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Bladder cancer" title="cancer" target="">cancer is relatively rare cancer, usually affecting the elderly
Bladder cancer - transitional cell carcinoma
Bladder cancer is the fifth
most common cancer in men, but only half as common in women. While
it can occur at any age, even in children, it is rare under the age
of 50 years and usually presents in old age.
More than 90% of bladder cancers
form in the lining of the bladder (the urothelium) and are known as
urothelial carcinomas, or transitional cell carcinomas.
Other types of bladder cancers,
including squamous cell carcinomas and adenocarcinomas, are rare in
Australia.
Around 75% of bladder cancers
are superficial and treatment is relatively simple, but in 25% of cases
the cancer has invaded the bladder wall and partial or complete removal
of the bladder is necessary.
What causes bladder cancer?
The risk factors for developing
bladder cancer include:
Cigarette smoking.
The duration of smoking and the number smoked per day impact on a person's
risk of developing bladder cancer.
Exposure to carcinogenic
chemicals in the environment, mainly from the textile or petrochemical
industries.
A genetic predisposition
in people born in some areas of Europe is suspected.
Chemotherapy
and radiotherapy. People undergoing chemotherapy or radiotherapy
for other cancers are more vulnerable to developing bladder cancer.
For example, women who have been treated with radiotherapy for uterine
or ovarian cancer have a higher risk of developing bladder cancer than
women who just have surgery. Both men and women treated with the chemotherapy
cyclophosphamide have an increased risk of bladder cancer.
What are the symptoms of
bladder cancer?
The symptoms of bladder cancer
are similar to those of urinary tract infection and include:
Blood in the
urine (haematuria). This is often painless.
Feeling pain
or burning on urination.
Frequent urge
to urinate
How is bladder cancer diagnosed?
A doctor will perform a physical
examination and order several tests to rule out other causes of the
symptoms and to specifically check for cancer.
An x-ray
will be ordered to examine the lining of the urethra, bladder and kidneys
A urine test
will be ordered to check for cancer cells in the urine
If cancer is suspected,
a cystoscopy is carried out. This involves inserting an endoscopic
camera on a thin tube through the urethra to visualise the bladder.
This is usually done under a local anaesthetic but if a biopsy is required
it would be done under a general anaesthetic.
If cancer is diagnosed,
imaging scans are used to work out the size of the tumour and
whether it is invasive. This is known as "staging".
How is bladder cancer treated?
The treatment will vary, depending
on whether the cancer is invasive.
For a superficial tumour:
The cytoscope is
used to cut the cancer out (transurethral resection) under a general
anaesthetic. However because the tumours frequently recur, the patient
will need regular review, undergoing repeat check-up cytoscopies under
local anaesthetic for up to a decade.
Chemotherapy is
not routinely required for superficial cancer. However if there are
many tumours or they appear particularly aggressive, chemotherapy or
immunotherapy may be advised. This is a drug delivered in a fluid by
putting a catheter into the bladder once a week for six weeks (intravesical
chemotherapy). No anaesthetic is needed and it can be done in an outpatient
setting. Systemic chemotherapy (a drug delivered through the bloodstream)
is usually only used in patients with advanced disease.
Invasive cancer:
Partial or complete
removal of the bladder, known as cystectomy, may be required. Following
a cystectomy the urine needs to be diverted in one of the following
ways:
Urine is directed
through the intestinal tissue, known as an ileal conduit, with an opening
or "stoma" on the abdominal wall. The patient will wear a pouch
externally on the skin to collect urine; or
An orthotopic neobladder
is created. In this operation the patient's bladder is removed and
replaced with loops of their own bowel, fashioned into a pouch. There
is no change to normal bowel function and the patient passes urine naturally
through the urethra.
What are the side-effects
of the treatment?
Chemotherapy:
The side-effects from intravesical chemotherapy include:
Feelings of urgency
to urinate, having to urinate frequently, pain in the bladder and sometimes
incontinence. These symptoms run their course and eventually stop
Nausea and loss
of appetite
Surgery: The side-effects
from bladder removal are substantial and life-changing.
Men face impotence
and infertility:
Most men who have
the operation will be impotent because the nerves to the penis become
damaged.
Bladder removal
also means infertility. Men can no longer ejaculate as the prostate
has to be removed as well to limit the spread of the cancer.
Women also face
sexual dysfunction and sometimes infertility:
Part of the interior
vaginal wall may be removed along with the bladder. This leads to a
shortening or narrowing of the vagina which can cause discomfort during
sex.
In some cases the
ovaries, Fallopian tubes and uterus are removed as well leading to immediate
menopause with symptoms such as hot flushes, vaginal dryness and insomnia.
Women are then infertile.
Where can I get support?
