What to know about bladder cancer

Article written by Doctor of Urology Department, Share99 Central Park International Health Hub

Bladder cancer is a type of cancer that occurs in the bladder, the hollow body located in the lower abdomen that contains urine released by the kidneys. Accordingly, bladder cancer, if examined and treated at an early stage, will bring a high life to the patient.

The bladder is a ball-shaped body in the pelvic region, containing urine. Accordingly, bladder cancer is a type of cancer derived from the bladder, they usually come from the inner lining cells of the bladder. The disease can occur at any age but is most common in older adults.

Mostly, bladder cancer is diagnosed at an early stage. At that time, the patient has a very high chance of treatment from the disease. However, even early-stage cancer is still likely to recur. For this reason, after treatment, people with bladder cancer are often monitored for years to detect recurrent cancer.

Signs and symptoms of bladder cancer include:

• Appearance of blood in the urine (hematoma): urine of a light red or cola color. Urine may be normal, but there is blood when examined with a microscope.
• Urinate frequently.
• Painful urination.
• Back pain.
• Pelvic pain.

When you see the above signs or blood appears in the urine, it is recommended to go to medical centers for examination and treatment.

It is not always possible to clearly know what causes bladder cancer. However, bladder cancer is associated with smoking, parasite infections, radiation infections and exposure to chemicals.

Bladder cancer appears when cells in the bladder begin to grow abnormally. Instead of growing and dividing in an orderly way, the cells develop mutations that cause out-of-control growth and do not die. Abnormal cells form a tumor.

Factors that may increase the risk of bladder cancer include:

• Smoking: Smoking can increase the risk of bladder cancer due to the accumulation of harmful chemicals in the urine. When smoking, the body treats chemicals in the smoke and eliminates certain substances through the urine. Toxic chemicals can damage the bladder mucosa, increasing the risk of cancer.
• Age: The risk of bladder cancer increases with age. Bladder cancer can occur at any age, but it is rarely found in people younger than 40 years of age.
• Whites: Whites are more likely to have bladder cancer than people of other races.
• Men: Men have a higher frequency of bladder cancer than women.
• Exposure to chemicals: The kidneys play an important role in the filtration of toxic chemicals from the blood and excretion into the bladder. For this reason, there are a number of chemicals that are believed to be able to increase the risk of bladder cancer. These chemicals include arsenic, chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products.
• Previous cancer treatment chemicals: cyclophosphamide is an anti-cancer drug that can increase the risk of bladder cancer. Cancer patients who receive pelvic radiotherapy are at increased risk for bladder cancer.
• Some diabetes medications: People who take the diabetes drug pioglitazone (Actos) for more than a year have an increased risk of bladder cancer. Combined diabetes medications contain pioglitazone such as pioglitazone and metformin (Actoplus Met), pioglitazone and glimepiride (Duetact).
• Chronic cystitis: chronic infections such as long-term use of the cathethe membrane, which can increase the risk of scab cell bladder cancer. In some parts of the world, scab cell histoid tissue cancer is associated with chronic cystitis caused by a parasite infection called trough fluke disease.
• Family factors: If a family member has a disease, the risk of bladder cancer increases. Family history of heredative nonpolyposis colorectal cancer, also known as syndrome.
• Lynch disease: May increase the risk of cancer in the urinary system, as well as in the colon, uterus, ovaries and other organs.

Different types of cells of the bladder can all become cancerous. The origin of the bladder cell where the cancer comes from determines the type of bladder cancer. The type of bladder cancer will determine the treatment.

Types of bladder cancer include:

• Transitional cell cancer: Transitional cell cancer occurs in the inner lining cells of the bladder. The transition cell expands when the bladder is full and shrinks when the bladder is empty. These cells are also found inside the ureter and urethra and the place can also form tumors. Transitional cell cancer is the most common type of bladder cancer.
• Scab cell mesenterous tissue cancer: Scab cells appear in the bladder due to irritation in response to infection. Over time these cells can become cancerous. Rare scab cell cancer. However, the disease is more common in some parts of the world, where there is a high frequency of infection with parasites in the bladder such as trough flukes.
• Glandular cancer: Originates from glandular cells that secrete mucus in the bladder. Gland cancer of the bladder is a rare disease.

Some bladder cancers may consist of more than one type of cell.

Bladder cancer often recurs. Because of this, after successful initial treatment, the person must be monitored for many years afterwards. The doctor will give the patient some tests every time he/she re-examines. You should ask your doctor for your next treatment plan. In general, the doctor will prescribe bladder scans, for internal examination of the urethra and bladder from 3 to 6 months for the first years and 6 months or 1 year for the next time.

People with bladder cancer at high risk of recurrence may undergo more frequent testing.

Tests and procedures used to diagnose bladder cancer may include:

• Bladder endoscopy: when screening the bladder, the doctor inserts a cystoscope into the urinary tract (urethra). The lens has a lighting system that allows the doctor to see and examine the inside of the urethra and bladder. Your doctor will pump lubricants and some anesthetics during bladder endoscopy to help you feel comfortable.
• Biopsy: during bladder scans, your doctor may use a special instrument inserted into the bladder to collect a cell sample (biopsy) for testing. This procedure is sometimes referred to as endoscopic bladder tumor angopic (TURBT) biomass. TURBT can also be used to cut the tumour completely in the treatment of bladder cancer. TURBT is usually performed with live anesthesia or general anesthesia.
• Urine cell: A sample of the patient's urine is analyzed under a microscope to find cancer cells.
• Imaging: imaging tests allow the doctor to examine the structures of the urinary tract. Sometimes one uses an injectable phototholytic drug into a vein to highlight the urinary tract image. Intravenous ureteral x-ray is a type of X-ray that uses a retiologist to better survey the kidneys, ureter and bladder. X-rays, computer-layered cutting (CT scans) are a type of radiothography that allows your doctor to better view the urinary tract and surrounding tissues.

