By Dr. Sneha Kommineni, Consultant - Medical Oncology, Aster RV Hospital, Bangalore
Bladder cancer originates in the cells lining the bladder, the organ that stores urine. It is one of the most common forms of cancer, affecting both men and women, with a higher risk in older individuals. The rate of Bladder cancer is steadily climbing, especially in urban and industrial regions. Bladder cancer is the 9th most frequent cancer in the world. In India, it ranks 17th in incidence and 19th in mortality. Approximately 75% of patients with bladder cancer are diagnosed with a variant known as non-muscle invasive bladder cancer, which simply means the cancer has not invaded the muscle layer of the bladder wall.
Therefore, early detection and timely treatments hold the key to a better prognosis and outcome of the disease condition, as research and awareness continue to forge ahead in pursuit of understanding bladder cancer and producing better treatment modalities for those diagnosed with this disease.
What causes Bladder Cancer
Bladder cancer starts with long-term exposure to harmful substances. People living in urban or industrial regions face higher risks because pollutants and industrial chemicals are more common in these environments. Chemicals used in dye, leather, rubber, and similar industries can slowly irritate and alter the bladder lining. Even contaminants like arsenic in drinking water can quietly accumulate in the body, contributing to changes in bladder cells.
Lifestyle choices can also influence risk. For example, often use of artificial dyes in food or hair products may cause bladder irritation. For some, the cause may lie in chronic bladder problems. Persistent infections, long-standing inflammation, or prior radiation to the pelvic region can repeatedly injure the bladder lining, leading to abnormal cell growth. Smoking is the most significant risk factor, as harmful chemicals are excreted through urine and damage the bladder lining over time.
There are also cases where the cause is biological rather than environmental. Some individuals have genetic variations or hereditary conditions that make the bladder more vulnerable to change.
Early Symptoms
Blood in your pee (urine) is the most common bladder cancer symptom. But having blood in your pee isn’t a sure sign of bladder cancer. Other conditions cause this issue, too. But you should contact a healthcare provider whenever you spot blood in your pee.
Other symptoms of bladder cancer:
· Blood or blood clots in the urine
· Pain or burning sensation upon urination
· Frequent urination than usual
· The urge to urinate frequently during the night
· Inability to urinate when the need to urinate is felt
Most of these symptoms are often misdiagnosed as ageing-related changes or urinary tract infections. When detected at an early stage (non-invasive), bladder cancer is usually treatable with minimally invasive methods such as transurethral resection and intravesical therapy.
Treatment available in India
The investigations and treatments recommended by scientific bodies internationally are all available in India, including Urine cytology, Advanced histopathology and immunohistochemistry and all imaging modalities like CT scans, MRI scans, PET scans and nuclear scans.
Treatment for bladder cancer varies depending on how deeply it has grown. Below are the treatments available in India.
· Transurethral resection of bladder tumour (TURBT) or Endoscopic removal of the bladder cancers
· Intravesical chemotherapy– The treatment strategists use chemotherapy and immunotherapy to fight cancer at its core. Intravesical therapy targets cancer without damaging healthy tissue.
· Radical Cysto-Prostatectomy (Removal of bladder and reconstruction or diversion of Urine), which is indicated in invasive cancers. These procedures have become safer with the availability of advanced Laparoscopic and Robotic surgical equipment and expertise.
· Advances in Radiation with newer techniques, including Proton therapy, have also made these treatments safer and better tolerated.
Bladder cancer may be complex, but it's not unbeatable. Many patients lead healthy lives because of early detection and a coordinated team of specialists. Awareness, action, and access to a multidisciplinary care team are your best defence.