Bladder cancer is the most common neoplasm of the upper urinary tract and the 7th most common cancer worldwide.
It is most often diagnosed in males over 60 years old.
Signs and symptoms include hematuria, dysuria, and burning while urinating.
We also need to watch for urinary tract obstructions that can lead to hydronephrosis and infection.
Diagnosis: We can use cystoscopy, imaging, and biopsy to diagnose bladder cancer.
Treatments depend on how invasive the cancer is:
If there is no muscularis invasion, we can use endoscopic resection intravesical therapy.
If the muscularis has been invaded, we need to perform cystectomy, possibly with chemotherapy.
Unfortunately, bladder cancer commonly reoccurs.
We need to watch for metastasis, particularly to the lymph nodes, lungs, liver, and bone.
Urothelial cell carcinoma is the most common form of bladder cancer (formerly called transitional cell carcinoma), which accounts for approximately 90% of all bladder cancers.
This form of cancer can affect any of the structures lined by urothelial cells: the urethra, bladder, ureters, and renal pelvis;
The mucosal layer lines these structures and comprises transitional cells and lamina propria; carcinoma originates in the transitional cells.
Lesions can be papillary or flat, and start out in the mucosa, but can invade deeper tissues.
Key risk factors include smoking, exposure to paint, petroleum, and certain dyes; urothelial cell carcinoma is also associated with Lynch syndrome (aka hereditary nonpolyposis colorectal cancer).
Squamous cell bladder carcinoma is less common than urothelial cell cancer; in these patients, chronic bladder irritation or infection triggers transitional cell transformation to squamous cells.