Many cancer patients gain
emotional support and practical help for everyday living, by seeking
out support groups. The following websites may have useful information:
<a href=http://www.cancercouncil.com.au/www.cancercouncil.com.au
<a href=http://www.healthinsite.gov.au/www.healthinsite.gov.au
Bladder cancer" title="cancer" target="">cancer is relatively rare cancer, usually affecting the elderly
Bladder cancer - transitional cell carcinoma
Bladder cancer is the fifth
most common cancer in men, but only half as common in women. While
it can occur at any age, even in children, it is rare under the age
of 50 years and usually presents in old age.
More than 90% of bladder cancers
form in the lining of the bladder (the urothelium) and are known as
urothelial carcinomas, or transitional cell carcinomas.
Other types of bladder cancers,
including squamous cell carcinomas and adenocarcinomas, are rare in
Australia.
Around 75% of bladder cancers
are superficial and treatment is relatively simple, but in 25% of cases
the cancer has invaded the bladder wall and partial or complete removal
of the bladder is necessary.
What causes bladder cancer?
The risk factors for developing
bladder cancer include:
Cigarette smoking.
The duration of smoking and the number smoked per day impact on a person's
risk of developing bladder cancer.
Exposure to carcinogenic
chemicals in the environment, mainly from the textile or petrochemical
industries.
A genetic predisposition
in people born in some areas of Europe is suspected.
Chemotherapy
and radiotherapy. People undergoing chemotherapy or radiotherapy
for other cancers are more vulnerable to developing bladder cancer.
For example, women who have been treated with radiotherapy for uterine
or ovarian cancer have a higher risk of developing bladder cancer than
women who just have surgery. Both men and women treated with the chemotherapy
cyclophosphamide have an increased risk of bladder cancer.
What are the symptoms of
bladder cancer?
The symptoms of bladder cancer
are similar to those of urinary tract infection and include:
Blood in the
urine (haematuria). This is often painless.
Feeling pain
or burning on urination.
Frequent urge
to urinate
How is bladder cancer diagnosed?
A doctor will perform a physical
examination and order several tests to rule out other causes of the
symptoms and to specifically check for cancer.
An x-ray
will be ordered to examine the lining of the urethra, bladder and kidneys
A urine test
will be ordered to check for cancer cells in the urine
If cancer is suspected,
a cystoscopy is carried out. This involves inserting an endoscopic
camera on a thin tube through the urethra to visualise the bladder.
This is usually done under a local anaesthetic but if a biopsy is required
it would be done under a general anaesthetic.
If cancer is diagnosed,
imaging scans are used to work out the size of the tumour and
whether it is invasive. This is known as "staging".
How is bladder cancer treated?
The treatment will vary, depending
on whether the cancer is invasive.
For a superficial tumour:
The cytoscope is
used to cut the cancer out (transurethral resection) under a general
anaesthetic. However because the tumours frequently recur, the patient
will need regular review, undergoing repeat check-up cytoscopies under
local anaesthetic for up to a decade.
Chemotherapy is
not routinely required for superficial cancer. However if there are
many tumours or they appear particularly aggressive, chemotherapy or
immunotherapy may be advised. This is a drug delivered in a fluid by
putting a catheter into the bladder once a week for six weeks (intravesical
chemotherapy). No anaesthetic is needed and it can be done in an outpatient
setting. Systemic chemotherapy (a drug delivered through the bloodstream)
is usually only used in patients with advanced disease.
Invasive cancer:
Partial or complete
removal of the bladder, known as cystectomy, may be required. Following
a cystectomy the urine needs to be diverted in one of the following
ways:
Urine is directed
through the intestinal tissue, known as an ileal conduit, with an opening
or "stoma" on the abdominal wall. The patient will wear a pouch
externally on the skin to collect urine; or
An orthotopic neobladder
is created. In this operation the patient's bladder is removed and
replaced with loops of their own bowel, fashioned into a pouch. There
is no change to normal bowel function and the patient passes urine naturally
through the urethra.
What are the side-effects
of the treatment?
Chemotherapy:
The side-effects from intravesical chemotherapy include:
Feelings of urgency
to urinate, having to urinate frequently, pain in the bladder and sometimes
incontinence. These symptoms run their course and eventually stop
Nausea and loss
of appetite
Surgery: The side-effects
from bladder removal are substantial and life-changing.
Men face impotence
and infertility:
Most men who have
the operation will be impotent because the nerves to the penis become
damaged.
Bladder removal
also means infertility. Men can no longer ejaculate as the prostate
has to be removed as well to limit the spread of the cancer.
Women also face
sexual dysfunction and sometimes infertility:
Part of the interior
vaginal wall may be removed along with the bladder. This leads to a
shortening or narrowing of the vagina which can cause discomfort during
sex.
In some cases the
ovaries, Fallopian tubes and uterus are removed as well leading to immediate
menopause with symptoms such as hot flushes, vaginal dryness and insomnia.
Women are then infertile.
Where can I get support?
Many cancer patients gain
emotional support and practical help for everyday living, by seeking
out support groups. The following websites may have useful information:
<a href=http://www.cancercouncil.com.au/www.cancercouncil.com.au
<a href=http://www.healthinsite.gov.au/www.healthinsite.gov.au