Bladder Cancer and Treatment Options in India

Bladder cancer is a form of cancer that affects the bladder. In this form, the cells present in the bladder start multiplying uncontrollably. Bladder cancer is rare and begins at the lining of the bladder. Although it is rare, certain conditions such as smoking and using tobacco can increase your chances of developing bladder cancer. 

The first signs might include blood in the urine. Sometimes, the blood in the urine is not visible as it may only add a brown tinge to the urine. Additionally, the blood may come and go. Other symptoms include pain in the lower back, abdomen, or bones, frequent urination, sudden urges to urinate, a burning sensation when urinating, incomplete emptying of the bladder, passing tissue fragments in the urine, urine leakage (incontinence), fatigue, weight loss, and swelling in the feet.

When it comes to diagnosis, a variety of tests are done. One of them is cystoscopy. This procedure involves inserting a thin tube with a light and camera into the bladder. The doctor then fills the bladder with liquid to examine the bladder lining on their screen. This process takes about five minutes, and an anesthetic gel is applied locally to reduce any pain. At this stage, the doctor might remove some tumors and send them for biopsy.

Imaging tests: As simple as the name suggests, this test takes images of the tumor to determine its size and whether it has spread to other parts of the body. Other minor tests include ultrasound, kidney function tests, liver function tests, and screening tests. 

Kinds of bladder cancer: 

Urothelial Cancer: This form of cancer impacts the urothelial tissues, which line the bladder. Urothelial cancer is the most common type of bladder cancer, accounting for nearly all cases. The cancer originates in the cells that make up the bladder's inner lining, known as the urothelium. These cells, when abnormal, can grow uncontrollably, forming tumors. Urothelial cancer can vary in its aggressiveness and may be superficial, affecting only the bladder lining, or invasive, penetrating deeper into the bladder walls.

Squamous Cell Carcinoma: This type of bladder cancer begins in the squamous cells, which are flat cells that can develop on the bladder's surface due to chronic irritation or inflammation. Although less common than urothelial cancer, squamous cell carcinoma can be more aggressive. It is often linked to long-term irritation from factors such as chronic urinary infections or the use of certain irritants like tobacco.

Adenocarcinoma: Adenocarcinoma starts in the glandular cells within the bladder that are responsible for secreting fluids. This type is relatively rare compared to urothelial cancer but can be particularly challenging to treat. Adenocarcinoma tends to grow more slowly but may still be aggressive and require comprehensive treatment approaches.

Small Cell Carcinoma: This is a rare and aggressive form of bladder cancer that originates from neuroendocrine cells. Small cell carcinoma is known for its rapid growth and tendency to spread quickly to other parts of the body. Its rarity means that it often presents with advanced disease at diagnosis, making early detection and prompt treatment crucial.

Mixed Histology: In some cases, bladder cancers can have features of more than one type of cancer. This means that the tumors may contain a mix of different cell types, such as urothelial carcinoma combined with squamous cell carcinoma or adenocarcinoma. The presence of mixed histology can complicate diagnosis and treatment, requiring a tailored approach based on the specific characteristics of the tumor.

Understanding the type of bladder cancer is important for determining the most effective treatment plan and managing the disease's progression. Each type has its own characteristics and treatment responses, so a thorough diagnosis is key to addressing the condition appropriately.