Bladder Cancer Symptoms, and Risk Factors
The urinary bladder is the receptacle for urine excreted by the kidneys. The uncontrolled growth of cells marks urinary bladder cancer. This condition is often associated with the infiltration of healthy tissues. (Know what cancer is?) The cancerous spread is either local or sometimes can metastasize anywhere in the body. People with bladder cancer usually have one or more tumors in their bladder. This article will analyze Bladder Cancer Symptoms, types, and risk factors.
Bladder Cancer Types
- Urothelial carcinoma: It is the most common type of urinary bladder cancer and accounts for 90% of the cases. The disease begins in the urothelial cells present in the urinary tract. Urothelial carcinoma is also known as transitional cell carcinoma.
- Squamous cell carcinoma: Squamous cell carcinoma accounts for around 4% of bladder cancer caused mainly by irritation and inflammation of the cell lining the bladder. If the irritation and swelling persist for a long time, then the squamous cells lining the bladder become cancerous.
- Adenocarcinoma: It is the most uncommon type, affecting only 2% of people with bladder cancer. It originates from the epithelial cells.
Bladder Cancer Symptoms
- Blood in urine
- Pain in back
- Painful and frequent urination
- Urine incontinence
- The urgency to pass urine
- Pain in the abdomen
- Difficulty in passing urine
- Burning sensation while passing urine
- Loss of weight
- Loss of appetite
- Fatigue
- Swelling in feet
- Pain in bones
Causes of Bladder Cancer
Some causes that are known are:
Abuse of tobacco- Patients consuming tobacco are 5 to 7 times more likely to develop bladder cancer than those who do not. Tobacco has multiple carcinogens that interfere with the host immunity, damage the lining epithelium of the bladder (as the carcinogens are excreted in the urine)
Exposure to certain chemicals- Aromatic dyes, having benzene rings(aniline dyes, benzidine, beta-naphthyl amine) are irritants that lead to increased bladder proliferation epithelium, leading to disordered growth and finally a malignant change into cancer. These chemicals are commonly used in leather, dye, and print industries. (Know what cancer is?)
Radiation exposure- Radiations such as those from high dose ionizing radiations can lead to cancer of the bladder. Radiations cause a break in the DNA strands, leading to ineffective cell division. Also, they induce mutations, which favor the rapid proliferation of the cancer cells, which escape the body’s innate immune systems and thus become immortal and continue to divide.
Chronic irritation and inflammation of the urinary bladder- Chronic irritation (physical or chemical or infective) leads to tissue injury. One of the characteristic responses of tissues to chronic injurious stimuli is metaplasia. One cell type is replaced by another cell type, which is better suited to the stress/irritation. Thus, squamous cells, known as squamous cell metaplasia, replaced the transitional bladder epithelium. Metaplasia, over long time durations, is fertile grounds for the development of in-situ cancers. Bladder stones and infections may also increase the risk of bladder cancer.
Certain parasitic infection- Schistosoma hematobium, is a parasite that infects the bladder epithelium. It is a trematode/flat fluke, which is also called a bladder worm. With the help of their suckers, they continuously attach and detach from the host, causing a chronic inflammatory reaction. A chronic inflammatory state decreases immunity, promotes cell proliferation, and consequently increased the risk for mutations and cancer. Also, the worms deposited in the bladder wall exacerbate the chronic inflammation and lead to neovascularisation (new blood vessel formation to rid the parasite’s body) and increased turnover of the epithelial cells. (Know what cancer is?)
Bladder Cancer Risk factors
Smoking increases the risk of bladder cancer- Smoked form of tobacco is one of the commonest forms of tobacco abuse. A cigarette has nearly 70+ carcinogens, which by themselves induce mutations or promote cancerous development in a genetically susceptible host.
Older adults are at higher risk, but rarely bladder cancer is also diagnosed in people younger than forty years- Increasing age is a risk factor for developing any cancer. As the telomerase shortening occurs at the ends of the chromosomes, there are increased chances of protein misfolding, changes in the DNA sequence, and a progressively diminishing immunity. Cancer is a multifactorial disorder of increased cell proliferation. It is the result of various environmental triggers on a genetically susceptible host.
European and European-American are at higher risk- Racial predilection of cancers is not very understood. Western population (Europeans and Americans) are generally at a higher risk of developing bladder carcinoma due to changing lifestyle habits and the increasing incidence of other comorbid conditions like hypertension, diabetes mellitus, HIV-AIDS, immunosuppression due to long term intake of steroids, all of which impair the immune responses.
Men are at higher risk than women- Men have a genetic predisposition towards developing bladder carcinoma due to the increased prevalence of smoking as compared to women. Also, many males work in dye factories compared to women, thus accentuating their risk potential for bladder cancer.
Exposure to certain drugs- Cyclophosphamide, an anti-cancer drug, is responsible for causing bladder cancer as it is toxic to the bladder cells. Pioglitazone, an anti-diabetic drug, is also prophesied to cause cancer, but it has not been conclusively proven.
People with a history of cancer- Bladder cancer have a high recurrence rate. Thus, even after surgery, cancer may develop again in some patients due to inadequate treatment or newly developed mutations. (check: surgery in cancer)
People with a Family History-Persons who suffer from Lynch Syndrome or Hereditary Non-Polyposis Colorectal Cancer (HNPCC) may have an increased risk of developing bladder cancer (upper and lower tract).
Dietary Factors- Persons who consume a high-fat diet have a disturbed gut microbiota, and thus, their gut-associated lymphoid tissue immunity diminishes. It can predispose to abdominal infections, which may also reach the bladder. Furthermore, decreased or reduced water intake leads to urine concentration, in which stones may precipitate, or the toxins may further accumulate. This also leads to irritation, obstruction, and inflammation, increasing the bladder’s risk of cancer.
Periodically monitor the factors enlisted under Bladder Cancer Symptoms and Risk factors for early detection.
Complications
- Pain
- Depression
- Significant anxiety
- Nutritional deficiency
- Metastasis of cancer
- Swelling of the ureters
- Mood swings
- Removal of the urinary bladder
- Erectile dysfunction in men
- Narrowing of the vagina in women
Check here: Top 38 Accredited Cancer Hospitals from India
Lifestyle changes to prevent urinary bladder cancer:
- Avoid tobacco
- Limit exposure to cancer-causing chemicals at work
- Drink plenty of fluids
- Eat healthy food. Avoid fatty food
- Exercise daily.
- Eat plenty of fruits and vegetables.
- Avoid food that has an artificial color.
- Get treated for any inflammation and irritation of the urinary bladder.
- Avoid getting contaminated with the parasite while traveling.
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