There are more than 3000 deaths from bladder cancer each year in the UK, mainly in people aged over 55. It's rare in people under 40 and Caucasian (white) people are significantly more at risk than those of African or Asian origin. Although the death rate amongst women has remained the same for a long time, the death rate amongst men is slowly dropping. Research has identified some possible causes but the major risk factor in the UK is cigarette smoking, causing 50% of cases in men and 30% in women. Cigarette smoke contains chemicals known to be carcinogenic with increasing risk the more cigarettes are smoked. Workplace chemicals and prolonged exposure to them are the other main cause of bladder cancer, for example, those used in dye factories, rubber, gasworks, plastics and other chemical industries. These chemicals were banned in the UK in 1967. However, it can take about 25 years after exposure to the chemicals for bladder cancers to develop. If you think that you were exposed to certain chemicals through your work, let your cancer doctor know. You may be able to claim Industrial Disease Benefit from the Department of Social Security.
In parts of the world where bilharzia (a chronic parasitic infection of the bladder) is common, there are many cases of cancer of the bladder. This infection does not occur in the UK, but can affect people who have lived in Africa, and such countries as Iraq or Egypt where it is associated with an infection of the bladder called schistomiasis, which is endemic in those countries.
What is Bladder Cancer?
Bladder cancer is more common than people realise. Over 10,000 cases are diagnosed each year in the UK. The majority of these (about 7,500) are diagnosed in men, meaning that, on average, one man in thirty will get bladder cancer at some time in his life. Bladder cancer occurs most commonly in people between 50 and 70 years of age. It is twice as common in men as in women. Bladder cancer is very rare in men and women younger than 40 years of age.
The most common symptom is blood in the urine, although there are many other conditions (such as bladder infections) which can cause this. The other less common symptoms (frequency of urination and pain when urinating) can also have other causes.
Read more about treatment for Bladder Cancer
The bladder is a hollow, muscular, balloon-like organ that collects and stores urine. It is in the lower part of the abdomen (the pelvis). Urine consists of water and waste products not needed by the body. The bladder is lined with a urine-proof membrane which stops the urine being absorbed back into the body. The cells of this membrane are called transitional cells or urothelial cells, and the lining membrane is called the urothelium.
The two kidneys produce urine, which is carried to the bladder by two tubes called ureters. The bladder stores the urine, and when it is full enough, nerve signals are sent to the brain. To get rid of the urine, the muscle of the bladder contracts, forcing the urine out of the body through a tube called the urethra.
- In women, the urethra is a very short tube in front of the vagina.
- In men the tube is longer and passes through the prostate gland and the penis.
Bladder cancer spreads by extending into the nearby organs, including the prostate, uterus, vagina, ureters, and rectum. It can also spread to the pelvic lymph nodes or to other parts of the body, such as the liver, lungs and bones.
If a patient shows symptoms that suggest bladder cancer, the doctor may check general signs of health and may then order lab tests and one or more of the following procedures:
- Physical exam: The doctor feels the abdomen and pelvis for tumours. The physical exam may include a rectal or vaginal exam.
- Urine tests: The laboratory checks the urine for blood, cancer cells and other signs of disease.
- Cytoscopy: The doctor inserts a thin, lighted tube, called a cystoscope (a tube with a small camera on the end), through the urethra and into the bladder to examine the lining. The patient usually does not need anaesthesia for this procedure.
- Intravenous pyelogram (IVP): An iodine-based contrast dye is injected into a vein and then a series of x-ray type images are taken at timed intervals. As the kidneys are responsible for removing contrast dye from the blood, it then collects in the urine in the bladder and shows up on the x-ray. This test is designed to study the kidneys, bladder, and ureters (the tubes which carry urine from the kidneys to the bladder). Abnormalities in the appearance of the kidneys or ureters, abnormalities in the distribution of contrast within a kidney, unequal amounts of dye in each kidney, or abnormalities in the collecting systems can be identified. These all suggest particular diseases and conditions.