Bladder
Cancer. Two words that deliver a devastating impact. Every year, over
570,000 people are diagnosed with bladder cancer and 1.7m people find
themselves living with the condition. It is the 10th most commonly diagnosed cancer and the 13th
cause of death from cancer globally. But, a timely diagnosis offers a
significant increase in the chance of long-term survival and quality of
life. Blood in the urine is the most important warning sign of bladder
cancer to watch out for. Yet bladder cancer is the forgotten cancer, and it should not be. We
need to unite and raise our voices for people affected by bladder
cancer. World Bladder Cancer Awareness month in May 2023 is a chance for
us to do exactly that !
🔺 About 2023 theme :
We are thrilled to announce our new, evolved campaign theme for this year:
‘Feeling unsure? Get checked.’
One of the main barriers in timely
diagnosis of bladder cancer are related to the symptoms. Both, symptoms
and the way in which people respond to them can vary, especially as some
of the symptoms are not immediately seen as linked to bladder cancer.
The discovery of blood in the urine, painful urination, and irregular
urination can all be mistaken for other conditions, causing bladder
cancer to be overlooked.
Our campaign aims to bring attention to the
misrepresentation of symptoms and encourage people to re-evaluate their
symptoms, as what they thought they saw may actually be something
different.
During Bladder Cancer Awareness Month 2023,
our goal is to spark conversations that raise awareness about the
disease by highlighting the symptoms of bladder cancer and overcoming
any barriers to seeking medical advice.
The key element of our 2023 campaign is the
“unsure icon”, reflecting the uncertainty around bladder cancer and its
timely diagnosis.
🔺 Our Involvement :
There are a number of different ways that you can participate in and support the bladder cancer awareness month campaign and help us raise awareness about bladder cancer. Whether you represent a national organisation, a smaller group, or are an individual – we need all hands on deck!
* Explore the campaign toolkit to discover the campaign and how we can contribute in our communities
* Reading and sharing our infographics
* Signing up for our monthly newsletter
* Sharing the symptom awareness video
* Following and sharing the content on social media
We all have a role to play in raising awareness about bladder cancer and whether you do it in-person or online,
🔺 Bladder Cancer :
Bladder cancer is the second most common urologic cancer in adults. There are 67,000 new cases of bladder cancer each year in the United States.
Bladder cancer tends to occur most commonly in individuals over the age of 60 and is about 2 to 3 times more common in men than in women. Cigarette smoking and exposure to certain industrial chemicals (derivatives of compounds called arylamines and petrochemicals) are strongly associated with the development of bladder cancer.
Transitional cell carcinoma, also known as urothelial carcinoma, is the most common type of bladder cancer. Transitional cell bladder cancer may present in several different forms, including :-
* Carcinoma in situ (CIS)
* Papillary carcinoma
* Sessile carcinoma
The depth of invasion, involvement of the bladder muscle and invasion into the lymphovascular spaces determine the risk, prognosis and treatment. Bladder cancer can be classified into two broad categories – non-muscle invasive and muscle invasive urothelial carcinoma.
🔹 Non-muscle Invasive Bladder Cancer :-
At the initial diagnosis, approximately 70% of patients with TCC have non-muscle invasive papillary cancers, but 50-70% of these patients have a recurrence within 5 years of treatment. Ten to twenty percent of superficial lesions progress to deep muscle invasive disease. Papillary tumors respond well to conservative treatment and are easily removed endoscopically (through a camera without a surgical incision). The rate of recurrence is approximately 70%; therefore additional treatment to prevent recurrence is usually prescribed in the form of intra-vesical therapy (placed directly into the bladder) and follow-up examinations are important. CIS tends to cause symptoms more frequently and may signal biologically aggressive disease. The risk of progression is 4-8% with some patients having a more rapid progression than papillary tumors. The overall 5-year survival for patients with non-muscle invasive and localized bladder cancer is greater than 92%.
