Bladder Cancer

Bladder cancer is characterized by the appearance of atypical cells that start to multiply out of control in the bladder. In the initial stage of the disease malign cells can be found only in the bladder. With the lack of proper treatment the cancer cells can multiply out of control and invade the muscular tissue. In the invasive stage the cancer gets to the lymph nodes and other organs in the surrounding area causing irregular function of kidneys and urinary tract. If the cancer is limited to the wall of the bladder, it is called superficial bladder cancer. Invasive bladder cancer develops from the transitional cells that can go beyond the superficial coat, invading the muscular tissue of the bladder or other organs and lymph nodes in the area. The bladder is responsible for storing and eliminating urine that forms in the kidneys. It is an organ in the lower abdomen shaped like a balloon with a muscular wall that can grow or shrink depending on the quantity of urine that it stores. One or more cancers can form at the same time in different parts of the bladder.

Symptoms and causes The causes of bladder cancer are not entirely known, but there are studies that have shown that a greater incidence appears in men than women and in smokers.

Risk factors :

• Smoking is the main risk factor, bladder cancer is three times more frequent in smokers than non-smokers.
• Age over 40 years old.
• Masculine sex, men develop this kind of cancer four times more frequently than women.
• Caucasian ethnicity: the occurrence of bladder cancer in Caucasian men is twice more frequent that in Hispanics or Afro-Americans. The Asian-Americans encounter a low risk of developing bladder cancer.
• A diet high in nitrates, meat and fat.
• Radiotherapy or chemotherapy for uterine or ovarian cancer.
• Medical history of bladder cancer in the family.
• Toxins in the work place.
• Chronic infections of the bladder (chronic cystitis).
• Infections caused by certain parasites such as Schistosomiasis.

• Hematuria (blood or blood clots in urine) shows up at 80-90% of the patients and usually it is not painful;
• Dysuria (discomfort during urination).
• Frequent urination.
• Frequent urinary tract infections. Symptoms that usually indicate a more advanced stage of cancer :
• Lumbar pain.
• Swelling of the legs.
• Presence of a pelvis tumor in the area of the bladder.
• Weight loss or anemia.
• Bone pain, rectal or anal pain, and general pain in the pelvis area.

• CAT scan or computerized axial tomography is a procedure that offers detailed images from all angles and from various areas of the body using an x-ray machine.
• NMR or nuclear magnetic resonance uses a computer with magnets and radio waves to generate a series of images of the surfaces from inside the body.
• IVP or intravenous pyelogram used to see any blockages in the urinary trac.
• Cystoscopy permits visualization inside the bladder and urethra.
• Biopsy is the method used to sample cells and tissue to be examined microscopically.

• The stage of the cancer, whether it is superficial or invasion, whether it spread to other parts of the body etc.
• The type of cells that the cancer develops from and their modifications (transitional cell carcinoma, squamous cell carcinoma, adenocarcinoma).
• Patient’s age and state of health.

1. Ileal conduit : A small urine bowl is created using a tiny segment of the small intestine. The end of the ileum is led out through the lower abdominal wall and the urine is drained into an external bag;
2. Neobladder : The "new” bladder is made out of a segment of intestine connected to the urethras on one side and to the urethras on the other, so it allows urine to drain down from the kidneys. With this procedure, the patient will have to train the new bladder to work properly.
3. Continent cutaneous reservoir : A pouch is created also from the small intestine letting the urine drain outside a body, but no stoma (drainage bag) is needed. It is connected to the abdominal wall and it can be drained every several hours with a catheter.