Q. How common is bladder cancer?A. Bladder cancer is more common than people realise. Over 10,000 cases are diagnosed each year in the Indian sub-continent. The majority of these (about 7,500) are diagnosed in men, meaning that, on average, one man in thirty will get this cancer at some time in his life.
Q. How dangerous is bladder cancer?A. It is really dangerous with Hb levels falling down due to increased blood loss through the urine. This rate however has gone low as per the medicinal advances.
Q. Who is at risk from bladder cancer?
Q. Is smoking linked to bladder cancer?A.Smokers are two to five times more likely to get bladder cancer than normal,says Dr. Hari krishna (cancer specialist). The more they smoke, or the longer they smoke, the higher the risk. It is estimated that half of all bladder cancers in men, and one third in women, are the result of smoking.
Q. What are the symptoms of bladder cancer?
Q. How is bladder cancer diagnosed?
A.First, a urine sample is taken and sent for analysis, too see if any abnormal cells can be found in it. The next test is usually cytoscopy: under local anaesthetic a thin flexible tube is passed up the urethra (the tube that carries the urine out) and into the bladder. Fibre-optics in the tube allow the doctor to inspect the inside of the bladder. In some cases, X-rays and blood tests may also be required for detection of cancer in it.
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Q. How is bladder cancer treated?
Q. How effective are these treatments?A.This depends on how advanced the cancer is and the age of the patient. Patients with early bladder cancer and patients under 40 have an 80 to 90% chance of surviving for five years and longer. If the cancer has spread into the muscle wall of the bladder, or if the patient is over 80, only about half of them survive for five years after diagnosis. Unusually, men seem to survive this cancer better than women, although we do not understand why.
Q. What is the Bladder?A.The bladder serves as a reservoir for urine in our bodies. It permits the storage of urine for a period of time before releasing it as we urinate. It can be thought of as a muscular balloon; a flattened structure when there is no urine (immediately after a person urinates) but able to be filled to up to a liter (though this would be very uncomfortable) with urine. Normally, as the bladder nears 500 cc (1/2 of a liter), we feel the urge to urinate. The muscular structure of the bladder also helps other pelvic muscles push the urine out when it is released. The bladder is located deep in the pelvis, just above the pubic symphysis, which is a bone that can be felt in the midline on the front of our pelvis. In fact, when the bladder is over distended, it can be felt by a physician. Ureters empty urine into the bladder from the kidneys, and the urethra leads out from the bladder, emptying urine out of our bodies.
Q. What is bladder cancer?A.The definition of a tumor is a mass of quickly and abnormally growing cells. Tumors can be either benign or malignant. Benign tumors have uncontrolled cell growth, but without any invasion into normal tissues and without any spread. A malignant tumor is called cancer when these tumor cells gain the propensity to invade tissues and spread locally as well as to distant parts of the body. In this sense, bladder cancer occurs when cells in the lining of the bladder grow uncontrollably and form tumors that can invade normal tissues and spread to other parts of the body.
Cancers are described by the types of cells from which they arise. Bladder cancers arise almost exclusively from the lining of the bladder. In the United States, 98% of bladder cancers are called transitional cell carcinomas. This simply means that the cancer started in the lining of the bladder, which is made up of transitional cells that appear elliptical under the microscope. Less commonly are other types of cancers that arise from the lining of the bladder, called adenocarcinomas, squamous cell carcinomas and small cell carcinomas. A common way for this cancer to grow is called a papillary growth pattern. When a it grows this way, it can be noninvasive, i.e., not invading into tissues at all, and hence not having a risk for distant spread (as long as it is treated). In addition to other invasive cancers, patients are sometimes diagnosed with precancerous lesions, called carcinoma-in-situ. Carcinoma-in-situ occurs when the lining of the bladder undergoes changes similar to cancerous changes without any invasion into the deeper tissues. Hence, while the cells themselves have cancer-like qualities, there is no risk of spread, as no invasion has occurred. However, both papillary bladder cancers and cancer-in-situ may become invasive and cause problems if not treated.
Q. Am I at risk for bladder cancer?A.It is the fourth most common cancer in men and the eighth most common cancer in women,says Dr. Tarang Krishna, cancer physician. Over 50,000 cases are diagnosed every year in the United States, with over 12,000 deaths. The incidence is almost same in India Classically, it is thought of as a disease that affects older men, with men affected more than women by a 3:1 ratio and 2/3 of the cases diagnosed in people over the age of 65. Cigarette smoking is the largest risk factor for bladder cancer (yet another reason to stop smoking). Smokers have 2-4 times the risk of having this cancer, and it contributes to up to 50% of all bladder cancers that are diagnosed. Other than Schistosoma haematobium infections, the only other risk factors known are from occupational exposures, such as polychromatic hydrocarbons (benzene, benzidine). More recently, an association has been made between chlorinated drinking water and bladder cancer, says Dr. Tarang. Though there have been suggestions of saccharin and high intake of dietary fat and cholesterol being causative for this cancer, these have yet to be substantiated.
Q. How can I prevent bladder cancer?A.Smoking is the strongest risk factor associated with the development of this cancer. Therefore, smoking cessation is the best way to prevent it, as per world renowned cancer specialist Dr. Hari Krishna Also, obviously reducing the exposure to carcinogenic compounds should decrease the risk of developing it. Other than these preventative measures, decreasing the risk of bladder cancer relies on early detection of symptoms and possibly screening high-risk individuals.
Q. What screening tests are available?A.The goal of screening tests are to detect cancers early and initiate treatment when the cancer is in an early stage, or even before it becomes invasive. Cytologic examination of urine (looking for abnormal cells in urine) has been the most commonly tested screening tool. It involves testing urine for the presence of abnormal cells, which would indicate the possibility of a cancer. This method is fairly inexpensive and without risk to the patient. If abnormal cells are seen, over 95% of the time it accurately predicts the presence of bladder cancer. However, a fair amount of cancers can be missed using this method. Also, the incidence of preclinical (too small to cause any symptoms) bladder cancer in the general population is likely too low for cytologic examination of urine to be useful as a mass screening tool. Routine examination of the urine for the detection of blood (by far the most common presentation of bladder cancer) has also been tested and also appears to be inadequate for mass screening. Therefore, there is no tried screening method for the cancer, so the best method for detecting this cancer and preventing an aggressiveness of the cancer is to not smoke or stop smoking and to not ignore the early symptoms of bladder cancer, which usually involves blood noted in the urine (see below).
Q. What are the signs of bladder cancer?A.By far the most common sign of bladder cancer is the presence of blood in the urine, called hematuria The blood in the urine can either be noticeable by the naked eye, called gross hematuria, or noted only when the urine is analyzed in a laboratory, called microscopic hematuria Either gross hematuria or microscopic hematuria is present in over 80% of cases of this cancer. Therefore, when someone is noted to have blood in the urine, it must be proven to be something other than bladder cancer.
Other signs of this cancer could include symptoms of a urinary tract infection. These include increased frequency of urination, a feeling of urgency to urinate, pain (burning) with urination, and the feeling of incomplete bladder emptying. These are all caused by irritation of the bladder wall by the tumor.
In advanced cases of it, the tumor can actually obstruct either the entrance of urine into the bladder or the exit of urine from the bladder. This causes severe flank pain, infection, and damage to the kidneys. Obviously, bladder cancers that cause these symptoms need to be dealt with immediately.