Bladder Cancer

Each year, nearly 55,000 people in the United States learn that they have bladder cancer. Acupuncture and Herbal Treatment Centre in KL insist to help patients with bladder cancer and their families and friends better understand this disease.

This booklet discusses symptoms, diagnosis, treatment, and rehabilitation. It also has information to help patients cope with bladder cancer.

The Bladder

The bladder is a hollow organ in the lower abdomen. It stores urine, the waste that is produced when the kidneys filter the blood. The bladder has a muscular wall that allows it to get larger and smaller as urine is stored or emptied. The wall of the bladder is lined with several layers of transitional cells.

Urine passes from the two kidneys into the bladder through two tubes called ureters. Urine leaves the bladder through another tube, the urethra.

What Is Cancer?

Cancer is a group of many different diseases that have some important things in common. They all affect cells, the body's basic unit of life. To understand different types of cancer, such as bladder cancer, it is helpful to know about normal cells and what happens when they become cancerous.

The body is made up of many types of cells. Normally, cells grow and divide to produce more cells only when the body needs them. This orderly process helps keep the body healthy. Sometimes cells keep dividing when new cells are not needed. These cells form a mass of extra tissue, called a growth or tumor. Tumors can be benign or malignant.

Benign tumors are not cancer. They often can be removed and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body. Most important, benign tumors are rarely a threat to life.

Malignant tumors are cancer. Cells in malignant tumors are abnormal and divide without control or order. These cancer cells can invade and destroy the tissues around them. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or the lymphatic system. This process is the way cancer spreads from the original (primary) tumor to form new tumors in other parts of the body. The spread of cancer is called metastasis.

Most cancers are named for the part of the body or type of cells in which they begin. About 90 percent of bladder cancers are transitional cell carcinomas, cancers that begin in the cells lining the bladder. Cancer that is confined to the lining of the bladder is called superficial bladder cancer. After treatment, superficial bladder cancer can recur; if this happens, most often it recurs as another superficial cancer.

In some cases, cancer that begins in the transitional cells spreads through the lining of the bladder and invades the muscular wall of the bladder. This is known as invasive bladder cancer. Invasive cancer may grow through the bladder wall and spread to nearby organs.

Bladder cancer cells may also be found in the lymph nodes surrounding the bladder. If the cancer has reached these nodes, it may mean that cancer cells have spread to other lymph nodes and to distant organs, such as the lungs. The cancer cells in the new tumor are still bladder cancer cells. The new tumor is called metastatic bladder cancer rather than lung cancer because it has the same kind of abnormal cells that were found in the bladder.

Symptoms:

Painless blood in the urine (hematuria) is the most common symptom. It eventually occurs in nearly all cases of bladder cancer. In the majority of cases, the blood is visible during urination. In some cases, it is invisible except under a microscope, and is usually discovered when analyzing a urine sample as part of a routine examination. 

Hematuria does not by itself confirm the presence of bladder cancer. Blood in the urine has many possible causes. For example, it may result from a urinary tract infection or kidney stones rather than from cancer. It is important to note that hematuria, particularly microscopic, might be entirely normal for some individuals. A diagnostic investigation is necessary to determine whether bladder cancer is present.

Other symptoms of bladder cancer may include frequent urination and pain upon urination (dysuria).

Diagnosis and Staging:

To find the cause of symptoms, the doctor asks about the patient's medical history and does a physical exam. The physical will include a rectal or vaginal exam that allows the doctor to check for tumors that can be felt. In addition, urine samples are sent to the laboratory for testing to check for blood and cancer cells.

The doctor may use an instrument to look directly into the bladder, a procedure called cystoscopy. This procedure may be done with local or general anesthesia. The doctor inserts a thin, lighted tube (called a cystoscope) into the bladder through the urethra to examine the lining of the bladder. The doctor can remove samples of tissues through this tube. The sample is then examined under a microscope by a pathologist. The removal of tissue to look for cancer cells is called a biopsy. In many cases, performing a biopsy is the only sure way to tell whether cancer is present. If the entire cancer is removed during the biopsy, bladder cancer can be diagnosed and treated in a single procedure. A patient who needs a biopsy may want to ask the doctor some of the following questions:

1. Why do I need to have a biopsy?

2.  How long will it take? Will I be awake? Will it hurt?

3.  What side effects can I expect?

4.  How soon will I know the results?

5.  If I do have cancer, who will talk with me about treatment?

6. When?

Once bladder cancer is diagnosed, the doctor will want to learn the grade of the cancer and the stage, or extent, of the disease. Grade is important because it tells how closely the cancer resembles normal tissue and suggests how fast the cancer is likely to grow. Low-grade cancers more closely resemble normal tissue and are likely to grow and spread more slowly than high-grade cancers.

Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The stage of bladder cancer may be determined at the time of diagnosis, or it may be necessary to perform additional tests. Such tests may include imaging tests--CT scan, MRI, sonogram, IVP, bone scan, or chest x-ray.

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