Bladder Cancer Types, Stages, Signs, Symptoms & Treatment

Bladder cancer, like any other cancer, is an abnormal growth of cells in the walls of the bladder, also known as the urothelial cells. This growth gradually forms a tumour and eventually spreads to other parts of the body.

Though urothelial cancer can occur in the kidneys and ureters as well, it is more common in the bladder. This cancer is treatable as it usually gets diagnosed at an early stage. Due to its recurring nature, follow-up sessions may be necessary for years.

Types of bladder cancer

There are 3 main types of bladder cancer depending upon the kind of tumour:

Urothelial carcinoma :

Also known as transitional cell carcinoma (TCC), this is the most common type of bladder cancer. It begins in the urothelial cells found in the urinary tract.

Squamous cell carcinoma :

Squamous cells develop in the bladder lining in response to irritation and inflammation and may become cancerous. This cancer accounts for about 4% of all bladder cancers.

Adenocarcinoma : 

There are other types of bladder cancers too, such as sarcoma of the bladder and small cell
bladder cancer but they are very rare. 

Risk factors

1. Smoking and excessive use of tobacco- People with smoking habits are more likely to suffer from bladder cancer as compared to non-smokers. 
2. Exposure to certain chemicals such as aromatic amines which are mostly used in the dyes and paint and rubber-making industries increases the risk of bladder cancer.
3. Certain drugs such as pioglitazone and dietary supplements which contain aristolochic acid may be associated with bladder cancer.
4. Nowadays, the presence of arsenic in drinking water is also increasing the risk of bladder cancer
5. People with a history of bladder cancer and other associated problems like bladder irritation are often at a higher risk of being diagnosed with bladder cancer or recurring cancer. 
6. Factors like race, ethnicity, age, gender and genetics too affect the risks and possibilities of developing bladder cancer.

Signs and symptoms

The most common symptoms are:

• Painful urination
• Blood in the urine
• Frequent urination
• Urgent urination
• Pain in the abdominal area
• Pain in the lower back

Diagnostic procedures

On susceptibility, a series of lab tests and exams are done to confirm the diagnosis. Some of the major diagnostic procedures are listed below:

Step 1

Urinalysis: This is a simple lab test done to check for blood and other substances in a urine sample.

Cytology: For this test, a sample of urine is looked at via a microscope to see if there are any cancer or pre-cancer cells in it.

Urine Culture: This test may be done to see if an infection (rather than cancer) is the cause. One or more of these tests may be used along with urine cytology to help see if you have bladder cancer.

Step 2

Cystoscopy: If bladder cancer is suspected in the above tests, then most doctors will recommend a cystoscopy.

Step 3

TURBT/TUR: If an abnormal area (or areas) is seen during a cystoscopy, then transurethral resection of bladder tumour (TURBT), also known as just a transurethral resection (TUR), is done.

Step 4

Analysis and Detection: The test results are then sent to the lab and their invasiveness and grades are detected.

If detected, then the imaging tests such as X-ray, MRI, CT scan, etc. are done to analyse the size and extent of the spread of cancer.

Step 5

Biopsy: If imaging tests suggest that cancer has spread outside the bladder, a biopsy might be needed to be sure.

Stages and grades

Bladder cancer can be either in the early stage (confined to the lining of the bladder) or invasive (penetrating the bladder wall and spreading to nearby organs or lymph nodes).

The stages are from TA (confined to the internal lining of the bladder) to IV (most invasive).

In the beginning stages (TA, T1 or CIS), the cancer is confined to the lining of the bladder or in the connective tissue just below the lining. It has not yet spread into the main muscle wall of the bladder.

The latter stages, i.e., from stage II to IV, denote invasive cancer. These involve the spread of cancer to the muscle wall and/or to the other organs or bones from the bladder.

However, doctors use the more advanced systems of staging, i.e., TNM, which stands for tumour, node involvement and metastases.

In this:

• T2 suggests the spread of cancer to the main muscle wall below the lining. In T4, the tumour spreads beyond the bladder to the nearby organs or the pelvic side wall.
• These stages represent invasive bladder cancer.
• Lymph node involvement ranges from N0 (no cancer in lymph nodes) to N3 (cancer in many lymph nodes, or one or more bulky lymph nodes larger than 5 cm).
• M0 means that there is no metastasis outside of the pelvis. M1 means that it has metastasised outside the pelvis.

Treatment

Four major types of treatment for patients with bladder cancer include: surgery, chemotherapy, intravesical chemotherapy or immunotherapy for superficial cancers, and radiation therapy.

Sometimes, a combination of these treatments may be used.

In case of any signs and/or symptoms, one should immediately contact the oncosurgeon, gynaecologist or nearby doctors or physicians.

In case of any suspicion, the doctors will immediately run various tests and diagnostic procedures which will help the doctor to decide what kind of treatment is best and plan the patient’s prognosis.

The treatments and diagnostic procedures are readily available in Ghaziabad and Delhi NCR at Yashoda Super Speciality Hospital & Cancer Institute, Sanjay Nagar, Ghaziabad. 

We have a team of preeminent specialists and cutting-edge technology which are the best in Delhi NCR for the treatment of bladder cancer.

Dr Vaibhav Saxena is a renowned and highly experienced urologist with experience in doing more than 10,000 urological procedures including advanced laparoscopic procedures and cancer surgery.

Dr Pradeep Prakash is a dedicated urologist having more than 13 years of experience in the medical field (6 years as a superspecialist).

He has the rare achievement of having obtained all his medical education from the reputed AIIMS, New Delhi.

Visit us at www.yashodahealthcare.com or call 9810922042 to know more.