Urinary Bladder Cancer

• Hematuria or the presence of blood cells in the urine
• Increased frequency of urination
• Painful micturition
• Persistent pain in the back

If you experience symptoms, like red discoloration of the urine or intense pain during urination persistently, you must visit Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai and get an appointment with an expert doctor.

Bladder cancer develops when the bladder cells undergo changes or mutations in their DNA. A cell's DNA directs it to function properly. When the DNA is mutated, the cells begin to multiply uncontrollably and accumulate, giving rise to the formation of a tumour. These abnormal cells can sometimes metastasize to distant organs or body parts.

There are different types of bladder cancers depending upon the type of bladder cells that become cancerous. They include:

• Urothelial carcinoma
  It was previously referred to as transitional cell carcinoma and originates from the cells lining the inside of the bladder.
• Squamous cell carcinoma
  It occurs due to chronic irritation of the bladder after an infection or long-term use of a urinary catheter.
• Adenocarcinoma
  It is a rare form of bladder cancer that begins in the cells that form part of the mucus-secreting glands in the bladder. Adenocarcinoma of the bladder is very rare.

• Smoking
  Smoking in any form increases the risk of developing bladder cancer. This is because they cause the accumulation of toxic chemicals in the urine. These toxic chemicals damage the lining of the bladder, increasing the risk of cancer.
• Increasing age
  Though bladder cancer can occur at any age, its risk increases as you age. Most people are diagnosed with this form of cancer after the age of 55.
• Gender
  Males are more susceptible to developing bladder cancer than women are.
• Exposure to certain chemicals
  Your kidneys filter toxic chemicals from the bloodstream and send them into the bladder. Therefore, being around certain chemicals like arsenic and those used in the manufacture of dyes, rubber, leather, and paint products may increase the risk of developing bladder cancer.
• History of cancer treatment
  Treatment of previous cancers with drugs such as cyclophosphamide increases the risk of developing bladder cancer. Additionally, patients with a history of radiation exposure as a part of the treatment plan for past cancers have a higher chance of developing bladder cancer.
• Chronic inflammation of the urinary bladder
  Chronic or recurrent infections or inflammations of the urinary bladder that might occur after long-term use of a urinary catheter may increase the risk of developing squamous cell cancer of the urinary bladder.
• Family history of bladder cancer
  Your risk of developing bladder cancer increases if someone in your family or a close blood relative suffers from the disease.
• Past personal history of bladder cancer
  If you had and recovered from bladder cancer in the past, your risk of developing it again increases.

• Don't smoke
  Smoking greatly increases the risk of developing many types of cancers, including bladder cancer. So, if you are a smoker, look for ways to quit the bad habit. If you are not, don't start smoking. If you are addicted to smoking, quitting might be hard for you. You can ask for help from your doctor about strategies to quit smoking or join support groups and talk to people who have successfully fought the addiction.
• Be careful around chemicals
  If your profession needs you to work with chemicals, follow all safety instructions while you are working.
• Eat a healthy diet
  Consume a well-balanced diet rich in a variety of fruits and vegetables. The antioxidants in fruits and vegetables are helpful to reduce the risk of developing cancers.

• Cystoscopy
  This test is used to visualise the inner structures of the bladder by inserting a camera through a small, narrow tube called a cystoscope.
• Biopsy
  It is done for people who have symptoms highly suspicious of malignancy. A small sample of the malignant tissue is removed and sent for histopathological examination. Sometimes, a biopsy is performed during cystoscopy by passing a special tube through the scope to collect the sample from the bladder.
• Urine cytology
  It involves analysing a sample of urine under a microscope to look for any cancerous cells.

Some other tests like computerised tomography (CT) urogram or retrograde pyelogram may be performed to examine the internal structures of your urinary tract and look for any abnormalities.

After establishing the diagnosis of bladder cancer, additional tests may be recommended to determine the extent of metastasis of cancer to the nearby lymph nodes or other body parts. These tests include CT scan, Magnetic resonance imaging (MRI), Positron emission tomography (PET), Bone scan, and Chest X-ray. Doctors use the information derived from these procedures to stage cancer. The stages of bladder cancer are denoted by Roman numerals ranging from 0 to IV. Stage 0 indicates an early, less aggressive cancer confined to the inner layers of the bladder, while stage IV indicates that the cancer is advanced and may have spread to other body parts.

• Low-grade bladder cancer
  It consists of cells similar in appearance and organisation as that of normal cells. Low-grade bladder tumours are less aggressive, grow more slowly, and are less likely to involve the muscular wall of the urinary bladder than a high-grade tumour.
• High-grade bladder cancer
  It consists of cells completely different from that of normal cells. High-grade bladder tumours are more aggressive and are more likely to invade the muscular wall of the bladder and other tissues and organs.

With an oncology team comprising the best doctors for Urinary Bladder Cancer in Navi Mumbai and state-of-the art infrastructure, Kokilaben Dhirubhai Ambani Hospital provides the best Bladder Cancer treatment in Navi Mumbai. The treatment plan for urinary bladder cancer depends on many factors, including the type, grade, stage, location and extent of spread of cancer. The patient's overall health and personal choices are also taken into account while deciding the treatment options. The treatment options for bladder cancer include:

• Surgery
  It is aimed at removing the cancer cells as much as possible.
• Chemotherapy
  An intravesical chemotherapy may be performed to treat bladder cancers confined to the lining of the bladder but have a high potential to recur or progress to a higher stage. Systemic chemotherapy or chemotherapy that is given to the whole body is not an option for bladder cancers.
• Radiation therapy
  This therapy uses high-powered rays of energy from sources like X-rays and protons to destroy cancer cells. The energy rays come from a machine that revolves around the body of the patient as he lies on a table. Radiation therapy is also used before the operation to shrink the tumour or destroy any remaining cancerous cells after surgery. It is often used together with chemotherapy or targeted therapy. For advanced, surgically non-resectable tumours, radiotherapy may be used to relieve side effects, like pain or bleeding, caused by growing cancer.
• Targeted drug therapy
  This treatment modality is focused on specific weaknesses present within cancer cells. By targeting these weaknesses, the cancer cells weaken and die. Targeted drugs are usually combined with chemotherapy to treat advanced or recurrent stomach cancers.
• Immunotherapy
  It is a drug treatment that stimulates the immune system to fight cancer cells more effectively. Sometimes the body's disease-fighting immune system might not attack the cancer cells because the cancer cells produce proteins that mask them from the immune system. Immunotherapy acts by interfering with that process. It is mostly reserved for advanced and metastatic bladder cancers.

Bladder cancers have a tendency to come back even after complete treatment. Because of this, patients with bladder cancer need post-treatment follow-ups for years. The tests one needs to get done depend on certain factors, including the type of bladder cancer and how it was treated.

In general, a test to examine the inside of the urethra and bladder called a cystoscopy is recommended to be done every four to six months for the first few years after treatment. After a few years of surveillance and careful follow-up, a cystoscopy exam may be needed only once a year. Other tests may be recommended at regular intervals. People who have had aggressive tumours need more frequent testing.