Before focusing on various aspects related and relevant to bladder cancer, it is essential to clarify, define and distinguish among the terms and concepts often used in the analysis and interpretation of facts concerning bladder cancer.
The urinary bladder is a muscular sac in the pelvis (the bony cavity forming the lower part of the abdomen) lying just above and behind the pubic bone. When the urinary bladder gets empty, and as such takes the shape of a pear, then the urine made in the kidneys travels down to the urinary bladder through the two tubes (ureters). The urinary bladder subsequently stores urine allowing urination to be infrequent and controlled.
Bladder cancer is one arising from the tissue in the urinary bladder. It is a malignant disease in which the cells grow abnormally. Bladder cancer is the 8th highest cause of cancer death.
A benign tumor is harmless and non-cancerous, although, it is an abnormal growth of cells. A benign tumor is generally localized and does not spread invading other parts of the body. When a tumor turns into “malignant “, it is called cancer.
The symptom is subjective evidence, while the sign is any objective evidence of disease. Therefore, the symptom is a phenomenon that is experienced by the individual affected by the disease. And the warning is is a phenomenon that can be detected by tests (and not by experiences)
A risk factor is not necessarily a cause. A risk factor may be anything that influences a person’s chance of developing cancer (for instance), but veritably, most of the risk factors do not directly cause cancer. Many had several risk factors are found without developing any disease in their lifetime. On the contrary, others having no risk factor at all do develop cancer. Risk factor refers to surrogates for underlying causes. For bladder cancer (as), smoking is a high-risk factor, and exposure to chemicals is a low-risk factor.
Again causes mainly include the agents directly responsible for the diseases, such as bacteria (these are cell organisms and are directly responsible for illness, such as urinary tract infection, tuberculosis), viruses (viruses are even smaller than bacteria and cause a multitude of diseases ranging from the common cold to AIDS), fungus (it is a kind of living organism different from plants and animals which have cells with nuclei. Examples are yeasts and mushroom) and parasites (it is an organism which lives in the body of another organism known as the host. Parasites lives and benefits by deriving nutrients at the cost of the host. Examples are tapeworms, fleas, etc).
Some diseases can’t be cured, such as Hepatitis. B. But medical treatment can help manage the disease. Medical therapies include medical therapy, surgery, dietary restrictions, movement restrictions, and more importantly, other procedures to help reduce the symptoms and physical discomforts produced by the disease. Whereas cure implies full recovery of the illness to return to a healthy life.
Medical professionals apply medicine, surgery, therapy, etc. for the treatment of the disease. On the other hand, healing, more specifically, psychotherapy, is applied to cure mental disorders. Therapy is a part of the overall treatment that helps the patient to feel better and stronger. For instance, chemotherapy and radiotherapy are applied to healing cancer.
Medical treatment falls under the overall plan of control of, especially chronic or malignant diseases. Management includes the method of providing total care and relief in terms of medicine intake of the right dose and at the right time. Also, Management includes changing the type and dose of medicine as well as length of period for the drug to continue depending on the level of improvement (and conversely deterioration) of the disease, restriction on diets and physical movements, surgical treatment, post-treatment care, etc. Management is an umbrella that treatment is under.
Prognosis is a guess and forecast regarding the outcome of the treatment. Whereas diagnosis is Identifying the problem, named as ‘depression’, ‘obsession’ or ‘compulsion’ etc.
The two ureters run from the kidneys to the urinary bladder, while the human body having only one urethra runs from the urinary bladder downwards and is the last part of the urinary system. In contrast, ureters are located in the middle part of the urinary system. Usually, an adult ureter is 10 inches-- 12 inches long having a diameter of 0.12 inches -- 0.16 inches. But in the case of the urethra, it is only 2 inches long (in the case of a female adult) and 8 inches long (in the case of a male adult). The smooth muscles in the ureters can produce contraction (unlike tissue in the urethra).
Ten symptoms of bladder cancer, which are mostly experienced by the patients include:
Signs for bladder cancer are usually detected by initially examining the symptoms and then conducting a physical test (rectal test for male and vaginal; test for female). Further, the doctor will check for a lump or other irregularities. Additionally, the following diagnostic testing may be needed.
Despite anatomical differences, the signs, as well as symptoms of bladder cancer for both males and females, are similar. However, females are usually observed to ignore the finding of blood in the urine (a symptom of bladder cancer) during or immediately before the menstruation period. For this reason, females, in general, get late in consulting a doctor. And consequently, more time is wasted for the cancer cells to grow and spread.
When signs and symptoms of bladder cancer arrive one after another, patients should be alert to blood detected in the urine when it is usually felt painless and found grossly red. Under such circumstances, the patient should immediately seek medical advice and never wait to hear the poor consolation “it is an only infection and nothing more“. If caught early, bladder cancer is curable; but if found late, it is difficult.
