HYDERABAD: Bladder cancer stands out among the many diseases that commonly afflict older individuals. In India, it ranks as the ninth most prevalent cancer, with approximately 35% of cases already metastatic or advanced by the time patients seek medical attention. As awareness sharpens, shedding light on prevention and diagnosis becomes paramount. This Bladder Cancer Awareness Month, CE engages with city-based doctors to dissect the nuances of bladder cancer, debunking myths and highlighting facts.
Decoding the what and why of bladder cancer, Dr Satish Pawar, Sr Consultant & Head of Surgical Oncology at CARE Hospitals, explained, “Bladder cancer is a common type of cancer that begins in the cells of the bladder. The cells that line the bladder, known as urothelial cells, are where bladder cancer typically starts. The kidneys and the tubes (ureters) that join your kidneys to your bladder also contain urothelial cells. Although it is far more common in the bladder, ureteric and kidney cancers can also occur from urothelial carcinoma.”
The root cause of bladder cancer is the development of DNA alterations (mutations) in bladder cells, which is the first step toward bladder cancer. The instructions that inform a cell what to do are encoded in its DNA. The alterations instruct the cell to divide quickly and to continue existing while other healthy cells would have died. A tumour created by the abnormal cells has the ability to penetrate and kill healthy body tissue. The abnormal cells may eventually separate and travel throughout the body, a process known as metastasis.
Dr Satish Pawar said that men are more likely to develop bladder cancer than women, especially after 55. Other factors that increase the risk of developing bladder cancer include smoking cigarettes, which may increase the risk of bladder cancer by causing harmful chemicals to accumulate in the urine. These harmful chemicals may damage the lining of your bladder, which can increase your risk of cancer. Increasing age, exposure to certain chemicals including arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles, and paint products, previous cancer treatment, chronic bladder inflammation, and personal or family history of cancer are a few other risk factors.
Bladder cancer signs and symptoms may include blood in the urine (hematuria), which may cause urine to appear bright red or cola-colored, though sometimes the urine appears normal and blood is detected in a lab test, frequent urination, painful urination, and back pain.
Diagnosis includes cystoscopy, biopsy, urine cytology, CT scan, magnetic resonance imaging (MRI), positron emission tomography (PET), bone scan, and chest X-ray. Treatment options for bladder cancer depend on several factors, including the type of cancer, grade of the cancer, and stage of the cancer, which are taken into consideration along with your overall health and your treatment preferences. Bladder cancer treatment also includes surgery to remove the cancer cells, chemotherapy, radiation therapy, immunotherapy, and targeted therapy.
Although there’s no guaranteed way to prevent bladder cancer, you can take steps to help reduce your risk. For instance, don’t smoke. Take caution around chemicals. If you work with chemicals, follow all safety instructions to avoid exposure. Choose a variety of fruits and vegetables. A diet rich in colourful fruits and vegetables, containing antioxidants, may help reduce your risk of cancer.
Myths & facts
Myth 1: Only men are susceptible to bladder cancer
Fact: While more prevalent in men, women are also at risk. Neglecting symptoms due to this misconception can delay diagnosis and exacerbate cancer progression.
Myth 2: Bladder cancer is easily conquerable
Fact: Patients endure pain, surgeries, and psychological distress. Dismissing their struggles belittles their ordeal.
Myth 3: Bladder cancer solely stems from smoking
Fact: Although smoking elevates risk, nonsmokers can also develop bladder cancer. Blaming victims fosters stigma.
Myth 4: Bladder removal is the sole effective treatment
Fact: Diverse treatment avenues exist, including bladder-preserving techniques and immunotherapy, heralding improved outcomes.
Myth 5: Living with a urinary diversion impairs quality of life
Fact: Various urinary diversion options offer fulfilling lives post-surgery, with advancements enhancing quality of life.
Myth 6: Bladder cancer and its treatment are always apparent
Fact: Symptoms may be subtle, and treatment effects often invisible, underscoring the need for empathy and understanding.
- Dr Palanki Satya Dattatreya, Director & Chief of Medical Oncology Services, Renova Soumya Cancer Centre