Bladder cancer

What is bladder cancer?

Fortunately, most of these tumors (around 75% of cases) are diagnosed at a non-muscle-invasive stage, i.e. when the root has not yet reached the bladder muscle, called the detrusor muscle. However, one of the main problems of this cancer is its high rate of recurrence and progression. In other words, the tumor tends to recur and, in some of these relapses, it can invade the muscle.

For this reason, it is important to carry out periodic check-ups to rule out its reappearance, even after having undergone intravesical lavage treatments with chemotherapy instillations or BCG (bacillus Calmette-Guérin) immunotherapy through a catheter.

Bladder cancer is a disease originating in the layer that lines the inside of the bladder, a layer that is also found in the ureters and reaches the kidneys. Therefore, it is also necessary to periodically check the upper urinary tract - from the bladder to the kidneys - for relapses or the appearance of new tumors in this area.

About the bladder

The urinary bladder is a hollow muscular organ responsible for storing urine for later emptying. Urine is produced in the kidneys and reaches the bladder through ducts called ureters. Once stored in the bladder, the bladder muscle or detrusor muscle - a layer of muscle that forms part of the wall of the urinary bladder - contracts and causes the urine to be expelled through the urethra.

Inside, the bladder has a thin layer that covers it on the inside: the urothelium. Immediately after the urothelium is the lamina propria, a tissue that is surrounded by the bladder muscle, covered in turn by fat and by a membrane on its surface called the peritoneum.

How does bladder cancer form?

Cancer is characterized by the development of abnormal cells that divide, grow and spread uncontrollably. Normal cells divide and die during a programmed period of time. However, cancer cells lose the ability to die and divide uncontrollably. This multiplication of cells eventually forms masses called tumors.

In bladder cancer, the transformation from normal to cancerous cells usually originates in the urothelium. Fortunately, in most cases it is diagnosed before the roots of the tumor penetrate the urothelium and the next layer, the lamina propria, and therefore have not invaded the muscularis layer. These are the so-called non-muscle-infiltrating bladder tumors. They are malignant tumors, but their location gives them the characteristic of being non-invasive, that is, they have not spread to the muscular layer.

Tumors that invade the muscular layer, called muscle-infiltrating tumors, represent a higher risk and have fewer and more aggressive therapeutic options.

A cancer is said to be recurrent when it reappears after treatment. The recurrence or recurrence can be local, located where it started or near this area, or at a distance in the form of metastasis, spread to other organs or bones.