Unknown, bladder cancer is yet the 7th most common cancer in France. The first warning sign is the presence of blood in the urine.
THE bladder cancer is about 4 times more common in men than in women. It’s the 7th most common cancer in France and the 2nd urological cancer after that of the prostate. He touches 13,000 to 20,000 new people every year in France, recalls the French Association of Urology (AFU) in a press release May 2023, month dedicated to bladder cancer. “Bladder Cancer Month aims to raise awareness among the general public about the severity of this cancer but also of very good prognosis if diagnosed early. There first cause of bladder cancer being the tobaccothe communication around this cancer also makes it possible to remind people of the risks associated with smoking” recalls Dr. Benjamin Pradere, urologist and member of the cancerology committee of the AFU. In 80 to 90% of cases, the first symptom of bladder cancer is the visible blood in the urine.
Definition: what is bladder cancer?
Bladder cancer most often develops from the mucosa of the bladder, on the urothelial epithelium, hence the name of urothelial carcinoma also given to him. There are two types of bladder cancer:
- superficiali.e. limited to the mucosa of the bladder,
- invasive, reaching a deeper tissue layer of the bladder called muscularis. This is more violent and requires much heavier treatment.
The stage corresponds to the degree of severity of the cancer depending on the size of the initial tumor and its spread. Doctors use the so-called “TNM” classification, T for the size of the tumor (which ranges from 0 to 4), N indicating the possible presence of affected lymph nodes (from 0 to 3) and the letter M for the presence of metastases (0 to 1). The higher the scores, the worse the prognosis.
What are the symptoms of bladder cancer?
“The main symptom of bladder cancer is presence of blood in the urine (hematuria)which can then be pink or dark red depending on the intensity of the bleeding“explains Dr. Adriana Perez, oncologist at the Institute of High Energy Radiotherapy in Bobigny. Macroscopic hematuria (visible to the naked eye) reveals bladder cancer in 80% of cases.”Other symptoms that may alert range from urinary burning to pain in the lower back passing through the recurrent urinary tract infections or bladder spasms“, says Dr. Perez.
What is the life expectancy with bladder cancer?
When bladder cancer is caught in time, survival is greater than 80% at 5 years. If the diagnosis is made later, survival drops to 50% And 5% at the metastatic stage. To anticipate possible relapses, people affected by bladder cancer should be monitored regularly throughout their lives.
What is the cause of bladder cancer?
As with the majority of cancers, it is difficult to determine the causes of the occurrence of bladder cancer. On the other hand, the main risk factors can be identified.
- The first culprit is, as often, the smokingwhich would be responsible for 30 to 40% of bladder cancers.
- Prolonged exposure to certain substances in the context of a professional activity (textiles, dyes, paints, rubber, etc.) would also be implicated in its occurrence.
- Some chemotherapy as treatment for another cancer may increase the risk of later developing bladder cancer.
There is no systematic screening for bladder cancer. In case of suspicion, the first examination proposed by the doctor is urinalysis. If abnormal cells are detected, the cancer is proven but it is essential to locate the tumor which can be at any level of the urinary tract, from the kidneys to the urethra. Three examinations are then possible:
- there cystoscopy, which allows the bladder to be explored using a cystoscope. A sample of tissue fragment is usually taken.
- microscopic examination tissue removed, to confirm the diagnosis and establish the grade (degree of malignancy) of the cancer and its stage (degree of extension of the disease).
- intravenous urographywhich helps identify any abnormalities in the urinary tract.
What is the treatment for bladder cancer?
“Bladder cancer treatments have three goals: to suppress the tumor and any metastasis, to reduce the risk of recurrence and to treat the symptoms.“says Dr. Adriana Perez. There are three treatments for bladder cancer, depending on its location and stage.
► Surgery. Its purpose is to remove the tumour, in order to limit the progression of the disease and reduce the risk of recurrence. Two types of surgery exist depending on the case:
- Transurethral resection of the bladder (TURB) for superficial tumors.
- Removal of part of the bladder (partial cystectomy) or the entire bladder (total cystectomy)
► Radiation therapy may be indicated to destroy the tumour. It is generally associated with chemotherapy and is then referred to as concomitant radio-chemotherapy. It can also be performed alone, in case of contraindication to chemotherapy. Radiation therapy can also be used to relieve pain or control symptoms due to bleeding.
► Chemotherapy acts on the whole body and allows cancer cells to be destroyed even at a distance from the initial tumour, in the case of metastases.
Prevention: how to avoid bladder cancer?
The main prevention measure for bladder cancer is to NO SMOKING. People regularly exposed to hazardous chemicals should undergo regular monitoring. A urinalysis is necessary every year in order to detect the possible presence of blood in the urine, together with a more complete health check-up.
Thank you to Dr. Adriana Perez, oncologist at the High Energy Radiotherapy Institute in Bobigny.
Source: “As misunderstood as it is devastating, bladder cancer is campaigning to prevent”, press release from the French Association of Urology, May 2023