Understanding bladder cancer: Risk factors, symptoms, diagnosis, and prevention

In his latest online article, Mr Werner Struss gives us an insight into bladder cancer. He talks about the common risk factors, the early signs and symptoms, diagnosis and if it can be prevented.

What are the common risk factors associated with bladder cancer?

• Smoking. Harmful chemicals from smoking (cigarettes, vaping, cigars or pipes) can be excreted and accumulate in the urine. These chemicals may damage the lining of your bladder, which can increase your risk of cancer.
• Age. Bladder cancer risk increases as you age. Though it can occur at any age, most people diagnosed with bladder cancer are older than 55.
• Gender. Men are more likely to develop bladder cancer than women are.
• Exposure to certain chemicals. Your kidneys play a key role in filtering harmful chemicals from your bloodstream and moving them into your bladder. Because of this, it's thought that being around certain chemicals may increase the risk of bladder cancer. Chemicals linked to bladder cancer risk include arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products.
• Previous cancer treatment. Treatment with the anti-cancer drug cyclophosphamide increases the risk of bladder cancer. People who received radiation treatments aimed at the pelvis for a previous cancer have a higher risk of developing bladder cancer.
• Chronic bladder inflammation. Chronic or repeated urinary infections or inflammations (cystitis), such as might happen with long-term use of a urinary catheter, may increase the risk of a squamous cell bladder cancer. In some areas of the world, squamous cell carcinoma is linked to chronic bladder inflammation caused by the parasitic infection known as schistosomiasis.

What are the early signs and symptoms of bladder cancer?

• Visible blood in the urine (haematuria), which may cause urine to appear bright red or red wine coloured, however urine may appear normal and blood is detected on a microscopic dip test or investigation (urine analysis)
• Frequent and/or urgent urination
• Painful urination (dysuria)

How is bladder cancer diagnosed?

• Initial flexible scope (with camera and light source) examines the inside of your bladder (cystoscopy). To perform cystoscopy, your doctor inserts a small, narrow tube (cystoscope) through your urethra up into the bladder. Cystoscopy can be done as an outpatient or in the hospital.
• Tissue sampling for investigation (bladder biopsy). This procedure is called cystoscopy and biopsy or transurethral resection of bladder tumour (TURBT). This is an endoscopic minimally invasive procedure through the urethra, you won't have any cuts (incisions) in your abdomen.

As part of the TURBT procedure, your doctor may recommend a single injection of chemotherapy into your bladder to destroy any remaining cancer cells and to prevent cancer from coming back. The medication remains in your bladder for an hour after which it will be drained.

• Imaging investigations. Additional imaging investigations like ultrasound of the kidneys and/or CT scans of the renal tract (CT Urogram) can also be requested by your doctor to stage any cancer more closely.

Can bladder cancer be prevented?

Currently there are no clear preventative measures for bladder cancer. However, you can reduce the risk by:

• Not smoking. If you smoke, talk to your doctor about a plan to help you stop. Medications, support groups and other methods may help you quit.
• Take caution around cancerogenic (cancer causing) chemicals. If you work with chemicals, follow all safety instructions to avoid exposure.
• Following a Mediterranean diet. Choose a diet rich in a variety of fruits and vegetables. The antioxidants in fruits and vegetables may aid in reducing your risk of cancer.

If you have any worries or concerns about bladder cancer you can schedule an appointment with Mr Werner Struss on his Top Doctors profile if you wish.