Bladder cancer is the 7th most common tumour in men. Its incidence in Europe is 19.1 and 4.0 per 100,000 person-years in men and women, respectively, and its risk increases rapidly with age.
The most common way it presents is with haematuria (blood in the urine), although it may present with persistent, irritable urinary discomfort, which can sometimes be confused with infections and cystitis, delaying the diagnosis of the tumour. In the presence of these symptoms, it is worthwhile to be suspicious and actively investigate the possibility of a urinary tract tumour.
Tobacco represents the greatest risk factor associated with bladder cancer, responsible for approximately 50% of cases. Industrial exposure to enamels, dyes, heavy metals and hydrocarbons (aromatic amines, polycyclic aromatic hydrocarbons and chlorinated hydrocarbons) is responsible for 10% of these tumours, representing the second greatest risk factor, although this has been decreasing with safety improvements in today's industries.
Smoking accounts for 47% of all cases of bladder cancer
The average age of patients who develop bladder cancer is 73 years
Diagnosis is carried out systematically via ultrasound or intravenous urography (IVU), cystoscopy and urine cytology. However, a definitive diagnosis is only possible with a cystoscopy, a resection of the tumour and an anatomopathological report, which provides information on the type of tumour, its grade and the extent of depth it has intruded into the bladder wall. Current imaging techniques available at the IVO, such as the STORZ SPIES imaging system, have improved the imaging, and therefore the diagnosis of these tumours.
According to the depth, tumours are classified as non-muscle invasive bladder cancer (NMIBC) or superficial, which account for approximately 75% at diagnosis, and muscle invasive bladder cancer (MIBC), representing 25% of cases.
After resection and diagnosis by the pathologist, superficial tumours may be followed up endoscopically, according to their risk of recurrence. Multiple, large, and recurrent tumours (those that have come back) may benefit from adjuvant treatment with intravesical Mitomycin or Epirubicin. High-grade tumours are treated with intravesical immunotherapy (BCG) to reduce the risk of recurrence and progression. The IVO works with a strict intravesical adjuvant protocol that, in addition to standard treatments, also includes innovative instillation systems such as hyperthermia and electromotive drug administration (EMDA), which improve the administration of these drugs.
When tumours are invasive (MIBC), the standard treatment is radical surgery, which can be performed with either open or laparoscopic approaches and with the latest reconstruction techniques. At the IVO, in very select cases, a conservative approach can also be considered, with bladder preservation, as an alternative to a radical cystectomy.
At the IVO, we have specialised professionals with extensive experience in the treatment of this type of cancer. Even in advanced cases, when the disease has spread outside the bladder, palliative treatment is still possible. The management of these patients requires a multidisciplinary approach involving urology, medical oncology, radiology and, occasionally, radiation oncology, palliative medicine and home care.
The Urology Service offers alternatives for the prevention, diagnosis and treatment of urological tumours
The Service's team of professionals accompanies cancer patients throughout the whole disease process.
A clinical trial is a research study carried out on people with the aim of learning more about how the body reacts to certain treatments. These trials generally seek to find drugs that are more effective than the current best therapeutic option for patients, or that have similar efficacy but a better toxicity profile.
Bearing in mind that almost all currently available treatments are the result of clinical research, the importance of clinical trials is obvious.
The IVO has a clinical trials unit for all types of tumours and participates in phase 1-3 studies as well as other types of studies.
Whether you receive the news of an initial diagnosis of cancer or a relapse, coping with cancer can be emotionally overwhelming. Each person has their own way of coping with a bladder cancer diagnosis, but there are some recommendations that can help you through this process: