SYMPTOMS

The symptoms of urinary bladder cancer can include:

Blood in the urine (hematuria): This is the most common symptom. Your urine may look pink, red, or cola-colored, or the blood might not be visible but found during a urine test.

Frequent urination: Feeling the need to urinate more often than usual.

Pain or burning when urinating: Discomfort or a burning sensation during urination.

Urgency to urinate: Feeling a strong need to urinate, even if your bladder isn’t full.

Pelvic or lower back pain: Pain in the lower belly or back, especially if the cancer is more advanced.

Difficulty urinating: Struggling to start urination or feeling like your bladder isn’t emptying fully.

If you notice any of these symptoms, especially blood in your urine, it’s important to see a doctor. Early detection can make treatment more effective.

TYPES OF BLADDER CANCER

There are three main types of bladder cancer, depending on the kind of cells where the cancer starts:

Urothelial carcinoma (transitional cell carcinoma):

This is the most common type of bladder cancer.

It starts in the urothelial cells, which line the inside of the bladder.

These cells stretch and change shape as the bladder fills and empties.

Squamous cell carcinoma:

This type is less common and usually develops after long-term irritation or inflammation of the bladder, like from infections or the use of a urinary catheter.

It tends to grow more aggressively than urothelial carcinoma.

Adenocarcinoma:

This rare type of bladder cancer starts in the gland-like cells in the bladder.

It can happen after long-term bladder irritation or inflammation.

These types are diagnosed through medical tests, and the treatment may vary based on the type and how advanced the cancer is.

CAUSES AND RISK FACTORS OF URINARY BLADDER CANCERS

Causes of Urinary Bladder Cancer:

Bladder cancer happens when the cells in the bladder grow abnormally and form a tumor. The exact cause isn’t always clear, but it can start because of damage to the cells’ DNA. This damage can be caused by certain harmful substances or long-term irritation in the bladder.

Risk Factors for Urinary Bladder Cancer:

Some things increase the chance of getting bladder cancer, including:

Smoking:

Cigarettes, cigars, and pipes expose the bladder to harmful chemicals that can damage its lining.

Exposure to harmful chemicals:

Working with or being around chemicals used in industries like dye, rubber, leather, and paint can raise the risk.

Age:

Most people with bladder cancer are older than 55.

Gender:

Men are more likely to get bladder cancer than women.

Chronic bladder irritation:

Long-term irritation or infections, like from frequent urinary tract infections or bladder stones, can increase risk.

Family history of bladder cancer:

If a close family member has had bladder cancer, your risk may be higher.

Previous cancer treatments:

Some treatments for other cancers, like radiation to the pelvis or certain chemotherapy drugs, can raise the risk.

Unhealthy diet:

A diet low in fruits and vegetables might increase the risk.

If you have one or more of these risk factors, it doesn’t mean you’ll get bladder cancer, but it’s a good idea to talk to a doctor about how to stay healthy.

TREATMENT OF URINARY BLADDER CANCER

Treatment of Urinary Bladder Cancer

The treatment for bladder cancer depends on how advanced the cancer is, its type, and your overall health. Here are the main treatments:

Surgery:

Transurethral resection (TURBT): A procedure to remove cancer from the bladder using a small tool inserted through the urethra.

Cystectomy: Removal of part or all of the bladder if the cancer is more advanced.

If the bladder is removed, doctors may create a new way for urine to leave the body (called a urinary diversion).

Chemotherapy:

Uses strong medicines to kill cancer cells or stop them from growing.

Can be given directly into the bladder (intravesical therapy) for early-stage cancer or through the bloodstream for advanced cancer.

Immunotherapy:

Boosts the body’s immune system to help it fight the cancer.

For example, BCG therapy is a type of immunotherapy placed directly in the bladder.

Radiation Therapy:

Uses high-energy rays to destroy cancer cells.

Often used when surgery isn’t an option or to shrink the cancer before surgery.

Targeted Therapy:

Uses drugs to target specific weaknesses in cancer cells.

Lifestyle and follow-up care:

After treatment, regular check-ups are needed to make sure the cancer hasn’t come back.

A healthy diet, exercise, and quitting smoking can help improve recovery and lower the chance of recurrence.

Doctors may combine these treatments depending on what’s best for you. Early treatment works best, so seeing a doctor quickly is important if you notice symptoms.

PREVENTION OF BLADDER CANCER

Prevention of Urinary Bladder Cancer

While you can’t always prevent bladder cancer, you can lower your risk by making healthy choices:

Stop smoking:

Smoking is a major cause of bladder cancer. Quitting reduces your risk significantly.

Avoid harmful chemicals:

If you work with chemicals, like in factories or labs, always use proper protective equipment to reduce exposure.

Drink plenty of water:

Staying hydrated helps flush harmful substances out of your bladder.

Eat a healthy diet:

Include plenty of fruits and vegetables in your meals. They contain vitamins and antioxidants that protect your body.

Avoid unnecessary exposure to radiation:

Limit medical imaging tests, like X-rays or CT scans, to what’s necessary.

Treat bladder issues early:

If you have frequent urinary tract infections or bladder irritation, see a doctor to get proper treatment.

Making these lifestyle changes can help protect your bladder and reduce the chances of cancer.

NEWER ADVANCEMENTS/RESEARCHES

Recent advancements in urinary bladder cancer research have led to improved diagnostic methods and treatment options, offering hope for better patient outcomes.

Immunotherapy and Targeted Therapies:

Immune Checkpoint Inhibitors: Drugs like avelumab (Bavencio) have been approved for treating advanced bladder cancer, enhancing the body’s immune response to target cancer cells.

Antibody-Drug Conjugates (ADCs): These “guided missile” therapies deliver chemotherapy directly to cancer cells, minimizing damage to healthy cells. For instance, sacituzumab govitecan (Trodelvy) has shown promise in treating advanced bladder cancer.

Gene Therapy:

Nadofaragene Firadenovec (Adstiladrin): This gene therapy introduces a virus carrying a gene into bladder cells, prompting them to produce a protein that stimulates an immune response against cancer cells. It’s approved for non-muscle-invasive bladder cancer that hasn’t responded to standard treatments.

Artificial Intelligence (AI) in Diagnosis:

AI-Powered Imaging: AI models are being developed to assist in diagnosing and grading bladder cancer from imaging studies, potentially leading to earlier and more accurate detection.

Personalized Medicine:

Molecular Profiling: Understanding the genetic makeup of a patient’s tumor allows for tailored treatments. For example, targeting specific mutations like FGFR alterations with drugs such as erdafitinib (Balversa) has been effective in certain cases.

Combination Therapies:

Chemotherapy and Immunotherapy: Combining traditional chemotherapy with immunotherapy agents has improved survival rates in advanced bladder cancer patients.

These advancements are transforming bladder cancer care, leading to more effective and personalized treatment strategies.