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Bladder Cancer



Introduction
Bladder cancer is a form of cancer affecting the internal lining of the bladder. Bladder cancer can be superficial or invasive.
What is going on in the body?
Cancer occurs when a cell undergoes changes that cause it to grow and multiply uncontrollably. Eventually a tumor will form. More than one tumor in the bladder may develop at the same time. If not treated, a tumor will grow through the bladder wall. It may then spread to structures around the bladder. Cells from the tumor can also enter the bloodstream and spread to distant parts of the body, a process known as metastasis.
What are the causes and risks of the disease?
Use of tobacco products, smoking in particular, may lead to bladder cancer. The cancer-causing chemicals are absorbed in the lungs and then excreted into the urine. The lining of the bladder is exposed to concentrated amounts of these poisons for long periods. Other chemicals, such as aniline dyes, are known to cause similar damage.
The following occupations are associated with an increased risk of bladder cancer:

  • bootblacks
  • chemical or petroleum workers
  • drill press operators
  • dye workers
  • hairdressers
  • leather workers
  • painters
  • textile workers
  • tire and rubber workers
  • truck drivers
    • Other known risk factors for bladder cancer include the following:

  • alcohol abuse
  • certain types of chronic bladder infections
  • family history of bladder cancer
    • Suspected risk factors include:

  • artificial sweeteners
  • caffeine
  • frequent urinary tract infections
  • high dietary cholesterol
  • highly chlorinated drinking water
  • pain medicines containing phenacetin
  • water contaminated with pesticides 

    • What are the signs and symptoms of the disease?
    Blood in the urine is often the only sign of bladder cancer. Sometimes the blood is not visible. It can only be detected when a urine sample is tested. Some people will have symptoms similar to a urinary tract infection, such as painful urination and an urgent need to urinate frequently. If the cancer has metastasized, then the symptoms will be related to the area affected

    How is the disease diagnosed?
    Often a person who notices blood in the urine will see a healthcare provider. Diagnosis begins with a medical history and physical exam. A urine sample will be checked for cancer cells. An X-ray of the bladder, called intravenous urogram or IVU, is routinely part of the diagnostic work-up. The provider may also do a cystoscopy, looking at the inside of the bladder with a thin, lighted tube.
    If a tumor is seen, the provider will do a biopsy to take a piece of it for examination. If the cancer is confirmed, more surgery may be necessary to investigate how deep the cancer has grown into the bladder wall. Other studies such as CT scans may be done to determine the extent of the problem. This is known as staging. 

    What can be done to prevent the disease?
    Avoiding exposure to tobacco products will help prevent this and other cancers. When working with chemicals at work or at home, a person should take precautions to avoid contamination.
    What are the long-term effects of the disease?
    Five-year survival rates for early bladder cancer are as high as 90%. Early detection saves lives. Bladder cancer is fatal if not successfully treated.
    What are the risks to others?
    Bladder cancer is not contagious and poses no risk to others.



    Reference
    Redman, B.G; Kawachi, M.; & Schwartz, D.(1996). Urothelial and kidney cancers in Cancer Management: A Multidisciplinary Approach. PRR: Huntington, NY. Pp.417-431.
    Christine Miaskowski, Patricia Buchsel, 1999 Oncology Nursing: Assessment and Clinical Care. Mosby pg. 1031-1083

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