Bladder Cancer

I’ve been told that I have bladder cancer. What is it exactly?  

The bladder is a hollow, muscular organ located in the lower abdomen that stores urine. Bladder cancer usually begins in the urothelial cells that line the inside of the bladder. Those same cells are also found in the kidneys, ureters (tubes that connect the kidneys with the bladder), and urethra. Bladder cancer affects about 500 people in Ireland each year. 

What are the risks factors for bladder cancer? 

Several factors can increase the risk of developing bladder cancer, including:  

  • Age: your risk of developing cancer increases as you age. Most people diagnosed with bladder cancer are above the age of 55. 
  • Gender: men are more likely to develop bladder cancer than women.
  • Smoking: chemicals from cigarettes are processed by the body and excreted in urine, potentially damaging the lining of the bladder and increasing cancer risk.  
  • Previous cancer treatment: certain chemotherapy drugs (such as cyclophosphamide) and pelvic radiotherapy can raise the risk of bladder cancer.  
  • Chronic bladder inflammation: long-term bladder irritation from infections or catheter use may increase the risk of squamous cell carcinoma.  
  • Family history of cancer: although bladder cancer rarely runs in families, a family history can slightly raise the risk. Inherited conditions such as Lynch syndrome (hereditary nonpolyposis colorectal cancer) may also increase the likelihood of urinary system cancers.  

What are the different types of bladder cancer? 

Bladder cancer is classified based on where the cancer develops within the urinary system. The main types include:  

  • Urothelial carcinoma: the most common type of bladder cancer, which develops in the urothelial cells that line the inside of the bladder. These same cells are also present in the kidneys, ureters, and urethra, and cancer can develop in those organs as well.
  • Squamous cell carcinoma: a rare type of bladder cancer associated with chronic bladder irritation, which may result from infections or long-term use of a urinary catheter.  
  • Adenocarcinoma: another rare type of bladder cancer that develops in the mucus-secreting gland cells of the bladder.  

What are the symptoms of bladder cancer? 

The symptoms of bladder cancer may include: 

  • Blood in urine 
  • Frequent urination
  • Painful urination 
  • Difficulty urinating
  • Frequent bladder infections
  • Back pain 

How is bladder cancer diagnosed? 

If you experience any of the above symptoms, consult your GP. They may perform a urine test to check for infections. If bladder cancer is suspected, you will be referred to a specialist for further testing, which may include:  

  • Urine test: might be able to detect abnormalities, leading to further investigations. 
  • Blood test: checks kidney function and blood counts.  
  • Scan: ultrasound or CT scans help examine the bladder, kidneys, and ureters for potential growths.  
  • Flexible cystoscopy: can provide a visual of the bladder and tumour using a scope with a camera. This can be done under local anaesthetic. 

Transurethral resection of the bladder tumour (TURBT)

Transurethral resection of the bladder tumour (TURBT) is a surgical procedure with both a diagnostic and therapeutic purpose. It is typically done under general anaesthetic where the tumour is excised by the surgeon and sent to the histology lab for examination. This will confirm if the tumour is benign or malignant.

What are the treatment options for bladder cancer? 

The treatment for bladder cancer depends on its size, stage, type, whether it has spread, and your overall health. Treatment options may include:  

  • Surgery: surgery may include removing the tumours or, in the event that the cancer has spread, the whole bladder and then constructing a new way to pass urine.
  • Radiotherapy: this type of treatment uses high energy X-ray to target and destroy cancer cells. 
  • Chemotherapy: uses anti-cancer (cytotoxic) drugs to stop or slow down the growth of cancer cells. 

The above content was reviewed by Paula Jubinal and Arlyn Balopinos, Clinical Nurse Managers 2 in the Urology Clinic at Mater Private Network in Dublin.