The bladder tumor consists in the malignant transformation of the cells that cover the inner surface of the bladder itself, or the organ that collects urine filtered by the kidneys, before being eliminated from the body.
Bladder cancer accounts for about 3 percent of all cancers and, in urology, is second only to prostate cancer.
It is more common between the ages of 60 and 70 and is three times more common in men than in women. At diagnosis, bladder cancer is superficial in 85 percent of cases, infiltrating in 15 percent.
The survival at five years, in India, is about 60 percent after the bladder cancer treatment in Noida although it is very common the likelihood of recurrence – that is, the reappearance of the problem even after some time.
Who is at risk?
For bladder cancer, cigarette smoking is the main risk factor, followed by chronic exposure to aromatic amines and nitrosamines (frequent in workers in the textile, dye, rubber and leather industries), from any radiotherapy that they have involved pelvis, from taking drugs and from infection with parasites like Bilharzia and Schistosoma haematobium.
Diet also plays an important role: fries and fat consumed in large quantities are associated with an increased risk of developing bladder cancer.
Finally, evidence exists in favor of a genetic component as a predisposing factor.
The most common type of bladder cancer is the so-called transitional cell carcinoma which accounts for about 95 percent of cases.
Other types of bladder cancer are adenocarcinoma and primitive squamous carcinoma, which are much less frequent.
The bladder tumor appears more frequently on the lateral walls of the organ and has a papillary appearance (i.e. as small outgrowth) in 75% of cases or a flat or nodular shape.
The symptoms with which bladder cancer may occur are also common to other diseases affecting the urinary tract.
Frequent manifestations are the presence of blood in the urine (hematuria) and the formation of clots, the burning sensation in the bladder when the abdomen is compressed, the difficulty and the pain to urinate, the greater ease in contracting infections. With the progression of the disease, these disorders can become important.
Bladder cancer can spread locally and remotely via the lymphatic system, first to the lymph nodes and then, via the bloodstream, to the lungs, liver, and bones.
His behavior is not always predictable with regard to relapses, aggression, and metastases.
There are currently no scientifically reliable screening programs or methods of early diagnosis. Even urinary cytology can give false negatives if the cancer cells are difficult to distinguish from healthy cells.
It is, therefore, necessary to put in place preventive measures linked to the habits of life which consist in the abolition of smoking, in a healthy and balanced diet and in the surveillance of workers at risk.
Diagnostic procedures, if there is a suspicion of bladder cancer, are based on ultrasound and cystoscopy. The latter consists of the introduction of an optical fiber instrument into the bladder via the urinary tract and, although annoying, allows one to see inside the bladder and take suspicious tissue samples which will then be analyzed under a microscope.
Also important is the search for tumor cells in the urine sample (urinary cytology).
The TC, the PET and also scintigraphy bone are useful to evaluate whether cancer has spread beyond the bladder involving other organs.
The classification of bladder cancer follows a division into four stages, which in turn are based on the TNM system.
The T parameter describes the size and characteristics of the primary tumor, the N parameter takes into consideration the possible involvement of the regional lymph nodes and finally, the M parameter refers to the presence or not of distant metastases.
How to cure
The possibility of surgical treatment of a bladder tumor includes transurethral resection, for non-infiltrating small tumors and partial or total cystectomy (organ removal), depending on the clinical stage, aggression and tumor type. High efficacy also has, in carcinoma in situ, especially to prevent the disease from recurring, the intravesical treatment with the Calmette-Guerin Bacillus (BCG, the same that was used to vaccinate against tuberculosis) which, deposited directly into the bladder on the neoplastic lesions, it causes their elimination.
However, the bladder cancer treatment in Delhi today involves combined interventions, which can see employees, in various combinations, surgery, chemotherapy or immunotherapy, and radiotherapy.