Urinary Bladder Cancer

The bladder is a hollow organ that collects urine from the kidneys through the tubes (ureters) for storage and eventual removal from the body through the urethra. Bladder cancer is the abnormal growth of bladder cells and is a common cancer; men have a higher risk of getting bladder cancer than women.

Invasive bladder cancer (like cancers of other organs) has the ability to spread (metastasize) to other body parts, including the lungs, bones, and liver.

Causes and Risk factors of Urinary Bladder cancer

• Cigarette smoking
• About 90% of people with bladder cancer are over age 55
• Men are more prone
• A close relative with a history of bladder cancer may increase the predisposition
• Exposure to toxic chemicals:dye workers, rubber workers, aluminum workers, leather workers, truck drivers, and pesticide applicators are at the highest risk.
• Radiation therapy (such as that for prostate or cervical cancer) and chemotherapy with cyclophosphamide (cytoxan) has been shown to increase the risk for development of bladder cancer. Moreover, it may also delay the diagnosis.
• Long-term chronic infections of the bladder, irritation due to stones or foreign bodies, and infections with the blood fluke

Bladder cancer symptoms and signs

• Bleeding in the urine (hematuria) and is not associated with pain
• Blockage of urine by formation of blood clots
• Desire to urinate small amounts in short intervals
• An inability to hold the urine for any length of time after the initial desire to void
• Burning sensation while passing urine
• Lower back pain

How is bladder cancer diagnosed

• Urinalysis
• Urine cytology
• Ultrasound
• CT scan
• MRI
• Cystoscopy
• Biopsy
• Newer biomarkers like NMP 22 and fluorescent in-situ hybridization (FISH) are currently in use to detect bladder cancer cells by a simple urine test

What is bladder cancer grading

Grade 1: low grade or well differentiated and tend to grow slowly and are not likely to spread.

Grade 2: medium grade or moderately differentiated and may grow or spread more quickly than low grade.

Grade 3: high grade or poorly differentiated and are more quickly growing and more likely to spread.

Grade 4: undifferentiated.

Treatment of Bladder cancer

Transurethral surgery (TURBT) for bladder cancer

TURBT is the most common treatment for bladder cancer.

Treatment for superficial bladder cancer

Surgical removal of the bladder (radical cystectomy).

High-grade, larger, multiple, or recurrent superficial bladder cancers may require additional treatment after the initial TURBT. One of the most effective and widely used medications is called the Bacille Calmette Guerin, commonly referred to as BCG.

What is the treatment for muscle-invasive bladder cancer

Surgical removal of the bladder and diversion of the urinary stream using intestinal segments. This procedure, known as radical cystectomy, is a major operation and a thorough discussion and counselling of the risks, complications, and benefits is required.

Radical cystectomy can be performed via open surgery, laparoscopy, or with robotic assistance.

Once the bladder has been removed, the urine needs to be diverted. There are three popular ways of doing that

Ileal conduit  The urine from the kidneys continuously drains into the bag through the ureters and the “ileal conduit.”

Orthotopic neobladder entails the creation of a new bladder (“neobladder”) with the help of an intestinal segment and connecting it to the natural urinary passage

Continent catheterizable pouch (for example, “Indiana pouch”) is a form of neobladder

Combination of extensive TURBT, chemotherapy, and radiation

Signs and symptoms of advanced Urinary Bladder cancer

• Due to obstruction by a tumor at the bladder neck), an inability to pass any urine
• Pain in the flanks (due to obstruction of urine flow from kidney to the bladder by the growing tumor mass in the bladder)
• Bone pains, foot and/or ankle swelling,
• Cough/blood in the phlegm (due to spread to cancer cells to bones or lungs).

You should know that treatment for pain is part of cancer treatment. It is important to resist the big myth that because cancer is a serious disease, pain is to be expected. Most people can get complete relief for their pain — or at least significant relief that allows them to enjoy the activities of daily life.

What is advanced or metastatic urinary bladder cancer

Advanced urinary bladder cancer includes stage 3 and stage 4 and terminal cancer. Stage 3 includes when cancer spreads to other tissues in and around the ovary and / or lymph nodes. Stage 4 includes metastasis.

Metastasis happens when cancer cells break away from a primary tumor and enter the bloodstream or lymphatic system (the system that produces stores and carries the cells that fight infections). When cancer cells spread and form a new tumour in a different organ, the new tumor is a metastatic tumor, the cells of which come from the original tumor. The most common sites of metastasis from urinary bladder cancer tumors are the liver, lungs, bones and brain. Cancer can spread to other parts of the body, too.

