Overview
The normal bladder
Your bladder is a hollow pelvic organ with flexible, muscular walls that stores urine. The average adult bladder holds about 2 cups of urine. Urine is made by the kidneys and is then carried to the bladder through tubes called ureters. The urine leaves the bladder through another tube called the urethra. In women, the urethra is a very short tube that ends just in front of the vagina. In men, the urethra is longer. It passes through the prostate gland and the penis, and ends at the tip of the penis.
The wall of the bladder has several layers. A layer of cells lines the inside of the kidney, ureter, bladder, and urethra. These cells are called urothelial or transitional cells, and so this layer is called the urothelium or transitional epithelium. Beneath the urothelium, there is a thin layer of connective tissue called the lamina propria. Next, there is a layer of muscle tissue called the muscularis propria. Beyond this muscle, another zone of fatty connective tissue separates the bladder from other nearby organs. These layers are very important in understanding bladder cancer. As the cancer penetrates or grows through these layers into the wall of the bladder, it becomes harder to treat.
Bladder tumors are grouped into several types by how their cells look under a microscope. The type of bladder cancer you have can affect your treatment options. This is because different types can respond differently to treatments such as radiation and chemotherapy.
The main types of cancers that affect the bladder are: -
- transitional cell carcinoma (also called urothelial carcinoma)
- squamous cell carcinoma
- adenocarcinoma
- small cell
We do know that the following factors increase a person's risk of developing a bladder cancer: -
- Smoking: - Smoking is the single greatest risk factor for bladder cancer. Smokers have more than twice the risk of developing bladder cancer as nonsmokers.
- Chemical exposures at work: - People who regularly work with certain chemicals or in certain industries have a greater risk of bladder cancer than the general population. Organic chemicals called aromatic amines are particularly linked with bladder cancer. These chemicals are used in the dye industry. Other industries linked to bladder cancer include rubber and leather processing, textiles, hair coloring, paints, and printing. Strict workplace protections can prevent much of the exposure that is believed to cause cancer.
- Diet: People whose diets include large amounts of fried meats and animal fats are thought to be at higher risk of bladder cancer.
- Aristolochia fangchi: - This herb is used in some dietary supplements and Chinese herbal remedies. People who took this herb as part of a weight loss program had higher rates of bladder cancer and kidney failure than the general population. Scientific studies on this herb have shown that it contains chemicals that can cause cancer in rats.
- Age: - Seniors are at the highest risk of developing bladder cancer.
- Sex: - Men are three times more likely than women to have bladder cancer.
- Race: - Whites have a much higher risk of developing bladder cancer than other races.
- History of bladder cancer: - If you have had bladder cancer in the past, your risk of developing another bladder cancer is higher than if you had never had bladder cancer.
- Chronic bladder inflammation: - Frequent bladder infections, bladder stones, and other urinary tract problems that irritate the bladder increase the risk of developing a cancer, more commonly squamous cell carcinoma.
- Birth defects: - Some people are born with a visible or invisible defect that connects their bladder with another organ in the abdomen or leaves the bladder exposed to continual infection. This increases the bladder's vulnerability to cellular abnormalities that can lead to cancer.
common symptoms
The most common symptoms of bladder cancer include the following: -- Blood in the urine (hematuria)
- Pain or burning during urination without evidence of urinary tract infection
- Change in bladder habits, such as having to urinate more often or feeling the strong urge to urinate without producing much urine
- Having these symptoms does not necessarily mean you have bladder cancer.
- If you have any of these symptoms, you should see your health-care provider right away. People who can see blood in their urine, especially older males who smoke, are considered to have a high likelihood of bladder cancer until proven otherwise.
Blood in the urine is usually the first warning sign of bladder cancer.
- Unfortunately, the blood is often invisible to the eye. This is called microscopic hematuria, and it is detectable with a simple urine test.
- In some cases, enough blood is in the urine to noticeably change the urine color. The urine may have a slightly pink or orange hue, or it may be bright red with or without clots.
- If your urine changes color, you need to see your health-care provider.
Bladder Cancer Treatment
Although medical treatments are fairly standardized, different doctors have different philosophies and practices in caring for their patients.- You may want to talk to more than one urologist to find the one with whom you feel most comfortable. Clinical experience in treating bladder cancer is of the utmost importance.
- Talk to family members, friends, and your health-care provider to get referrals. Many communities, medical societies, and cancer centers offer telephone or Internet referral services.
After you have chosen a urologist to treat your cancer, you will have ample opportunity to ask questions and discuss the treatments available to you.
- Your doctor will describe each type of treatment, give you the pros and cons, and make recommendations based on published treatment guidelines and his or her own experience.
- Treatment for bladder cancer depends on the type of cancer and its stage. Factors such as your age, your overall health, and whether you have already been treated for the cancer before are included in the treatment decision-making process.
- The decision of which treatment to pursue is made with your doctor (with input from other members of your care team) and your family members, but the decision is ultimately yours.
- Be certain you understand exactly what will be done and why, and what you can expect from your choices. With bladder cancer, understanding the side effects of treatment is especially important.
Like all cancers, bladder cancer is most likely to be cured if it is diagnosed early and treated promptly.
- The most widely used therapies are surgery, radiation therapy, and chemotherapy, either alone or in combination.
- Immunotherapy or biological therapy, which takes advantage of the body's innate cancer-fighting ability, is used in some cases, especially for patients with stages Ta, T1, and CIS.
- Your treatment plan will be individualized for your specific situation. Your treatment team will also include one or more nurses, a dietitian, a social worker, and other professionals as needed.
Bladder Cancer: Eating Well to Feel Better
Try these ideas to make sure you get the nutrients you need: -
- Stay positive. Most appetite-related symptoms go away over time.
- Go small. Try eating small meals more often, rather than a few large ones during the day.
- Up the protein and calories. Keep high-protein, high-calorie snacks nearby so you can have one when you feel up to it.
- Soup for you. Try soups, shakes, or smoothies instead of solid food; they go down easier.
- Be gentle on yourself. If nausea is a problem, eat foods that are easy on your stomach. These include toast, crackers, noodles, baked or broiled skinned chicken, soft and bland fruits and vegetables, clear liquids, ice chips, and carbonated drinks.
How Diet May Help Reduce Bladder Cancer Recurrence ?
Maintaining a good diet during cancer therapy can help you heal properly and keep your weight and energy levels up. A healthy diet will also support your body's immune function so you can fight off infection. After cancer therapy, a good nutrition plan will also help keep you healthy and reduce the risk of recurrence.
The American Institute for Cancer Research (AICR) has several recommendations for cancer prevention that also apply to patients recovering from cancer treatment: -
- Maintain a healthy body weight.
- Plan for at least 30 minutes of physical activity every day.
- Avoid sugary drinks and foods, especially processed foods high in added sugar, low in fiber, or high in fat.
- Eat lots of vegetables, fruits, whole grains, and legumes, like beans.
- Limit the amount of red meat in your diet, like beef and lamb, and avoid processed meats.
- Limit alcoholic drinks to two for men and one for women each day.
- Limit the amount of salt in your diet.
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