Bladder Cancer
At about 65,000 individuals diagnosed a year; bladder cancer is the sixth most common cancer diagnosis in the United States. While the incidence of this disease has been increasing over recent decades, there is also an improving survival rate, thanks primarily to significant advances in treatment and better understanding of the various forms of bladder cancers. As a noted Los Angeles urologist, Michael Safir M.D. is equipped to use the most advanced and effective tools in his Beverly Hills and West Hills urology offices to ensure the best outcome for each of his patients. This dedication and experience make the critical difference.
What is Bladder Cancer?
Bladder cancers occur when malignant cells form in the bladder and develop into a tumor. There are three major forms of bladder cancer; each may be diagnosed at various stages.
The Three Major Forms of Bladder Cancer:
- Transitional Cell Carcinoma: Also called urothelial carcinoma, this form of cancer begins in the cells that line the inside of the bladder. Most bladder cancers arise in these transitional cells. In about 30-40% of patients, the disease is multifocal, meaning more than one primary tumor is present at diagnosis.
- Squamous Cell Carcinoma: A far less common type of bladder cancer in the United States, squamous cell carcinoma arises from thin, flat cells in the bladder, and may form in response to certain infections or irritations. Known causes include damage from kidney stones, indwelling catheters, and in rarer cases (especially in the U.S.), parasitic infections.
- Adenocarcinoma: This form of bladder cancer begins in glandular cells, which secrete mucus and other bodily fluids. Adenocarcinoma almost always exhibits invasive behavior, so patients are carefully examined for signs of spread to other parts of the urinary tract and the rest of the body.
Stages of Bladder Cancer:
The lining of the bladder, as with other organs, constantly generates new cells. These cells, due to mutations or environmental factors, may become cancerous. Cancers in the bladder are typically categorized as superficial or muscle-invasive. Additionally, the cell types involved in the tumors can be referred to as low grade (slow-progressing) and high grade (aggressive).
- Superficial Tumors (Stages 0 or I): Arising from the inside lining of the bladder wall, these tumors can appear singly or in multiples. In most cases, they appear similar in shape to a mushroom, with a large top area and smaller "stem" of cells connecting to the lining of the bladder. In the past, these tumors were known as papillomas or bladder warts.
- Muscle-Invasive Tumors (Stages II-IV): This cancer, having begun in the transitional cells, invades the lining of the bladder and the wall of muscle surrounding it. These cancers are aggressive, and can easily spread to nearby organs and lymph nodes.
What Are the Causes and Risk Factors Associated With Bladder Cancer?
While the causes of bladder cancer are only partially understood, much has been learned regarding this disease. There are many identified causes of bladder cancer, with cigarette, cigar, and pipe smoking leading the way in over 50% of cases. The carcinogens in tobacco smoke eventually make their way to the urine and into the bladder, causing damage to cells and forming tumors.
Other risk factors include age, diet, race, gender, personal and family history of bladder cancer (several genetic risk factors have been identified), infections, treatments with certain drugs, radiation overexposure, exposure to secondhand smoke, and chronic inflammation due to such irritants as urinary tract infections and kidney stones. Being male, Caucasian, and a smoker are the most widely recognized risk factors that contribute to bladder cancer.
In addition, exposure to carcinogens in the workplace increases the risk for developing bladder cancer. Exposure to certain chemotherapy drugs, hair dyes, and industrial dyes containing the chemical aniline are all recognized as risks. Occupations that carry increased risk include hairdressers, machinists, printers, painters, truck drivers, and working in the rubber, chemical, textile, metals and leather industries.