Bladder Cancer

The bladder is a hollow organ where urine is stored. Bladder cancer is a disease in which cancer cells form in the tissues of the bladder.

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Bladder cancer is among the 10 most common cancers among males in Singapore. In fact, it is about five times more common in men than women. However, in its early stages, bladder cancer can often be cured.

There are three types of bladder cancer:
Transitional cell carcinoma — cancer that begins in cells in the innermost tissue layer of the bladder called the transitional cells
Squamous cell carcinoma — cancer that begins in the thin, flat cells of the bladder after long-term infection or irritation
Adenocarcinoma — cancer that begins in gland cells of the bladder due to long-term irritation

Bladder Cancer Risk Factors

A number of factors may increase the risk of bladder cancer, including:
Smoking — causes harmful chemicals to accumulate in the urine
Chemical exposure — repeated exposure to arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products; smokers who are exposed to such toxic chemicals may have an even higher risk of bladder cancer 
Chemotherapy — treatment with the anti-cancer drugs, cyclophosphamide and ifosfamide 
Chronic bladder inflammation — chronic or repeated urinary infections or inflammations (cystitis) with long-term use of a urinary catheter, or chronic inflammation caused by infection with a parasite called schistosomiasis
Having a personal or family history of bladder cancer
Bladder birth defects as they can increase the risk of adenocarcinoma of the bladder
Age — older adults, typically those aged 65 and beyond
Race — Caucasians have a greater risk of bladder cancer compared to people of other races
Gender — men are more likely to develop bladder cancer than women

Symptoms of Bladder Cancer

The signs and symptoms of bladder cancer include:
Blood in urine (haematuria) — blood may appear cola-coloured or bright red in your urine
Frequent urination
Painful urination
Urinary tract infection
Abdominal pain
Back pain

Bladder Cancer Diagnosis

If you develop bloody or painful urination, seek medical help immediately.

Tests and procedures used to diagnose bladder cancer may include:
Cystoscopy — to view the inside of the urethra and bladder and remove suspicious cells for testing
Urine cytology — involves testing a sample of urine to check for cancer cells
Imaging tests:
1. An intravenous pyelogram — a type of X-ray imaging test to highlight the kidneys, ureters and bladder
2. A computerised tomography (CT) scan — a type of X-ray test to see the urinary tract and its surrounding tissues

Bladder Cancer Prognosis

The prognosis (chance of recovery) for bladder cancer depends on the following:
The stage of the cancer (whether it is a superficial or invasive bladder cancer, and whether it has spread to other places in the body)
The type of bladder cancer
The patient's age and general health

Bladder Cancer Treatment

There are different types of treatment for patients with bladder cancer. They include:

Bladder Cancer Surgery

Transurethral resection with fulguration to remove the cancer or to burn the tumour away with high-energy electricity
Radical cystectomy — removal of the bladder and any lymph nodes and nearby organs that contain cancer
Segmental cystectomy — removal of part of the bladder
Urinary diversion — where a new way for the body to store and pass urine is created

Some patients may be given chemotherapy/radiotherapy after surgery to kill any cancer cells that are left.

Radiation Therapy

Radiation therapy is a cancer treatment that uses high-energy X-rays to kill cancer cells or prevent them from growing and spreading to other organs.

There are two types of radiation therapy:
External radiation therapy — uses a machine outside the body to send radiation toward the cancer
Internal radiation therapy — uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer 

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by preventing more growth and spread to other organs.

Bladder Cancer Prevention

You can reduce your risk of developing bladder cancer by taking these measures:

Avoiding/Quitting Smoking

Some cancer-causing chemicals in tobacco can collect in urine, where they may become concentrated and damage the bladder lining. Not smoking prevents the collection of the chemicals in the bladder. 

Avoiding Repeated Exposure to Industrial Chemicals

Repeated exposure to chemicals used by makers of dyes, rubber, leather, textiles and paint products may increase the risk of developing bladder cancer years after exposure. Following the safety instructions when handling chemicals to avoid exposure can decrease this risk.

Getting Medical Help for Chronic Bladder Inflammation

Chronic or repeated urinary infections or inflammations may increase the risk for some bladder cancers. Although doctors do not believe the infection or inflammation alone causes cancer, it is important to seek medical attention immediately if blood is found in the urine.

Drinking Plenty of Water

Drinking plenty of water dilutes toxic substances that may collect in the urine and flushes them out of the bladder quickly. 

Eating Fruits and Vegetables

Eating fruits and vegetables rich in antioxidants can help reduce your risk of cancer.

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