Bladder Cancer

Definition

Bladder cancer is a type of cancer that begins in the urinary bladder. The bladder is a balloon-shaped organ located in your pelvic area that serves to store urine.

Bladder cancer typically starts in the cells that line the inner surface of the bladder. While it usually affects older adults, it can occur at any age.

In most cases, bladder cancer is diagnosed at an early stage—when it is highly treatable. However, even when detected early, there is a relatively high risk of recurrence. For this reason, patients with bladder cancer require regular follow-up examinations for years after treatment.

Symptoms

Bladder cancer can cause the following signs and symptoms:

• Blood in the urine (hematuria): The urine may appear bright red or brownish in color. In some cases, it may look normal, but blood is detectable under a microscope. Hematuria may occur with or without pain.

• Back pain

• Pain in the pelvic area

When should you consult a doctor?

If you notice blood in your urine or experience any of the symptoms mentioned above, please schedule an appointment with your doctor as soon as possible.

Types of Bladder Cancer

Cancer can develop in different types of cells within your bladder.
The type of cell in which the cancer begins determines the type of bladder cancer. This, in turn, influences which treatment option is most suitable for you.

The main types of bladder cancer are described as follows:

• Urothelial carcinoma
  This type of cancer begins in the innermost tissue layer of the bladder. The inside of your bladder is lined with so-called transitional epithelial cells (urothelium). These cells expand when the bladder is full and contract when it is empty. The same type of cells also line the inside of the ureters and urethra—tumors can also develop in these areas. Urothelial carcinoma is the most common type of bladder cancer in Austria
• Squamous cell carcinoma
  Squamous cells can develop in your bladder as a result of chronic infections or irritation. Over time, these cells may become cancerous. Squamous cell carcinoma is relatively rare in Austria but is more common in regions of the world where certain parasitic infections—such as schistosomiasis—are a leading cause of bladder infections.
• Adenocarcinoma
  Adenocarcinoma develops in the cells of the bladder’s mucus-producing glands. It is also considered rare in Austria.
• In some cases, bladder cancer may involve more than one type of cell.

Causes and Risk Factors

The exact causes of bladder cancer are not always clear. Smoking is considered the most important risk factor. Other contributing factors include parasitic infections, radiation exposure, and exposure to certain chemical substances. Bladder cancer develops when the cells in the bladder lining begin to grow abnormally. Instead of growing and dividing in a regulated way, these cells undergo genetic changes that cause them to grow uncontrollably and avoid normal cell death. Over time, these abnormal cells form a tumor.

Risk factors include:

• Smoking
  Smoking cigarettes, cigars, or pipes significantly increases your risk of developing bladder cancer, as it leads to the accumulation of harmful chemicals in the urine. When you smoke, your body processes the toxins in tobacco, and some of these are excreted in the urine. These substances can damage the delicate lining of the bladder, thereby increasing the risk of cancer.
• Advanced age
  The risk of developing bladder cancer increases with age. While it can occur at any age, it is relatively rare in people under the age of 40.
• Fair skin
  People with fair skin have a higher risk of developing bladder cancer compared to individuals of other ethnic backgrounds.
• Male gender
  Men are significantly more likely to develop bladder cancer than women.
• Exposure to certain chemicals
  Your kidneys filter harmful substances from your blood, which are then transported to the bladder. These substances often remain in the bladder for prolonged periods, where they can cause damage. Chemicals linked to bladder cancer include arsenic, as well as substances used in the textile, rubber, and leather industries, and in the manufacture of dyes and pigments.
• Previous cancer treatments
  Treatment with the chemotherapy drug cyclophosphamide can increase the risk of developing bladder cancer later in life. Similarly, individuals who have received radiation therapy to the pelvic area for previous cancers are also at increased risk.
• Use of certain diabetes medications
  People who take the diabetes medication pioglitazone or combination products containing pioglitazone (e.g., Actos) for longer than one year may have an increased risk of developing bladder cancer.
• Chronic bladder inflammation
  Chronic or recurrent urinary tract infections and bladder inflammation (cystitis)—such as may occur with long-term catheter use—can increase the risk of bladder cancer. In some parts of the world, squamous cell carcinoma of the bladder is linked to chronic bladder infections caused by parasitic infestation (schistosomiasis).
• Personal or family history of cancer
  If you have previously had bladder cancer, there is a risk it may recur. Your risk is also higher if one or more close relatives have had bladder cancer. A family history of hereditary non-polyposis colorectal cancer (Lynch syndrome) may also increase the risk of cancers of the upper urinary tract, colon, uterus, ovaries, and other organs.