The following risk factors may raise a person’s risk of developing bladder cancer.
Rather than growing and increasing in an orderly way, the cells develop mutations that cause them to grow out of control but never vanish. These abnormal cells form a tumor over time. About 50% of bladder cancer is first found while cancer is still confined to the inner layer of the bladder wall. These are non-invasive cancer. About 1 out of 3 (33.33%) invades into a deeper layer but is still confined within the bounds of the urinary bladder. In most of the remaining cases, cancer spreads into a deeper layer or lymph nodes outside the bladder. Hardly in 4% of cases, cancer spreads into remote parts of the body when it is difficult to cure.
There are broadly three types of bladder cancer which are stated below.
So far as the range of bladder cancer is concerned, the local range will imply bladder cancer infiltrating into the ureters, urethra, prostate, vagina, or pelvis. Bladder cancer that has spread into other parts of the body is secondary cancer or metastasis when it is likely to spread to lymph, nodes, lungs, liver, or bone.
Treatments for bladder cancer depend on the stage of disease during diagnosis, overall health condition, age, gender, etc. The effective treatment method includes the following measures.
Transurethral resections with figuration: The method uses a cystoscope in which the doctors enter the urinary bladder through the urethra. The tumor formed can be destroyed with high electricity energy.
Partial (segmented) cystectomy: This is a surgical procedure to remove the cancerous part of the urinary bladder.
Radical cystectomy: In this surgery, the entire bladder is removed. If nearby tissues or lymph nodes contain cancer, they can be removed as well. The surgeon constructs an alternative route for the passage of urine known as urinary diversion.
Even after successful surgery, doctors may recommend chemotherapy to destroy any cancer cells left behind or migrated elsewhere. Treatment is generally given intravenously.
Depending on how serious the cancer is, doctors may recommend radiation treatments. The surgeon can place a radioactive substance near cancer during surgery known as internal radiation therapy. The high-energy X- rays can kill cancer cells or prevent them from growing.
It is an artificial stimulation of the immune system to improve the natural ability to fight cancer. The own immune system in the body is used to kill cancer cells. In immunotherapy to treat bladder cancer, the drug used is called BCG (Bacillus Calmette Guerin), which is a vaccine used to protect the urinary bladder against further deterioration. The medications used in the immunotherapy include:
Every dark, dense cloud is followed by a silver lining alternately. So also, after the removal of the dangers of bladder cancer through various treatment methods, the patients are observed to have a great sigh of relief. But after that, some side effects will crop up with each type of treatment which is stated below:
9.1) After partial cystectomy, it may not be possible to hold as much urine as before.
9.2) For a radical cystectomy, females will get their uterus, ovaries, and part of their vagina removed. After that, they will experience immediate menopause (The time comes in most women’s lives when menstrual periods stop permanently, and as such, they are no longer able to bear children. It occurs within the age of 49—52 years).
In the case of males, they will have their prostate and seminal vesicles removed. This may cause impotence afterward.
9.3) The possible side effects of immunotherapy include
In the case of bladder cancer, if the tumor is invasive but has not yet spread beyond the urinary bladder, the chances of a 5-year survival rate are 70%. If the tumor extends through the bladder to the surrounding areas, such as lymph, nodes, or organs, the chances of a 5-year survival rate are 35%.
For example, if the patient suffering from bladder cancer the chances of survival (to live at least for 5 years after diagnosis) is 70%, then the implication is that as compared to the people who do not have bladder cancer, the chance of survival for the bladder cancer patients (to live at least for 5 years) is 30% less.
12.1) A person suffering from a malignant disease like bladder cancer, detected at an early stage, need not worry at all. Because every dark tunnel of mental anxiety emits a golden ray of hope at the far end of the dark tunnel. Fortunately, one can live without a urinary bladder. As such many are found to undergo surgery for complete removal of the urinary bladder to get rid of cancer spread, provided it is detected at an early stage. For satisfying the need, a new route will be created to pass urine. In this connection, doctors usually recommend 3- 4 weeks of healing before returning to normal activities that may include intense exercise or lifting a weight. Moreover, it may take six weeks to resume sexual activities.
12.2) “Prevention is better than cure“- this wise saying holds in case of all fatal diseases including bladder cancer. As humans, we can easily defer and delay the “inevitable arrival of the “Angel of Death “by practicing a healthy lifestyle. This includes following healthy dietary habits, building good habits of rising early in the morning to perform physical exercise, enjoying quality sleep, performing a regular physical check-up under a medical specialist even if there is no health problem and more importantly, avoiding expensive bad habits like smoking and alcohol. Smoking is branded as the prime and primary cause of almost all fatal diseases, including bladder cancer. In this connection, it needs to be mentioned that only due to smoking-related diseases on average, one person dies every 10 seconds globally (i.e.3.16 million deaths annually according to the source of the World Health Organization).
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