Once bladder cancer has been confirmed, your doctor may request further testing to assess the extent (stage) of the cancer. These tests include:

• CT scan
• Mri
• Bone Scan
• Chest X-ray

Stages of bladder cancer:

• Stage I: Cancer occurs in the inner lining of the bladder but has not invaded the bladder muscle layer.
• Phase II. The cancer has invaded the bladder muscles but is still limited to the bladder.
• Phase III. Cancer cells have spread through the bladder wall to the surrounding tissue.
• Phase IV. By this stage, cancer cells can spread to the lymph nodes and other bodies, such as bones, liver, lungs.

The treatment for bladder cancer depends on a number of factors, including the types and stages of cancer, the overall health and therapeutic preferences of the person. Discuss your options with your doctor to determine which treatments are best for you.

Early bladder cancer treatments

If the cancer is very small and has not yet invaded the muscles of the bladder, your doctor may recommend surgical removal of the tumor: removal of the tumor of the endoscopic bladder through the urethra (TURBT) is often used to remove bladder cancer that is limited to the inner layer of the bladder.

When TURBT, the doctor uses a small metal wire ring inserted inside the cystoscope and into the bladder. This device is used to cut and burn cancer cells with an electric current. In some cases, high-energy lasers can be used instead of current. TURBT can cause painful urination or low blood for a few days after the procedure.

• Surgery to remove the tumor and a small part of the bladder: This surgery is also known as a bladder halfectect. Surgeons remove only part of the bladder that contains cancer cells. This surgery is rarely used and can only be an option if the cancer is alone limited to an area of the bladder that can be easily removed without damaging bladder function.
• Biological therapy (immunity): Biological therapy, sometimes called immunity, works by activating the body's immune system to fight cancer cells. Biological therapy for bladder cancer is usually given through the urethra and directly to the bladder (chemotherapy in the bladder).
• Bacille Calmette-Guerin (BCG): A biological drug used to treat bladder cancer, a bacterium used as in the TB vaccine. Bio-therapy drugs are a synthetic version of interferons, an immune system protein that helps fight infections. Synthetic versions, called interferon alfa-2b (Intron A), are sometimes used in combination with BCG. Bio-therapy drugs often cause flu-like symptoms and can irritate the bladder.
• Invasive bladder cancer surgery: If the cancer has invaded the deeper layers of the bladder city, you can consider: The surgical removal of the entire bladder is the surgical removal of the entire bladder, as well as the surrounding lymph nodes. In men, bladder removal usually consists of a removal of the prostate gland and a sac of chimpanzees. In women, bladder removal consists of a removal of the uterus, ovaries and part of the vagina. Today, full bladder removal has robotic support, which means surgeons sit nearby and use controls to accurately move surgical instruments. Bladder removal carries a potential risk of infection and bleeding. For men, removing the prostate gland and chimpanzee sac can cause erectile dysfunction. However, your surgeon tries to preserve the nerves necessary for an erection. In women, removal of the ovaries causes infertility and early menopause.
• Urine transfer surgery: Immediately after the bladder removal, the surgeon transfers urine through a new way. There are many options, which one is best for you depending on your condition and preferences. The surgeon can use a segment of the intestine that creates a bag containing urine. Urine from the kidneys pours into this container bag and escapes out of the body through a hole that opens to the skin covered with a carrying bag on your abdomen. In another operation, the doctor can use a segment of the intestine to create a small bag containing urine inside the body. You use a cathethe tube a few times a day to drain urine from the container through a hole in the abdomen. Another option, the doctor can make a bag containing the same intestines as the bladder (neobladder). This new bladder is located inside the body and is connected to your urethra, allowing you to urinate normally. You may need to use a cathe tube to completely drain urine for the first 6 months.

• Chemotherapy: Chemotherapy uses drugs to kill cancer cells. Bladder cancer chemotherapy usually uses a combination of two or more chemotherapy drugs. The drug can be taken into the body intravenously in your arm (intravenously), or can be inserted directly into your bladder by pumping through a cathethe tube. Chemotherapy can be used to destroy cancer cells that may remain after surgery. The drug can also be used before surgery. In this case, chemotherapy can atrophy the tumor allowing doctors to perform a less invasive surgery. Chemotherapy is sometimes associated with radiotherapy in the event that surgery is no longer possible.
• Radiotherapy: Radiotherapy uses high-energy beams to kill cancer cells. Radiation from a corrective radiotherapy machine focuses precisely on a body area containing cancer. Radiotherapy can be used after surgery to kill the remaining cancer cells. In some cases, radiotherapy is sometimes associated with chemotherapy when the possibility of surgery is no longer possible, although this is often considered a last option.

Share99 International Health Hub is a general hospital with the function of examining and treating diseases. Accordingly, vinmec has also carried out diagnosis, endoscopic treatment, cancer screening from an early stage using modern medical methods, which not only brings high efficiency but also minimizes complications of recurrent diseases. Having great success is because Share99 is always fully equipped with modern facilities, the examination and treatment procedures are carried out by a team of professional and experienced doctors who will bring optimal medical treatment results to customers.

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