The urinary bladder is an organ that stores urine formed by the kidney. It is located in the centre of the lower abdomen. Abnormal growth of the cells lining in the bladder causes bladder cancer.

The initial growth is seen in the inner lining of the bladder, called as transitional cell carcinoma. When these cells multiply they form a ball of cells, also referred to as tumor. Tumors take up space, oxygen and nutrition of the surrounding organs. When these tumors invade and spread to the surrounding organs they are called cancerous. Bladder cancers are seen to spread to the surrounding organs, lymph nodes and then moves through the blood stream to organs like the lungs, liver, bones and so onCauses:Smoking: Cigarette smoking and tobacco is the main cause of bladder cancer. A 10 year study showed that the urinary bladder came in direct contact with the carcinogens that were excreted in the urine.Exposure to Chemicals: Aromatic amines are organic chemicals that are associated with bladder cancers. Other occupational threats are: rubber, leather, textile, hair coloring, and printing industries. Extensive use of the hair dryer is also linked to bladder cancer.Diet: People who consume fried meat, animal fats, and charcoal cooked food are at a larger risk of bladder cancer.

Aristolochia fangchi: Commonly used in dietary supplements and Chinese medicines. Studies have shown that this herb causes cancer in rats. People using this herb are at higher risk of bladder cancer.

Risk factors of bladder cancer:

Age: Elders have the highest risk of developing bladder cancer.

Gender: Men are more likely to have bladder cancer than women

History of bladder cancer: Bladder cancer has shown to repeat itself. If you have had bladder cancer in the past, it may return again.

Inflammation of the bladder: If your bladder has been a victim to infections, bladder stones and other urinary tract issues, you are at a risk of developing bladder cancer.

Defects at birth: Some people are born with abnormal bladders; due to this the bladder may be exposed to infection. These continuous infections can cause cancer.

Bladder cancer symptoms:
Some of the common symptoms of bladder cancer are:

• Blood in urine
• Burning sensation or pain during urination
• Frequent urination
• Change in urine color
• Urinary urgency
• Weight loss
• Fatigue
• Abdominal pain and Bone tenderness

Diagnosis of Bladder Cancer:

Patients with signs and symptoms of bladder cancer must seek medical attention. Cystoscopy, a procedure involving flexible tube, camera and a monitor is used to detect tumors. The camera attached to the tube is inserted into the bladder through the urethra.

Biopsies are sent for pathological investigations.

Some of the other tests done are:

• Abdominal CT scan
• Bladder biopsy
• Intravenous pyelogram
• Pelvic CT scan
• Urinalysis
• Urine cytology

If the cancer is confirmed, further tests are done to check for the stage of the cancer and it spreading. This is called as staging.

Stages of cancer

• Stage CIS
• Stage Ta
• Stage T1
• Stage T2
• Stage T3
• Stage T4
• Stage T1-4N1-2M1-2

Bladder cancer treatment

The treatment for bladder cancer depends upon the type of cancer and its stage. Risk factors also play an important role in deciding the appropriate form of treatment.

Some of the treatments used in the treatment of bladder cancer are as follows:

Surgery: Removal of the tumor, parts of the bladder or the entire bladder depends on the stage of the cancer.

Chemotherapy: Stage II and Stage III patients are given chemotherapy. This prevents the tumor from returning.

Immunotherapy: This treatment uses medication that triggers the immune system to kill the cancer cells. Bacille Calmette-Guerin (BCG) vaccine is commonly used in immunotherapy.

Photodynamic therapy: This therapy is still under study. It is the use of lasers to break/destroy tumors.

Follow up visits details the progression of the therapy and helps in the recovery of the patient

Prognosis
Bladder cancer patients are closely monitored by their doctor. Some of the after treatment tests include :

• Bone scans and CT scans
• Monitoring symptoms
• Complete Blood Count
• Bladder pressure exam
• Urinalysis

ACTOS and bladder cancer
ACTOS is a drug used in the treatment of Type II diabetes. A Study in France has found a connection between ACTOS and bladder cancer. Patients using ACTOS were found to be at a risk of bladder cancer and the drug has been banned in many places.