Bladder cancer is highly treatable, especially when detected early. Approaches to bladder cancer treatment include chemotherapy, biological therapy, radiation therapy and a number of options for bladder cancer surgery. The best treatment is determined by the individual and the nature of his or her cancer.
Epidemiology
Epidemiology is the characterization of a disease as it affects populations. It identifies those who may be susceptible and the risk factors that influence the disease’s occurrence. The incidence has already been noted. Risk factors include age, race, gender, family medical history, personal medical history, environmental factors and smoking. Of all these, smoking poses the greatest risk for bladder cancer.
Age is a factor. The cancer is relatively rare in people under age 40 (less than 1% of cancers) but appears more frequently in those 60 and older. Most bladder cancers are diagnosed in people in their late 60s. Whites are 1.5 times more likely to develop the cancer than other races. Asians are at the least risk. Men are more than twice as likely as women to develop bladder cancer. People whose families have a history of bladder cancer are at greater risk. These people do not inherit bladder cancer. Rather they inherit a certain susceptibility to the disease.
Chronic urinary infection, kidney and bladder stones, and chronic bladder infections tend to raise the risk of bladder cancer. Environmental factors, such as arsenic in drinking water, and chemicals involved in specific occupations increase risks. The cancer is seen more frequently in hairdressers, machinists, printers, painters, truck drivers and people who work in rubber, chemical, textile, metal and leather industries. The Chinese herb Aristolochia fangchi contained in some diet pills has been tied to both kidney failure and bladder cancers.
Smoking creates the greatest risk for bladder cancer. The National Cancer Institute estimates that smoking may be responsible for 48% of bladder cancer deaths among men and 28% of such deaths among women.
Anatomy
The urinary tract consists of two kidneys, two ureters which drain urine from the kidneys into the bladder for storage, and the urethra which drains the bladder. The bladder is surrounded by lymph nodes, small specialized organs which feed cells with immune system functions into the blood stream. In women, the uterus lies just behind the bladder. In men, the prostate lies at the base of the bladder.
All these organs can be affected by bladder cancer and some of the therapy and surgery employed to treat it. The bladder wall is made of four layers: the inner layer (mucosa), a basement membrane or layer of connective tissue (lamina propria), a wall of muscle (detrussor muscle), and an outer layer of perivesicle fat (serosa).
