What does your bladder do?
The bladder is part of your urinary system. An important job of the urinary system is to filter waste products from your blood and then, once produced, transport the waste products or out of your body. The diagram below shows the organs of the urinary system. Most of the urinary tract is lined with a special layer of cells called .The primary “machines” in the human filtering system are the two located close to the backbone and protected by the ribs. The , working independently, have the significant task of filtering approximately 20% of total blood volume each minute and removing the by-products of digestion and of other body functions. Once produced, the (the filtered waste product) is stored in the central part of the kidney called the renal . At regular intervals, the renal contracts and propels the through the ureters, narrow, thin-walled tubes that extend from inside the renal to the bladder.The bladder is a thick-walled structure, consisting of a relatively thin inner layer with a thick muscle covering. This inner layer or epithelium consists of several layers of cells. The epithelial layer is also called the transitional cell layer. The main function of the bladder is to store . For most people, the bladder can hold as much as 1 pint (16 ounces) of at a time and contracts or expands depending on how much fluid is in it. When the bladder contracts following a series of neurological “messages” to the brain and spinal cord, the moves through the outside the body.
What is ?
occurs when cells in the bladder start to grow out of control. Most bladder cancers develop on the inner layer of the bladder. Some can grow into the deeper bladder layers. As cancer grows through these layers into the wall of the bladder, it becomes harder to treat. The lining of the bladder, where tumors initiate, is also found in the inner layers of the , ureters and . So, similar cancers can occur in these areas, though much less frequently.
What are the different types of ?
The vast majority (~90%) of patients diagnosed with have urothelial carcinoma, also referred to as transitional cell cancer. Another 10% of patients have other types including , , or small cell cancer.
- Smoking: Smoking is the greatest . Smokers get twice as often as people who don’t smoke.
- Chemical Exposure: Some chemicals used in the making of dye have been linked to . People who work with chemicals called aromatic amines may have higher risk. These chemicals are used in making rubber, leather, printing materials, textiles and paint products.
- Race: Caucasians are twice as likely to develop as are African Americans or Hispanics. Asians have the lowest rate of .
- Age: The risk of increases as you get older.
- Gender: While men get more often than women, recent statistics show an increase in the number of women being diagnosed with the disease. Unfortunately, because the symptoms of are similar to those of other gynecologic and urinary diseases affecting women, women may be diagnosed when their disease is at a more advanced .
- Chronic bladder inflammation: Urinary infections, kidney stones and bladder stones don’t cause , but they have been linked to it.
- Personal history of : People who have had have a higher chance of getting another in their urinary system. People whose family members have had may also have a higher risk.
- Birth defects of the bladder: Very rarely, a connection between the belly button and the bladder doesn’t disappear as it should before birth and can become cancerous.
- : in drinking water has been linked to a higher risk of .
- Earlier Treatment: Some drugs (in particular Cytoxan/cyclophosphamide) or radiation used to treat other cancers can increase the risk of .
- Some drugs (in particular Cytoxan/cyclophosphamide) or radiation used to treat other cancers can increase the risk of .”
What are the signs and symptoms of
The most common clinical sign of is painless gross , blood in the that can easily be seen. Two features that tend to mask the severity of the gross and may influence patients to postpone seeking immediate medical care are 1) the bleeding may be occasional and short-lived; and 2) there is likely to be no pain associated with the bleeding. In addition, it may be that the tumors do not produce enough blood for a patient to see (microscopic ) and are only detected with the help of special chemicals and/or a microscope after a test is done by a physician.
However, blood in thedoes not necessarily mean a diagnosis of . Infections, kidney stones as well as aspirin and other blood-thinning medications may cause bleeding. In fact, the overwhelming majority of patients who have microscopic do not have cancer.
Irritation when urinating, urgency, frequency and a constant need to urinate may be symptoms apatient initially experiences. Oftentimes, though, these are merely symptoms of a urinary tract infection and antibiotics become the first line of treatment. To make the necessary distinction between an infection and something more serious, it is critical that a urinalysis and/or culture are done to detect any in the . If the culture is negative for , patients should be referred to a for further testing.
What types of tests will the doctor conduct to determine if I have
, CT scans (computed tomography), MRI scans ( ), and IVPs ( pylogram) can detect irregularities in the bladder wall, which would suggest a possible cancer. The will also look inside the bladder with a to visually examine your bladder and remove samples of any suspicious areas for . cytology will be performed to detect cancer cells in the . A number of other tests are also available. These -based markers detect cells or substances in voided that are relatively specific to . Patients should check with their urologists to learn whether such tests are being offered.
What is a
Although the radiological tests provide important information about the and the ureters, is still the best method of evaluating the bladder and the . The is inserted through the . Today, with the widespread use of the flexible , most of the diagnostic cystoscopies are done in the outpatient setting with little or no discomfort.
Newer technology known as “blue light” medical centers.uses an optical agent to view tumors and is available at major
is a technology that utilizes light of specific blue and green wavelengths which enhance visibility of vascular structures on the mucosa surface which can help in identification of suspicious lesions.
As thelooks through the , the locations where there appears to be abnormal features are noted and recorded. During the , the may choose to take a small piece of what appears to be abnormal ( ) and send it to the to read and analyze. In addition, a sample of the from the bladder is frequently sent for analysis (cytology) to determine if there are any cancer cells. The specimen as well as the sample will help the doctor make recommendations about the patient’s future care.
Patients will go home after theif it is done in the doctor’s office. Patients should expect that there may be some minor bleeding and possible irritative bladder symptoms following the . Although seeing blood in the may be very troubling for the patient, the , understanding that even small amounts of blood can affect the color of the dramatically, may not be concerned.
What are the types of
Three types of may form, and each type of can be present in one or more areas of the bladder, and more than one type can be present at the same time:
- Papillary tumors stick out from the bladder lining on a stalk. They tend to grow into the bladder cavity, away from the bladder wall, instead of deeper into the layers of the bladder wall.
- Sessile tumors lie flat against the bladder lining. Sessile tumors are much more likely than papillary tumors to grow deeper into the layers of the bladder wall.
- (CIS) is a cancerous patch of bladder lining, often referred to as a “flat ”. The patch may look almost normal or may look red and inflamed.
What is meant by “and grading” a ?
Ifis diagnosed, the doctor needs to know the , or extent, of the disease to plan the best treatment. is a careful attempt to find out whether the cancer has invaded the bladder wall, whether the disease has spread, and if so, to what parts of the body. refers to what the cancer cells look like, and how many cells are multiplying. The higher the , the more uneven the cells are and the more cells are multiplying. Knowing the can help your doctor predict how fast the cancer will grow and spread.
Urologists typically send a sample of the cancerto a , a doctor who specializes in examining to determine the and of the cancer. The writes a report with a diagnosis, and then sends it to your .
What are the different “stages” for a?
suggests the location of the in relation to the inner lining of the bladder. The higher the the further the has grown away from its original site on the surface. The following are the stages for bladder tumors:
Ta: Papillarywithout invading the bladder wall
TIS (CIS):(non-invasive flat high- (G3) cancer)
T1:invades the connective under the surface lining
T2:invades the muscle layer
T3:penetrates the bladder wall and invades the surrounding fat layer
T4invades other organs (i.e., , , , pelvic wall)
What are the different “grades” for a?
is expressed as a number between 1 (low) and 3 (high, i.e. G3); the higher the number the less the resembles a normal cell. In lieu of numbers to a , your doctor may refer to the simply as low or high .
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