life expectancy, symptoms, what is it?

Bladder cancer is approximately 4 times more common in men than in women. It is the 7th most common cancer in France and the 2nd urological cancer after that of the prostate. It affects 13,000 to 20,000 new people each year in France.

What is bladder cancer?

Bladder cancer most often develops from the lining of the bladder, on the urothelial epithelium, hence the name urothelial carcinoma which is also given to it. There are two types of bladder cancer:

• superficial, that is to say limited to the mucous membrane of the bladder,
• invasive, reaching a deeper tissue layer of the bladder called muscularis. This is more violent and requires much heavier treatment.

Stage is how serious the cancer is based on the size of the initial tumor and its spread. Doctors use the so-called “TNM” classification, T relating to 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 blood in the urine (hematuria), which may be pink or dark red depending on the intensity of the bleeding.“explains Dr. Adriana Perez, oncologist at the High Energy Radiotherapy Institute of Bobigny. Macroscopic hematuria (visible to the naked eye) reveals bladder cancer in 80% of cases. “Other symptoms that can alert you range from urinary burning to lower back pain, recurrent urinary infections or bladder spasms.“, specifies Dr. Perez.

What is the life expectancy with bladder cancer?

When bladder cancer is caught early, 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 must be monitored regularly throughout their lives.

What causes bladder cancer?

As with the majority of cancers, it is difficult to determine the causes of bladder cancer. However, we can identify the main risk factors. The first culprit is, as is often the case, smoking, which is responsible for 30 to 40% of bladder cancers. Prolonged exposure to certain substances in the context of professional activity (textiles, dyes, paints, rubber, etc.) would also be implicated in its occurrence. Certain chemotherapies used to treat another cancer can increase the risk of later developing bladder cancer.

There is no systematic screening for bladder cancer. In case of suspicion, the first test suggested by the doctor is a urine analysis. If abnormal cells are detected, cancer is proven but it is essential to locate the tumor which can be found at any level of the urinary tract, from the kidneys to the urethra. Three examinations are then possible:

• cystoscopy, which allows you to explore the bladder using a cystoscope. A sample of a tissue fragment is generally taken.
• the microscopic examination of the tissues taken, to confirm the diagnosis and establish the grade (degree of malignancy) of the cancer and its stage (degree of extension of the disease).
• intravenous urography, which helps identify possible abnormalities in the urinary tract.

What is the treatment for bladder cancer?

“Treatments for bladder cancer have three goals: to remove the tumor and possible metastases, to reduce the risk of recurrence and to treat the symptoms.” explains Dr. Adriana Perez. There are three treatments for bladder cancer, depending on its location and stage.

► Surgery. Its goal is to remove the tumor, 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 (TURBT) for superficial tumors.
• Excision of part of the bladder (partial cystectomy) or the entire bladder (total cystectomy)

► Radiotherapy may be indicated to destroy the tumor. It is generally associated with chemotherapy and we then speak of concomitant radiochemotherapy. It can also be performed alone, in the event of a contraindication to chemotherapy. Radiotherapy can also be used to relieve pain or to control symptoms caused by bleeding.

► Chemotherapy acts on the entire body and destroys cancer cells even far from the initial tumor, in the case of metastases.

Prevention: how to avoid bladder cancer?

The main preventive measure for bladder cancer is not smoking. People regularly exposed to dangerous chemicals will need regular monitoring. A urine analysis is required every year to detect the possible presence of blood in the urine, accompanied by a more complete health check-up.

Thanks to Dr Adriana Perez, oncologist at the High Energy Radiotherapy Institute of Bobigny.