Bladder Tumour - What Causes It?

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumour develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone to bladder cancer than women.
3. Ethnicity: White people are more prone to bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. Cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumours: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumour: The tumour has spread to the thick muscular outer layer. This is more advanced and the prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumour bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify the severity of the tumour.

Treatment

Once the tumour is diagnosed, treatment would depend on the severity of the tumour. For both invasive and noninvasive tumours, definitive therapy is surgery, known as transurethral resection of the bladder tumour (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

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