancer cells in the bladder. 11
  • Chemotherapy – uses drugs to kill the cancer cells by inserting a catheter (soft tube) directly into the bladder via the urethra (called intravesical chemotherapy).12

Treatment for muscle-invasive bladder cancer include;9

  • Surgery – the removal of the whole bladder is a common surgical treatment in cases where the cancer has spread to the muscle.9
  • Chemotherapy – involves the use of specific drugs to kill the cancer cells. Chemotherapy to treat muscle-invasive bladder cancer usually involves intravenous therapy (drugs given by injection into the vein). This type of chemotherapy is known as systemic. 13
  • Radiation therapy – can be used instead of surgery to treat muscle-invasive bladder cancer. It can also be used at the same time as chemotherapy to help maximise treatment outcomes.14

Frequently asked questions

Are there risk factors for bladder cancer?

Smoking is the leading modifiable risk factor for bladder cancer, causing approximately 50% of all bladder cancers in both men and women. 4

Exposure to chemicals in the workplace such as aromatic amines, used in the dye industry can increase the risk of bladder cancer.4 Exposure to other organic chemicals used in certain industries such as the paint, textile and hairdressing industry can also increase the risk of bladder cancer. 4

Additional risk factors include;

  • Age – bladder cancer risk increases with age, with most people being over 60 years of age when diagnosed. 3,4
  • Sex – being male increases your risk for bladder cancer compared with women. 3,4
  • Regular infections – such as a urinary tract infection (UTI), bladder stones or kidney infections can increase the risk, as well as long-term use of catheters. 3,4
  • Previous chemotherapy or radiation therapy – certain chemotherapy drugs and radiation to the pelvis area can increase the risk for bladder cancer. 3,4
  • Diabetes medication – the use of the drug pioglitazone has been implicated in the increased risk of bladder cancer.3,4
How common is bladder cancer?

Approximately 2,500 Australians are diagnosed with bladder cancer each year.3

Bladder cancer is more common in men than women, with men nearly four times more likely to be diagnosed.3

References

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