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Bladder cancer
Bladdercanceraffectstwiceasmanymenaswomen.Itisrareinpeopleunder55yearsofage andmostcommonamongthoseover70years.Morethan1,000Victoriansarediagnosedwith bladdercancereachyear. The bladder and kidneys Thebladderisahollow,muscular,balloon-likeorganthatstoresurine.Itsitsinsidethepelvis. Urineconsistsofwaterandwasteproductsnotneededbythebody.Thebladderislinedwitha membranethatstopstheurinegoingintothebody.Thecellsofthismembranearecalled transitionalcellsorurothelialcells.Themembraneliningiscalledtheurothelium. Thekidneysproduceurine,whichiscarriedtothebladderbytubescalledureters.Thebladder storestheurine.Whenitisfullenough,urineispassedfromthebodythroughatubecalledthe urethra.Inwomen,theurethraisaveryshorttubeinfrontofthevagina(birthcanal).Inmen,the tubeislongerandpassesthroughtheprostateandthepenis. Types of bladder cancer Mostbladdercancersarefoundinthecellsofthebladderlining.Thesearecalledtransitionalcells soitisknownastransitionalcellbladdercancer.Therearetwomaintypesoftransitionalcell cancer: Superficial or papillary bladder cancerthisisearlystagetransitionalcellbladder cancer.Thecancerhasnotspreadbeyondtheliningofthebladder.Mostbladdercancers aresuperficialwhentheyarediagnosed. Invasive bladder cancerthismeansthatthecancerhasspreadintothemusclelayer ofthebladderorfurther.

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Thereareother,rarertypesofbladdercancerssuchassquamouscellcarcinomasand adenocarcinomasofthebladder.Thesetypesaremorelikelytospreadintothedeeperlayersof thebladder. Risk factors Theexactcauseofbladdercancerisunclear.However,ithasbeenlinkedtoseveralriskfactors including: Cigarette smokingsomechemicalsincigarettescandefinitelycausebladdercancer. Yourriskifyousmokeisalmostfourtimesthatofanon-smoker.Smokingheavilyorfora longtimeincreasesyourrisk. Increasing agemostcasesoccurinpeopleover70years. Long-term chemical exposureespeciallyincertainoccupations;forexample, exposuretosomeofthechemicalsusedfordyeingintextileandrubberindustriesis thoughttoincreasetheriskofbladdercancer.(Thiscanbedifficulttoprove.) Repeated or chronic infections of the bladder thishasbeenlinkedtosquamouscell carcinomaofthebladder. Treatment for other types of cancersradiotherapytothepelvicareacanincrease yourriskofbladdercancer.Also,treatmentwiththechemotherapydrugcyclophosphamide increasesyourrisk.

Symptoms Thesymptomsofbladdercancerinclude: Bloodintheurine Theneedtourinateoften Apainful,burningsensationonurination.

Bladdercancer

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Allofthesesymptomscanbecausedbyother,muchlessseriousconditionsthancancer,suchasa urineinfection.Ifsymptomspersist,youshouldalwaysseeyourdoctor. Diagnosis Bladdercancerisusuallydiagnosedusinganumberoftestsandexaminations,including: Urine testaurinesampleissenttoalaboratorytobeexaminedunderamicroscopefor cancercells. Physical examinationincludesanexaminationofthepelvisandotherorgans. Cystoscopy and biopsyasmallflexibletelescopeisthreadedthroughtheurethrato viewtheliningofthebladderandurethra.Ifabnormalitiesareseen,asmallsampleis removedforfurtherexamination. Intravenous pyelogram (IVP)adyeisinjectedintoavein,usuallyinthearm,and goesthroughthebloodtothekidneys.Thedoctorcanwatchthedyemovearoundthe bodyonanx-rayscreenandpickupanythingunusual.

Ifbladdercancerisdiagnosed,youmayneedtohaveotherscansandx-raystodeterminethesize ofthecancerandwhetherornotithasspread(thestageofthecancer). Treatment superficial bladder cancers Mostbladdercancersaresuperficial;small,mushroom-likegrowthsthatcanberemovedduringa procedurecalledatransurethralresection(TURP).Acystoscopeisusedtosnipthecanceroffat thestem.Theareaaroundthecanceristhencauterised(burned)topreventexcessivebleeding. Thistypeofcanceroftenreturns,sofollow-upcystoscopieswillberequired. Immunotherapy(alsoknownasbiologicaltherapy)isalsosometimesusedtotreatsuperficial bladdercancers.Thisistheuseofsubstancesthatencouragetheimmunesystemtofightthe cancer.ThemostcommonimmunotherapyusedtotreatsuperficialbladdercancerisBacillus Calmette-Gurin(BCG)vaccine. Anothertreatmentthatmaybegivenisintravesicalchemotherapy.Thismeansthatthe chemotherapydrugsareinjecteddirectlyintothebladderthroughacatheter. Treatment invasive bladder cancer Treatmentforinvasivebladdercancermayincludeoneoracombinationof: Surgery (cystectomy)partorallofthebladdermayneedtoberemoved(knownasa partialorradicalcystectomy).Notmanypeoplehaveatypeofbladdercancerthatcanbe treatedwithpartialcystectomy.Ifthecancerhasspreadbeyondthebladder,thesurgeon canoftenstopthecancergrowingbyremovingthebladderandorgansnearby. Chemotherapytheuseofcancer-killingdrugs.Somechemotherapydrugsareinjected intoaveinandcirculatearoundthebody.Othersmaybeinjecteddirectlyintothebladder. Radiotherapytheuseofradiationtokillcancercells.

Alltreatmentscanhavesideeffects.Yourmedicalteamwilldiscussthesewithyoubeforeyou beginanytypeoftreatment. After surgery Afterapartialcystectomyyouwillbeabletopassurineasusual,butyourbladderwillbesmaller andholdlessurine,soyouwillneedtopassurinemoreoften. Afteraradicalcystectomy,anewplacetostoretheurinewillneedtobecreated.Themost commonwayofdoingthisistomakeaurostomy.Yourdoctorwilldiscussthisandotherpossible optionsbeforesurgery. Where to get help Yourdoctor Urologist TheCancerCouncilVictoria,CancerHelplineTel.131120 MultilingualCancerInformationLine,Victoria-seetheCCVwebsiteforcontactdetails

Things to remember

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Cigarettesmokingisthemostimportantfactorlinkedtobladdercancer. Bladdercancerismostcommoninpeopleover70yearsofage. Treatmentdependsonthetypeofbladdercanceryouhave.

This page has been produced in consultation with, and approved by:

CancerCouncilVictoria

Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

Bladdercancer

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