Bladder cancer: tobacco does not only affect the lungs

Bladder cancer originates when cells in the urinary bladder (a hollow organ in the pelvis with flexible muscular walls) begin to grow uncontrollably. As more cancer cells develop, they can form a tumor and spread to other areas of the body.

The bladder's primary function is to store urine before it exits the body. Urine is produced by the kidneys and transported to the bladder through tubes called ureters. During urination, the bladder muscles contract, and urine exits the bladder through a tube called the urethra.

The bladder wall consists of several layers made up of different types of cells.

Most bladder cancers begin in the innermost lining of the bladder, called the urothelium or transitional epithelium. As bladder cancer grows into or through the other layers of the bladder wall, it becomes more advanced and can be more challenging to treat.

Over time, bladder cancer can grow beyond the bladder into nearby structures. It can also spread to nearby lymph nodes or other parts of the body.

The most common type of bladder cancer is:

• Urothelial carcinoma (also known as transitional cell carcinoma): this type of cancer begins in the urothelial cells lining the inside of the bladder

Other, less common types of bladder cancer include:

• Squamous cell carcinoma: a type of cancer that is highly invasive
• Adenocarcinoma: a type of cancer where the cells share many characteristics with gland-forming cells found in colon cancer. Almost all bladder adenocarcinomas are invasive
• Small cell carcinoma: a type of cancer that begins in nerve-like cells called neuroendocrine cells. These cancers often grow rapidly and typically require chemotherapy similar to that used for small cell lung cancer
• Sarcoma: a rare type of bladder cancer that begins in the bladder's muscle cells

Several risk factors increase the likelihood of developing bladder cancer. Some can be controlled through a healthy lifestyle, while others, such as sex or age, cannot. Risk factors for bladder cancer may include:

• Smoking
• Occupational exposures
• Certain medications or herbal supplements
• Arsenic in drinking water
• Insufficient fluid intake
• Age
• Sex
• Chronic bladder irritation and infections
• Personal history of bladder or other urothelial cancers
• Birth defects involving the bladder
• Genetics and family history
• Prior chemotherapy or radiation therapy

• Blood in the urine
• Changes in bladder habits or symptoms of irritation
• Needing to urinate more frequently than usual
• Pain or burning during urination
• Feeling the urge to urinate even when the bladder is not full
• Difficulty urinating or having a weak urine stream
• Inability to urinate
• Pain on one side of the lower back
• Loss of appetite and weight loss
• Feeling tired or weak
• Swelling in the feet
• Bone pain

Survival rates for bladder cancer are directly related to the stage at which the cancer is classified, with a progressive decrease in survival likelihood as the tumor advances. The 5-year relative survival rate for individuals with stage I bladder cancer is approximately 88%, around 63% for stage II, and about 50% for stage III.

Bladder cancer that has spread to other parts of the body is often challenging to treat. Stage IV bladder cancer has a 5-year relative survival rate of approximately 15%. However, treatment options are often available for people with this stage of cancer.

IMPORTANT: EARLY DIAGNOSIS OF CANCER IS CRUCIAL SINCE A CANCER DIAGNOSED AT AN EARLY STAGE — BEFORE IT HAS GROWN SIGNIFICANTLY OR SPREAD TO OTHER PARTS OF THE BODY — HAS A HIGHER CHANCE OF SUCCESSFUL TREATMENT. IN CONTRAST, IF THE CANCER HAS SPREAD TO OTHER ORGANS, ITS TREATMENT BECOMES MORE CHALLENGING, AND SURVIVAL PROBABILITY IS MUCH LOWER.

To diagnose bladder cancer, several techniques have been developed, including cystoscopy imaging, biopsy analysis, urine cytology, and imaging tests such as computed tomography (CT). However, some of these methods can be stressful or even harmful to the patient, highlighting the need for the development of new diagnostic approaches.