What is Bladder Cancer?

What is Bladder Cancer?

The urinary bladder is a hollow, balloon-like organ located in the pelvis that collects and stores urine until it is ready to be excreted from the body. Urine is produced in the kidneys and is transported to the bladder through two tube-like structures called ureters. Pressure from the accumulation of urine in the urinary bladder forces the wall of the bladder to contract producing the urge to urinate. The urine is then excreted from the bladder via the urethra (a thin tube that carries urine from the bladder to the outside of the body).

The wall of the bladder is composed of several different layers that are important in understanding the development, progression, and treatment of bladder cancer. When viewed under a microscope, a cross-section of the bladder wall reveals the following layers of cells:

Epithelium - The epithelium is a layer of cells that lines the inside of the bladder wall and is also known as the urothelium or transitional epithelium. The vast majority of bladder cancers originate in the transitional epithelium.

Lamina propria - This is the layer of connective tissue and blood vessels located immediately beneath the transitional epithelium.

Muscularis propria - This is the deep layer of muscle cells that form the wall of the bladder.

Perivesicle soft tissue - This is the outermost layer of the bladder wall that consists of fat, fibrous connective tissue, and blood vessels. Bladder cancer that has spread to the perivesicle soft tissue is considered as having spread outside of the bladder.

Types of Bladder Cancer

There are four primary types of bladder tumors that can be distinguished on the basis of the appearance (morphology) of the cells under a microscope:

Transitional cell carcinoma - Also known as urothelial carcinoma, this type of bladder cancer affects the transitional epithelium that lines the wall of the bladder. In the United States, more than 90% of bladder tumors are classified as transitional cell carcinomas.

Squamous cell carcinoma - This type of bladder cancer represents only about 4% of all bladder tumors and is most commonly associated with chronic irritation of the bladder that can be caused by long-term indwelling bladder catheters or by bladder calculi (stones). Squamous cell carcinoma of the bladder has also been linked to schistosomiasis (a tropical disease spread by parasitic trematode worms) which is endemic in Africa and the Middle East.

Adenocarcinoma - This is an extremely rare form of bladder cancer accounting for less than 1% of all bladder tumors. It tends to occur in mostly younger patients.

Small cell carcinoma - This type of bladder cancer is also very rare and represents about 1% of all bladder tumors.

Superficial bladder tumors are those that are localized (confined) to the transitional epithelium (urothelium) - the layer of epithelial cells that lines the inside of the bladder wall and is in direct contact with the urine - but have not spread to the deeper layers of the bladder. Additionally, bladder tumors that have invaded the lamina propria but have not invaded the muscularis propria can be considered as superficial.

Invasive bladder cancer refers to a bladder tumor that is either invading the muscularis propria - the deeper layer of muscle cells that forms the wall of the bladder - or the perivesical fat located beyond the bladder muscle. This type of tumor is referred to as muscle-invasive bladder cancer. Muscle-invasive bladder cancer carries a higher risk of spreading beyond the bladder (metastases) and must be treated more aggressively than superficial bladder cancer. The term metastatic bladder cancer is used when the cancer cells have spread beyond the bladder to distant sites.

Bladder Cancer Statistics

Bladder cancer is the 4th leading cause of cancer and the 9th leading cause of cancer deaths among American men.

Approximately 60,000 new cases of bladder cancer are diagnosed in the United States each year.

Bladder cancer occurs about 4 times more frequently in men than in women.

The rate of occurrence of bladder cancer in whites is about twice as high as that for African Americans.

Bladder cancer is primarily a disease of the elderly population with about 50% of cases occurring in people age 72 or older. The median age of diagnosis is 65 years.

At the time of diagnosis, approximately 75% of bladder tumors are superficial; 20% are invasive; and up to 5% are metastatic.

There are over 500,000 bladder cancer survivors in the United States.

Knowledge is Critical when Dealing with a Life-Altering Condition such as Bladder Cancer

If you or a loved one has been diagnosed with bladder cancer, it's critical to learn everything you possibly can about this condition so that you can make informed decisions about your treatment. That's why we created the Medifocus Guidebook on Bladder Cancer, a comprehensive 159 page patient Guidebook that contains vital information about bladder cancer that you won't find anywhere in a single source.

The Medifocus Guidebook on Bladder Cancer starts out with a detailed overview of the condition and quickly imparts fundamentally important information about bladder cancer, including:

The underlying causes of bladder cancer.

The risk factors that can increase a person's chances for developing bladder cancer.

The important distinction between superficial bladder tumors and muscle-invasive bladder cancer in terms of both approach to treatment and the long-term prognosis (chances of recovery).

A detailed overview of the TNM classification system that is used by doctors to stage patients with bladder cancer into different groups by measuring the extent of spread of the cancer based on factors such as:

Size of the tumor

Lymph node involvement

Metastatic spread of the tumor to other sites in the body

The signs and symptoms of bladder cancer.

How bladder cancer is diagnosed based on factors such as signs/symptoms, patient history, physical examination, and imaging studies.

The role of cystoscopy and tissue biopsy in confirming the diagnosis of bladder cancer.

Understanding the Standard Treatments... and the Treatment Options

The goals of treatment for patients with bladder cancer include:

Eradication of the tumor.

Prevention of tumor recurrence.

Prevention of tumor progression from superficial to muscle-invasive bladder cancer.

Preservation of bladder function.

Enabling patients to lead a reasonably good quality of life.