🔹 Muscle-Invasive and Advanced Bladder Cancer :-
Between 20 and 25% of new cases of bladder cancer are muscle-invasive. Muscle-invasive bladder cancer is more aggressive than non-invasive disease, and approximately 50% of patients with muscle invasive disease will experience distant recurrence following therapy. Survival depends on disease stage and treatment; for organ-confined disease treated with surgery and in cases responsive to chemotherapy before cystectomy, 5-year survival is 85%. Common sites of metastasis include regional lymph nodes, bone, liver and lung. Survival decreases with more advanced disease. Five-year survival is approximately 50% in regionally advanced (lymph node positive) bladder cancer and <10% in the presence of distant metastases.
🔺 Signs & Symptoms :
🔹 Hematuria -
* Visible
* Microscopic
🔹 Irritative Urination Symptoms -
* Pain
* Burning
* Frequency
* Incomplete emptying
For the majority of people, the first symptom of bladder cancer is blood in the urine called hematuria. Hematuria is either gross (viewable with the naked eye) or microscopic.
Irritative urination symptoms may also be associated with bladder cancer and include pain and burning on urination, frequency, and incomplete emptying of the bladder.
🔺 Diagnosis :
* Cystoscopy
* Biopsy
* Intravenous pyleogram (IVP)
* Transurethral resection(TUR)
* Urine testing/cytology
After taking a detailed medical history, the urologist will examine a urine specimen and check for evidence of blood and signs of infection.
The gold standard for the evaluation of the lower urinary tract is direct visual examination with a specialized instrument call a cystoscope. A cystoscope is a small camera inserted into the bladder. The purpose of routine outpatient cystoscopy is to evaluate the lining of the bladder and the urethra, the channel where urine passes out of the bladder and then exits the body. If abnormalities such as tumors or patches of abnormal-appearing tissue are discovered during cystoscopy, a biopsy or a sample of tissue may be taken at that time to determine the presence of cancer.
Because transitional cell carcinoma can also occur in the lining of the ureters and kidneys, routine surveillance of the upper tracks is also important following a diagnosis of bladder cancer. Several tests can be used to evaluate the upper tracks, including IVP and CT scan. An IVP is a conventional X-ray test using dye to examine the kidneys and ureters, tubes that transport urine from the kidneys to the bladder. This x-ray will look at the collecting system of the kidneys to determine the presence of an abnormality. A CT scan (Computed Axial Tomographic Scanning) and an MRI (Magnetic Resonance Imaging) are two tests which may be ordered in addition to the IVP to give the urologist further information needed.
Urine specimens will also be examined for abnormal cells. High grade tumors readily shed tumors cells into the voided urine allowing for pathologic examination of the urine specimen (cytology) for the presence of tumor cells.
🔺 Staging for Bladder Cancer :
Clinical staging is performed with transurethral resection (TUR), CT scan, and exam under anesthesia (EUA). EUA allows the surgeon to manually assess the bladder after TUR for the presence of tumor.
Prognosis of bladder cancer is directly linked to the stage of the bladder cancer. Staging is a process that demonstrates how far the cancer has spread. The treatment and prognosis or outlook for bladder cancer will depend significantly on its stage.
TNM System Stands for Tumor, Lymph Nodes and Metastasis.
🔺 Treatment :
The majority of bladder cancers arise from the lining of the bladder
(non-invasive tumors). Treatment for non-muscle-invasive bladder cancer
can include:
- Cystoscopy with cautery destruction of the tumor
- Intra-vesical drug therapy
- TUR (Trans-Urethral Resection)
Most modern cystoscopes are equipped with channels that permit small
instruments to be passed into the bladder for the purpose of removing
tissue, stopping bleeding with a special electrical device called an
electro cautery or even performing laser treatment. If the bladder
cancer is small enough this cautery may be used to remove the cancer.
