Bladder cancer is cancer that begins in the bladder due to abnormal cell growth. Bladder cancer is often characterized by the presence of blood in the urine.
The bladder is an organ located in the middle of the lower abdomen. This organ functions to accommodate urine, before being excreted from the body through a channel called the urethra.
Bladder cancer occurs when cells in the bladder grow uncontrollably and form cancer cells. If they continue to grow, the cancer cells can spread to the tissues around the bladder, or to other organs that are more distant, such as the liver, bones, and lungs.
Types of Bladder Cancer
Bladder cancer is divided into several types based on where the cancer cells grow, namely:
Urothelial carcinoma
Urothelial carcinoma is the most common type of bladder cancer. Urothelial carcinoma start in cell urothelial, which are cells that line the inside of the bladder.
Squamous cell carcinoma
Squamous cells carcinoma Squamous cell carcinoma or squamous cell carcinoma is a type of bladder cancer that starts from the thin, flat squamous cells that grow in the lining of the bladder.
This type of bladder cancer occurs when the bladder is continuously irritated, for example from long-term use of a urinary catheter or repeated bladder infections.
Adenocarcinoma
Adenocarcinoma It grows in glandular cells, which are cells in the mucus-producing glands in the bladder. Adenocarcinoma It occurs when the bladder becomes inflamed over a long period of time.
Causes and Risk Factors for Bladder Cancer
Bladder cancer is caused by changes (mutations) in the cells in the bladder. These mutations cause cells to grow uncontrollably and form cancer cells that can spread (metastasize) to other organs of the body.
It is not known what causes these cells to mutate into cancer cells. However, there are several factors that can increase a person's risk of developing bladder cancer, namely:
- Have a smoking habit
- Male gender
- Increasing age, especially over the age of 55
- Have a history of cancer, both in yourself and in your family
- Exposure to chemicals, such as arsenic and chemicals used in the leather, rubber, textile, and paint industries, such as aniline dyes, benzidine, xenylamine, o-toluidine, 4-aminobiphenyl and 2-naphthylamine
- Have had radiotherapy to treat cancer near the bladder, such as bowel cancer
- Have had chemotherapy with cisplatin or cyclophosphamide
- Experiencing menopause too early, i.e. under the age of 45 years
- Using a urinary catheter in the long term
- Suffering from urinary tract infections and chronic bladder stones
- Suffering from untreated schistosomiasis
- Suffering from type 2 diabetes
Symptoms of Bladder Cancer
The most common symptom in patients with bladder cancer is the presence of blood in the urine (hematuria). This complaint will cause the color of the urine to be reddish or brown.
Other symptoms that can be experienced by bladder cancer sufferers are:
- Frequent urination
- Increased frequency of urination
- Difficulty holding urine (urinary incontinence)
- Frequent urge to urinate suddenly
- Pain or burning sensation when urinating
If bladder cancer continues to grow and spread to other parts of the body, the symptoms may vary, including:
- Pelvic pain
- Loss of appetite
- Weight loss
- Swelling in the legs
- Bone pain
When to go to the doctor
Immediately see a doctor if you experience any of the above symptoms, especially if you suspect blood in your urine.
Keep in mind, the presence of blood in the urine does not always mean bladder cancer, but it can also be due to cystitis, kidney infection, kidney stones, enlarged prostate gland, and urethritis, which is inflammation of the urethra.
Therefore, it is important to see a doctor if you find blood in your urine, so that the exact cause can be identified and appropriate treatment is given.
Bladder Cancer Diagnosis.
The doctor will ask the patient's symptoms, the patient's and family's medical history, and whether the patient has been exposed to chemicals that can increase the risk of developing bladder cancer.
After that, the doctor will perform a digital rectal examination to detect the presence of lumps that could indicate cancer.
If there is a suspicion of bladder cancer, the doctor will perform additional tests, such as:
- Cytology urine test, to detect the presence of cancer cells in the patient's urine sample
- Scanning with X-rays equipped with contrast material, CT scan, or MRI, to see the condition of the bladder
- Cystoscopy, to see the condition of the bladder through a small tube with a camera
- Tissue sampling (biopsy) from the bladder, to see if there are cancer cells in the tissue sample taken
After the patient is confirmed to have bladder cancer, the doctor will determine the stage or severity of the condition. This determination will help the doctor in determining the appropriate treatment method.
Bladder cancer is divided into 5 stages, from stage 0 to stage 4. The following is an explanation:
- Stage 0
Cancer has not spread past the lining of the bladder
- Stage I
The cancer has passed through the lining of the bladder, but has not yet reached the muscle layer in the bladder
- Stage II
Cancer has spread to the muscle lining of the bladder
- Stage III
Cancer has spread to the tissues around the bladder
- Stage IV
Cancer has spread to other organs around the bladder
Bladder Cancer Treatment
Treatment for bladder cancer depends on the type of cancer, stage, age, and the patient's overall health condition. Some methods that can be done by doctors are:
1. Immunotherapy
Immunotherapy is the administration of drugs or vaccines to help the immune system fight cancer cells. Immunotherapy can be done by injecting the vaccine through a vein or directly into the bladder (intravesical).
The vaccine used in bladder cancer immunotherapy is the BCG vaccine, which is used to prevent tuberculosis (TB). This vaccine will attract immune cells to the bladder to fight cancer cells.
2. Chemotherapy
Chemotherapy is the administration of two or more drugs to kill cancer cells. Just like immunotherapy, chemotherapy drugs can be injected directly into the bladder or injected through a vein.
Drugs that are often used in bladder cancer chemotherapy are a combination of cisplatin with methotrexate or vinblastine.
3. Radiotherapy
Radiotherapy or radiation therapy aims to kill cancer cells with the help of high levels of radiation, such as X-rays and protons. In some cases, radiotherapy can be combined with chemotherapy or done after surgery to remove cancer cells.
4. Operation
Types of surgery that can be performed to treat bladder cancer include:
- Transurethral resection of bladder tumor (TURBT), which is the removal of cancer using a special wire or recessctoscope
- Partial cystectomy, which is the removal of part of the bladder that is affected by cancer cells
- Radical cystectomy, which is the removal of the entire bladder and some of the surrounding organs
Bladder Cancer Complications
Bladder cancer can spread to other nearby organs, such as the lymph nodes in the pelvis, liver, lungs and bones. Other complications that may occur are:
- Lack of blood or anemia
- Erectile dysfunction in men
- Sexual dysfunction in women
- Uncontrolled urination (urinary incontinence)
- Swelling of the ureters (hydronephrosis)
- Narrowing of the urethra (urethral stricture)
Bladder Cancer Prevention
As explained above, it is not yet known what causes bladder cancer. Therefore, preventing this disease is a difficult thing to do. However, the risk of bladder cancer can be reduced by living a healthy lifestyle, such as:
- Quit smoking if you smoke, and stay away from secondhand smoke
- Avoid chemical exposure, namely by using personal protective equipment and following safety procedures in the work environment
- Eat fruits and vegetables rich in antioxidants, to reduce the risk of cancer
- Exercise regularly