Some people with metastatic cancer do not have symptoms. Their metastases may be found by tests, which may be performed for other reasons such as PET, MRI or CT scan. When symptoms do occur, the type and frequency depend on the size and location of the metastasis. For example, cancer that spreads to the bones is likely to cause pain and can lead to bone fractures. Shortness of breath may be a sign of lung involvement.

Liver metastasis

If they do have symptoms, they may be vague and can include:

• Loss of appetite or feeling full early
• Fatigue
• Fever
• Itching
• Pain in the abdomen
• Swelling in the legs
• Weight loss
• Yellowing of the skin or whites of the eyes, called jaundice

Lungs metastasis

Because the lungs get blood flow from the rest of the body, cancer can travel there from other organs. Cancer that has spread to the lungs often affects breathing.

Symptoms include:

• A cough that doesn’t go away
• Chest pain
• Blood in the mucus
• Trouble breathing
• Weight loss

Bone metastasis

When cancer travels to the bones, it can weaken them and cause them to release stored calcium. Symptoms include:

• Bone pain
• Constipation, nausea, and loss of appetite from high calcium levels in the blood
• Broken bones
• Numbness or weakness in the legs and possibly the arms
• Pain in the back or neck

Are you suffering from pain?

Any cancer has only 4 treatments. Surgery, chemotherapy, radiation and pain relief treatment / pain management.

What is the stage of cancer? Stage decides the treatment. All advanced cancers cannot be treated by chemotherapy and / or radiation therapy. Chemotherapy / radiation therapy may not benefit in stage 4 cancer. Recent research tells that unnecessary chemotherapy may reduce quality & life span too. Pain is the most common problem in stage 3 or 4. Please remember Pain definitely can be controlled or treated at any stage of cancer. Even if you are taking ayurvedic treatment for cancer or homeopathic treatment, it will not help in pain relief – You must take pain management treatment. Pain relief is important for continuing any treatment. Pain relief needs dedicated pain management treatment usually offered by Pain specialist doctors. In addition to best cancer specialist, ACCN is proud to have best pain specialist doctor in Delhi and in India. Pain management and cancer treatment goes side by side. Demand a pain free cancer treatment.

One must always remember that in stage 3 / stage 4 / terminal cancer – palliative care and pain relief treatment is usually the priority treatment so that pain relief continues at home too.  Pain free journey of cancer ie pain free cancer treatment helps in prolongation of life.

Advanced-Cancer Care Network, Delhi, India, with its branches (contact) at Delhi and Rohtak (Haryana) is a unique conglomeration of super-specialist doctors, who believe in well-being of human life.  ACCN is the most advanced centre for stage 3 cancer, stage 4 cancer, advanced stage cancer, terminal cancer, Cancer pain management and palliative care. It offers the unique and state-of-the-art treatment for pain relief and cancer treatment in India.

Click on Pain relief in Urinary bladder Cancer to know the best pain management methods at home for urinary blader cancer.

#wincancerpain

Palliative care

Palliative care is designed to give symptomatic relief to the patient, control the side-effects of illness or treatment and improve quality of life of cancer patients. Palliative care treatment is provided by a medical specialist, other than oncosurgeon or oncologist. This medical specialist is known as “Pain & Palliative Care Specialist”. India has very limited number of such specialists and if you are also not able to find one for yourself, please contact ACCN (Advanced – Cancer Care Network), we are proud to have India”s best and most qualified Pain Specialists and Palliative Care Specialists.

Click on Understanding palliative care to know the palliative care treatment for stage 3 cancer or stage 4 cancer or advanced stage cervical cancer.

Role of Palliative Care Treatment

It is usually said that role of palliative care starts, when cancer becomes incurable or advanced stage or terminal or at end-of-life. It is one of the biggest myths in cancer treatment protocols. Palliative care specialist must be consulted and involved in the cancer treatment right from the first day when cancer is diagnosed and treatment is started. Initially when cancer is at stage 1 or 2, complete focus is on cancer cure and palliative care has minimal but very important role. As the cancer (if) progresses, gradually role of palliative care also enlarges.In stage 3 or stage 4.role of palliative care becomes much more important than other regular cancer treatments.

Click on How we can help to know about our various services for advanced cancer patients.

Click on Symptom control to understand that how we can provide suffering free life to advanced cancer patient.

Benefits of Palliative Care

• Makes patient feel better and stay active during treatment
• Manages side-effects of cancer treatment
• Facilitates as high a quality of life as possible
• Helps cancer treatments do a better job
• Can be curative as well as life-supporting treatment
• Cancer diet planning
• Improves survival outcomes
• Increases immunity levels
• Improves communication between patient and family members
• Maintains hope and stick to principals of ethics