Bladder%20cancer Signs and Symptoms

Signs and Symptoms

Introduction

Bladder cancer is an uncontrollable growth of cancer cells in the hollow organs of the pelvis which is the bladder
Most common cancer involving the urinary system and it is the 10th most commonly diagnosed in the world
- It is the 6th common cancer in US, 11th in UK and 14th in Asia
- It is the 9th most common cancer in men in Malaysia, and 10th most common cancer in men in Singapore
The predominant histologic type of bladder cancer is the urothelial (transitional cell) carcinoma
- Less common histologic types include squamous cell carcinoma and adenocarcinoma
It is 3-4 times prevalent in men than in women
- Bladder cancer is the 7th most common cancer in men and the 17th most common cancer in women
- But women present with more advanced disease and have worse survival

Signs and Symptoms

Microscopic or gross, painless hematuria is the most common presenting complaint
- Gross hematuria is associated with higher disease stage than microscopic hematuria
Urinary frequency from irritation or a reduced bladder capacity can also develop
- Carcinoma in situ (CIS) may be suspected in patients with lower urinary tract symptoms (eg irritative voiding)
Dysuria and urgency are other complaints
Less commonly, a urinary tract infection (UTI) is the presenting symptom
Upper tract obstruction or pain may occur in more advanced tumors

Risk Factors

Active and passive tobacco smoking is the most important risk factor for bladder cancer
- Tobacco smoke contains aromatic amines and polycyclic aromatic hydrocarbons that are renally excreted

Occupational exposure to aromatic amines, polycyclic aromatic hydrocarbons and chlorinated hydrocarbons is the second most important risk factor for bladder cancer
- Occurs mainly in industrial plants processing paint, dye, metal and petroleum products

Increasing age
- Mean age of diagnosis is 73 years old

Exposure to ionizing radiation is connected with increased risk
- There is an increased risk of developing bladder cancer in patients undergoing external-beam radiotherapy, brachytherapy or a combination

Bladder schistosomiasis (Schistosoma haematobium)
- Well-established relationship relationship with squamous cell carcinoma of the bladder

Genetic predisposition
- Has shown to influence the incidence of bladder cancer through its impact on the susceptibility to other risk factors
- Increased risk for 1st- and 2nd-degree relatives
- Inherited mutations in carcinogen-detoxification genes such as N-acetyltransferase 2 (NAT2) and glutathione S-transferase mu 1 (GSTM1) are associated with susceptibility to bladder cancer

Tumour-treating fields – a versatile treatment modality for multiple cancer types

Dr. Uri Weinberg, Dr. David Tran, Prof. Thomas Seufferlein, 13 Dec 2021

Tumour-treating fields (TTFields) are a noninvasive cancer treatment modality, which first demonstrated clinical benefits in combination with chemotherapy in glioblastoma multiforme (GBM). At a webinar organized by the Hong Kong Cancer Therapy Society (HKCTS), experts discussed TTFields’ potential in other cancer types, including hepatocellular carcinoma (HCC) and pancreatic cancer, and the rationale for combining TTFields with immunotherapy.

Adding an androgen-receptor inhibitor to docetaxel and ADT in patients with mHSPC

Dr. Adrian Tse, 13 Dec 2023

A 68-year-old male patient presented with bone pain at multiple sites in November 2022. He did not have any other symptoms. He had hypertension and type 2 diabetes mellitus (T2DM), which were well controlled with amlodipine besylate 5 mg BID and metformin 1 g BID, respectively. He was generally well and had a baseline Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0.

Use of a novel erythroid maturation agent in transfusion-dependent β-thalassaemia

Dr. Gloria Yu-Yan Hwang, 28 Apr 2023

A 45-year-old female, diagnosed in infancy with transfusion-dependent β-thalassaemia (TDT) major of β⁰/β⁰genotype, presented with a liver abscess in December 2019. She was admitted to hospital multiple times for repeated drainage of the abscess, which was caused by Klebsiella, and required several prolonged courses of antibiotic treatment. The patient was on a regular transfusion schedule of 3 red blood cell (RBC) units every 4 weeks in addition to iron chelator therapy with intravenous (IV) deferoxamine and oral deferasirox.