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Symptoms and treatment for bladder cancer

Bladder cancer begins in the bladder, a central organ in the urinary system. The National Cancer Institute reports that 14,880 people will die from bladder cancer and 73,510 new cases of the disease will be diagnosed this year.

Causes
"The initial step in all cancer development is damage to cellular DNA, specifically in genes that regulate growth," says Michael A. Smith, a doctor with Life Extension of Fort Lauderdale, Fla.

The kidneys filter carcinogens (a substance that causes cancer) out of the body. The Official Foundation of the American Urological Association reports that before removal via urination, these carcinogens can rest in the bladder for several hours. The carcinogens damage the urothelium (the bladder's lining), which is where over 90 percent of all bladder cancers begin.

Most bladder tumors are found in the urothelium or the lamina propria, connective tissue between the lining and bladder muscle.

Experts estimate that cigarette smoking accounts for approximately 50 percent of all bladder cancer instances in the United States. Long-term exposure to chemical compounds (paints, solvents) is responsible for 20 to 25 percent of bladder cancer.

Caucasians and men are more likely to develop bladder cancer than other ethnic groups and women.

Symptoms
Hematuria, blood in the urine, is the main symptom of bladder cancer, according to the American Bladder Cancer Society. Other common warnings signs include dysuria (painful urination), lower back pain, recurrent urinary tract infections and overactive bladder.

Diagnosis
Doctors use several tests to diagnose bladder cancer. Urine cytology, cystoscopy, transurethral resection of bladder tumor (TURBT) and imaging tests are common methods, reports the Mayo Clinic.

A urine cytology is the analysis of a urine sample to detect possible cancer cells.

A cystoscopy entails inserting a cystoscope, a type of narrow tube with a lens and lighting system, into the urethra. The doctor can assess the inside of the bladder and urethra.

Imaging test (CT scans, X-rays, MRIs) are used to analyze the urinary tract. After the confirmation of bladder cancer, these may be used to understand the stage of the cancer's development.

There are four stages of bladder cancer, depending on the location to which the cancer has spread: only in the urothelium, inside the bladder wall, nearby tissue--prostate or vagina/uterus, and expanded into lymph nodes and beyond.

Yair Lotan, an associate professor of urology at UT Southwestern Medical Center, says  newly diagnosed individuals should "get an initial transurethral resection to stage the tumor. Treatments depend on the depth of penetration of the tumor and grade of the tumor."

Treatment
The Bladder Cancer Advocacy Network reports that different treatments should be applied for bladder cancers of various grades at differing stages.

Cystectomy is a surgery that removes the entire bladder, which necessitates another surgery to create a new path for the body to remove urine.

More threatening, but still non-invasive, tumors, require more extreme therapies, such as immunotherapy, a biological therapy that mobilizes the body's immune system against the cancer.

Smith called attention to a new treatment called photodynamic therapy, which uses a drug and a certain type of laser light to kill cancer cells, which minimizes damage to healthy cells.

Finally, doctors may use chemotherapy when bladder cancer invades the nearby lymph nodes (tiny glands that stores white blood cells).