Intra-vesical therapy is the use of one of several different types of
medical therapies placed directly into the bladder through a urethral
catheter. Therapies consist of drugs placed in the bladder in an attempt
to minimize the risk of tumor recurrence and progression. These drugs
come from a wide variety of sources. About 50-68% of patients with
superficial bladder cancer have a very good response to intra-vesical
therapy. The most commonly used intra-vesical is Bacille Calmette-Guerin
(BCG), which is administered once a week for 6 straight weeks. BCG is a
weaken tuberculosis (TB) bacterium. Maintenance therapy (repeated
therapy on a regular basis) with BCG or another drug administered
intermittently following initial diagnosis and treatment of superficial
bladder tumor decreases the likelihood of recurrence.
A Trans-urethral resection is a procedure performed through the
cystoscope whereby the tumor is resected without making a visible
incision on the body. A small T.V. camera is inserted into the bladder
to visualize the bladder. The entire removal of a bladder tumor can be
accomplished through this operative cystoscope.
Drug therapy after TUR is commonly prescribed for patients with tumors that are large, multiple or high-grade.
The biopsy specimen or TUR specimen is sent to the pathologist who
will evaluate the specimen for the presence, extent, and aggressiveness
of cancerous cells. Surveillance is required after diagnosis for bladder
cancer. Patients are generally monitored every 3 months for the first
year or two, then every 6 months for a year or two, and once a year
thereafter with a cystoscopy and a urine test for cancer (called urine
cytology).
Invasive bladder cancer is cancer that has invaded into the bladder
wall or outside the bladder. Invasive bladder cancer treatment options
are drastically different than those for superficial bladder cancer.
🔺 Invasive Bladder Cancer Treatment Options :
- Cystectomy with urinary diversion - In men, the bladder and prostate
are identified and dissected and removed. In women, the bladder,
uterus, fallopian tubes, ovaries and anterior portion of the vagina are
identified and dissected and removed. Surrounding lymph nodes are
removed to assess the extent or spread of the cancer. Next, one of
several reconstruction options are available to replace the removed
bladder
- Chemotherapy - Chemotherapy is a systemic treatment (i.e., drug that
is dispersed throughout the entire body) that is designed to kill
cancer cells. Typically, it is administered intravenously (through a
vein). The chemotherapy may be administered before surgery (neoadjuvant
therapy), after surgery (adjuvant therapy) or in the setting of
advanced disease. On the other hand in patients with non-invasive
bladder cancer, chemotherapy may be infused into the bladder through the
urethra (called intravesical chemotherapy) in hopes of reducing
recurrence and progression of disease.
- Radiation therapy with chemotherapy - Radiation uses high-energy
x-rays to destroy cancer cells. The addition of systemic chemotherapy
renders cancer cells more susceptible to the killing effects of
radiation. Radiation therapy is also used to relieve symptoms (called
palliative treatment) of advanced bladder.
FAQs : Bladder Cancer Awareness
Month 2023
1. Is there a bladder cancer awareness month?
Ans:- May is Bladder Cancer Awareness Month.
2. When is bladder cancer awareness day?
Ans:- Bladder Cancer Awareness Day is observed annually on May 7. On the day, awareness programs are organized to educate the public about the symptoms, causes, and treatment of this type of cancer.
3. What is the theme for bladder cancer awareness Month 2023?
Ans:- The theme for Bladder Cancer Awareness Month 2023 is "Prevention and Early Detection." This theme emphasizes the importance of taking steps to prevent bladder cancer and to get awareness of the early signs and symptoms of the disease.
4. When is World Bladder Cancer awareness Month in 2023?
Ans:- We need to unite and raise our voices for people affected by bladder cancer. World Bladder Cancer Awareness month in May 2023 is a chance for us to do exactly that !
5. When is the bladder cancer awareness month in India?
Ans:- Bladder Cancer Awareness Month is observed in May every year.
6. What's the key element of 2023 ?
Ans:- The key element of our 2023 campaign is the “unsure icon”, reflecting the uncertainty around bladder cancer and its timely diagnosis.
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