A Leading Urologist Talks About Tobacco and Bladder Cancer
What is bladder cancer?
Cancer is the growth of abnormal cells in the body, which form masses known as tumors. With bladder cancer, tumors grow in the muscular organ in the pelvis, the bladder, where urine is stored. It usually begins in the cells lining the interior surface of this hollow organ. This type of bladder cancer, transitional cell carcinoma, is the most common type of bladder cancer. As the tumors grow, the cancerous cells can grow through the lining to the muscular wall of the bladder. Bladder cancer can then spread to they lymph nodes, other organs in the pelvis, and to distant organs like liver and lungs.
What are the symptoms of bladder cancer?
Bladder cancer is usually discovered when someone notices blood in their urine. This occurs in 80 to 90% of patients who have bladder cancer and is usually painless. Some patients may experience painful or frequent urination. Finally, another common symptom is frequent urinary tract infections. As bladder cancer advances, it may cause pain in the lower back, in the region kidneys; swelling can occur in the lower legs and a pelvic mass may be felt near the bladder. Advanced bladders can spread and this results in bone pain, pain in the rectum or anus, weight loss, and anemia.
What are the risk factors for bladder cancer?
Cigarette smoking is the most important risk factor and smokers are far more likely than others to develop bladder cancer. It has also been associated with radiation, exposure to certain chemicals, and infection with a parasite known as schistosomiasis. This is rare in the United States, but occurs in developing countries. If you have had certain types of chemotherapy or radiation treatment in your pelvis or abdomen, you are at higher risk. People who take the medication Actos (pioglitazone) for diabetes for longer than a year are at increased risk. You may have an increased risk if you have a family history. Men are 4 times more likely to get bladder cancer compared to women, and the risk is highest for white men. Finally, as you age, your risk increases.
The primary cause of bladder cancer is tobacco and the best way to reduce your risk is to quit smoking. When you smoke, chemicals in the smoke, known as carcinogens, are absorbed into your bloodstream. They are filtered through your kidneys and end up in your urine that is stored in the bladder. These chemicals can damage the cells that line the inside of the bladder, causing abnormal growth that is characteristic of cancers. Other preventive measures you can take include avoidance of dangerous chemicals.
When to see a urologist?
If you have blood in your urine or pain with urination, you should see your doctor right away to determine if your condition is serious. You should also see your doctor if you are passing small amounts of urine frequently or if you have back pain or flank pain. If you have risk factors and concern about bladder cancer, you should be evaluated by a physician. A urologist can diagnose and treat diseases of the genitourinary tract. In addition to examining your urine, urologist will examine the inside of your bladder with a thin, lighted tube called a cystoscope. The urologist will take a sample of any abnormal tissues in the bladder to examine under the microscope for cancerous cells. Other tests, like an ultrasound, MRI, and intravenous pyelogram will help the urologist determine how far your cancer has spread.
Treatment options are available
Treatment options depend upon the stage of your cancer, which refers to its spread. If it is discovered early, surgery can often remove the tumor. In more advanced cases, all or part of the bladder may be removed. Radiation therapy is sometimes used after surgery, to kill any cancer cells that remain. Immunotherapy and chemotherapy are also important treatments used for bladder cancer. If you are a smoker, you should quit now. If you have symptoms that concern you, consult a urologist right away.
Most bladder cancer is diagnosed early, before it invades the bladder wall and spreads.