By: Dr. Dilip Harindran Vallathol, Consultant – Medical Oncology, Aster Medcity, Kochi
Bladder cancer stands out as a particularly challenging malignancy in of both diagnosis and treatment. It ranks among the more common cancers, originating in the cells lining the bladder, the balloon-shaped muscular organ in the lower abdomen responsible for storing urine. The key message for 2025, “Feeling Unsure? Get Checked,” underscores the importance of early detection. While bladder cancer is often identified at an early, more treatable stage, approximately 25% of individuals are not diagnosed until the disease has progressed. Globally, bladder cancer represents a significant health concern, with hundreds of thousands of new cases diagnosed annually. Understanding the subtle signs and seeking timely medical attention are crucial for improving outcomes.
Several distinct types of bladder cancer exist, with urothelial carcinoma (also known as transitional cell carcinoma) being the most prevalent. Less common types include squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. Each type can behave differently and may require tailored treatment approaches.
Bladder cancer signs and symptoms may include:
- Blood in urine, potentially causing it to appear bright red. However, it’s important to note that sometimes the urine appears normal, and blood is only detected through laboratory testing.
- Frequent and painful urination. These irritative voiding symptoms can sometimes mimic urinary tract infections but may also signal bladder issues.
- Back pain. Pain in the side or lower back can occur, particularly if the cancer is more advanced or affecting the upper urinary tract.
Risk factors for bladder cancer include a prior history of the disease, increasing the likelihood of recurrence. Furthermore, having a blood relative (parent, sibling, or child) with bladder cancer may slightly elevate the risk, although familial occurrence remains uncommon. The risk of bladder cancer significantly increases with age, with most diagnoses occurring in individuals over 55, although it can affect people of any age.
Smoking stands out as a major modifiable risk factor. The harmful chemicals in cigarette smoke accumulate in the urine. As the body processes these chemicals, some are excreted through urine, potentially damaging the bladder lining and increasing cancer risk. The duration and intensity of smoking directly correlate with the level of risk.
Exposure to certain chemicals also plays a significant role. The kidneys filter harmful substances from the bloodstream, concentrating them in the urine within the bladder. Consequently, exposure to specific chemicals can elevate bladder cancer risk. These chemicals include arsenic and substances used in the manufacturing of dyes, rubber, leather, textiles, and paint products.
Chronic or repeated urinary infections or inflammations (cystitis), such as those associated with long-term urinary catheter use, may increase the risk of squamous cell bladder cancer. Maintaining proper hygiene and addressing chronic urinary issues can be important preventative measures.
Gender also plays a role, with men being diagnosed with bladder cancer more frequently than women. While the reasons for this disparity are not fully understood, hormonal factors and occupational exposures may contribute.
Certain genetic mutations have also been linked to an increased risk of bladder cancer, although these are relatively rare.
Prevention strategies, while not guaranteeing complete protection, can help reduce the risk of bladder cancer. Key steps include:
- Quitting smoking is paramount.
- Exercising caution around chemicals by strictly adhering to all safety instructions to minimize exposure.
- Adopting a diet rich in a variety of colorful fruits and vegetables. The antioxidants present in these foods may offer some protection against cancer development. Staying well-hydrated by drinking plenty of fluids can also help dilute urine and flush potential carcinogens from the bladder more quickly.
Regular medical check-ups and prompt attention to any urinary symptoms are crucial for early detection and improved outcomes in bladder cancer.