Batting the big bladder
Bladder cancer occurs when abnormal cells within the bladder start to grow and multiply uncontrollably.
BENGALURU: As medical research continues to evolve, our understanding of various diseases deepens, enabling us to provide better care and treatment to those affected. One such disease that demands our attention is bladder cancer, a condition that affects millions worldwide. Veteran actor Vinod Khanna succumbed to advanced bladder cancer and this gap could have been filled by awareness and understanding of this cancer.
Bladder cancer occurs when abnormal cells within the bladder start to grow and multiply uncontrollably. These cells can form tumours, which left untreated, might spread to surrounding tissues and other parts of the body. While the exact cause of bladder cancer is not always clear, certain risk factors have been identified that increase the likelihood of its development.
● Risk Factors
Smoking remains the most significant risk factor for bladder cancer. The harmful chemicals present in tobacco smoke can be absorbed into the bloodstream and eventually excreted through urine, exposing the bladder to these carcinogens. Additionally, exposure to certain industrial chemicals and pollutants, particularly those used in the dye, rubber, and leather industries, has been linked to an increased risk of bladder cancer. Individuals with a family history of the disease, or those who have previously undergone radiation therapy, also face a higher risk.
● Recognising Symptoms
Awareness of the common symptoms associated with bladder cancer can lead to earlier diagnosis and more effective treatment. Blood in the urine, often painless, is the most prominent indicator. This condition, known as hematuria, may come and go, making it crucial not to dismiss even intermittent occurrences. Other symptoms include frequent urination, painful urination, and lower back pain. However, these symptoms can often overlap with other urinary tract issues, underlining the importance of seeking medical attention if they persist.
● Diagnostic Approaches
Early detection is key to improving the prognosis for bladder cancer patients. Physicians use various diagnostic tools to confirm the presence of the disease. These include urine tests to identify abnormal cells, imaging studies like ultrasound and CT/MRI scans to visualise the bladder and surrounding areas. Cystoscopy is a procedure where a thin, flexible tube with a camera is inserted into the bladder to inspect it visually.
● Treatment Strategies
The treatment approach for bladder cancer largely depends on the stage and aggressiveness of the disease. There are three primary treatment modalities:
● Surgery: If the cancer is localised within the bladder lining, a procedure known as transurethral resection of bladder tumour (TURBT) may be performed. This involves removing the tumour through the urethra. In more advanced cases, partial or complete removal of the bladder (cystectomy) might be necessary.
● Chemotherapy: This treatment uses drugs to destroy cancer cells or stop their growth. Chemotherapy can be administered before surgery (neoadjuvant) to shrink tumours, after surgery (adjuvant) to kill remaining cancer cells, or as the primary treatment for advanced cases.
● Radiation Therapy: In some cases, radiation therapy is used to target and kill cancer cells. It can be used alone or in combination with surgery and chemotherapy.
● Targeted Therapy/ Immunotherapy: Immunotherapy has emerged as a promising avenue. Immune checkpoint inhibitors, for instance, help the body’s immune system recognise and attack cancer cells. These are especially useful in patients with poor renal functions. Newer targeted drugs are available for improved care. Genomic profiling helps us decide about such therapies.
● Prevention and Prognosis: While not all cases of bladder cancer can be prevented, adopting a healthy lifestyle can significantly reduce the risk. Avoiding tobacco products, staying hydrated, and maintaining a balanced diet rich in fruits and vegetables can contribute to lowering the chances of developing the disease. Regular medical check-ups and screenings are also essential for early detection.
Bladder cancer is a complex disease that requires a multi-faceted approach to diagnosis and treatment. Through increased awareness, understanding the risk factors, recognising symptoms, and staying informed about available treatment options, we can make great strides in the battle against this formidable adversary. As medical professionals, we remain dedicated to providing the best care possible to our patients and advancing our knowledge to ultimately conquer bladder cancer.
(The writer is senior director, medical oncology & hemato-oncology, Fortis Hospital, Richmond Road)