Bladder cancer

Bladder cancer
Transitional cell carcinoma of the bladder. The white in the bladder is contrast.
SymptomsBlood in the urine, pain with urination[1]
Usual onset65 to 85 years old[2]
TypesTransitional cell carcinoma, squamous cell carcinoma, adenocarcinoma[3]
Risk factorsSmoking, family history, prior radiation therapy, frequent bladder infections, certain chemicals[1]
Diagnostic methodCystoscopy with tissue biopsies[4]
TreatmentSurgery, radiation therapy, chemotherapy, immunotherapy[1]
PrognosisFive-year survival rates ~77% (US)[2]
Frequency3.4 million current cases (2015)[5]
Deaths188,000 per year[6]

Bladder cancer is any of several types of cancer arising from the tissues of the urinary bladder.[1] It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body.[7][8] Symptoms include blood in the urine, pain with urination, and low back pain.[1]

Risk factors for bladder cancer include smoking, family history, prior radiation therapy, frequent bladder infections, and exposure to certain chemicals.[1] The most common type is transitional cell carcinoma.[3] Other types include squamous cell carcinoma and adenocarcinoma.[3] Diagnosis is typically by cystoscopy with tissue biopsies.[4] Staging of the cancer is typically determined by medical imaging such as CT scan and bone scan.[1]

Treatment depends on the stage of the cancer.[1] It may include some combination of surgery, radiation therapy, chemotherapy, or immunotherapy.[1] Surgical options may include transurethral resection, partial or complete removal of the bladder, or urinary diversion.[1] Typical five-year survival rates in the United States are 77%.[2]

Bladder cancer, as of 2015, affects about 3.4 million people with 430,000 new cases a year.[5][9] Age of onset is most often between 65 and 85 years of age.[2] Males are more often affected than females.[2] In 2015 it resulted in 188,000 deaths.[6]

Signs and symptoms

Location of bladder cancer

Bladder cancer characteristically causes blood (redness) in the urine. This blood in the urine may be visible to the naked eye (gross/macroscopic hematuria) or detectable only by microscope (microscopic hematuria). Hematuria is the most common symptom in bladder cancer. It occurs in approximately 80–90% of the patients.

Other possible symptoms include pain during urination, frequent urination, or feeling the need to urinate without being able to do so. These signs and symptoms are not specific to bladder cancer, and are also caused by non-cancerous conditions, including prostate infections, over-active bladder and cystitis. There are many other causes of hematuria, such as bladder or ureteric stones, infection, kidney disease, kidney cancers and vascular malformations.

Patients with advanced disease refer pelvic or bony pain, lower-extremity edema, or flank pain. Rarely a palpable mass can be detected on physical examination.

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