Dr. Rajkumar Singh
Bladder cancer is a common type of cancer that originates in the tissues of the urinary bladder, a hollow organ in the lower abdomen that stores urine.Most bladder cancers begin in the urothelium-the inner lining of the bladder. This lining comes into contact with urine and can be damaged by harmful substances excreted in it. Its overview include: a. Types of bladder cancer: Urothelial carcinoma (Transitional cell carcinoma) – most common (~90% of cases), squamous cell carcinoma – linked to chronic irritation (e.g., infections, catheters), and adenocarcinoma – very rare; originates in mucus-secreting glands. b. Causes and Risk Factors: Smoking – Major risk factor; smokers are 3x more likely to develop it. Exposure to chemicals – Especially in dye, rubber, leather, paint, and textile industries. Radiation therapy – Previous radiation to the pelvis.Chronic bladder irritation – Infections, long-term catheter use, bladder stones. Certain medications – Such as cyclophosphamide and arsenic in drinking water. Age & Gender – More common in people over 55; men are more at risk. Family history or genetic mutations – Though not very common. c. Symptoms of Bladder Cancer: Early symptoms: Hematuria – Blood in urine (most common symptom); may be visible or microscopic, frequent urination, urgency to urinate, and pain or burning while urinating. Advanced symptoms: Pelvic or back pain, weight loss, swelling in the legs, and bone pain (if cancer has spread). d. Diagnosis: Urinalysis – To detect blood or cancer cells. Cystoscopy – Visual inspection of bladder with a scope. Biopsy – Tissue sample taken during cystoscopy. Imaging – CT scan, MRI, or ultrasound to see the extent of spread. e. Stages of Bladder Cancer: Non-muscle-invasive – Limited to the inner layers; less aggressive .Muscle-invasive – Deeper into bladder muscle; more serious. Metastatic – Spread to distant organs. f. Treatment Options: Surgery – TURBT (for early cases), or partial/total bladder removal. Intravesical therapy – Medications (like BCG) placed directly into the bladder. Chemotherapy, radiation therapy, immunotherapy, and targeted therapy (in select cases)
Diet and precautions
There is a helpful guide on diet and precautions for someone dealing with or recovering from bladder cancer-whether during treatment, post-treatment, or as part of prevention. In the context, there’s no single “bladder cancer diet,” but eating for immune support, healing, and inflammation control is key. Recommended Foods Include: a. High in Antioxidants : These help fight free radicals that damage cells. Berries (blueberries, strawberries), leafy greens (spinach, kale), broccoli, cauliflower, Brussels sprouts (cruciferous veggies), and tomatoes (rich in lycopene) b. Rich in Fiber: Helps digestion and overall health. Whole grains (brown rice, oats, quinoa), beans and lentils, and fresh fruits and vegetables. c. Lean Proteins: Supports tissue repair and immunity.Fish (especially fatty fish like salmon), skinless chicken., tofu, tempeh, and eggs. d. Fluids: Stay hydrated to flush out toxins and reduce bladder irritation. Water (mainly), coconut water, and fresh fruit juices (diluted, low sugar). e. Anti-inflammatory Foods: Turmeric (curcumin), ginger, olive oil, and green tea (mild and in moderation). Precautions for Bladder Cancer Patients: Avoid Smoking: Smoking is the top cause and recurrence factor for bladder cancer. Limit Chemical Exposure: Avoid dyes, pesticides, or industrial chemicals if possible. Use gloves and ventilation if you work with such substances. Routine Check-ups: Regular cystoscopy or scans as per doctor’s schedule. Watch for Symptoms: Report any new urinary issues, pain, or visible blood in urine. Physical Activity: Light to moderate exercise improves immunity and energy. Walking, yoga, or tai chi are gentle yet effective. Support Immune Health: Manage stress, sleep well, and consider gentle supplements only if approved by your doctor (like Vitamin D or probiotics). Optional Natural Support (With Doctor’s OK): Turmeric (curcumin) – Anti-inflammatory; may help with cancer prevention. Green tea extract – Antioxidants, though best in moderation. Mushroom extracts (Reishi, Shiitake) – Immune-boosting properties.
Advancements and future treatment
There are the latest advancements in bladder cancer treatment (as of 2024-2025), which are transforming how the disease is managed-especially in advanced or recurrent cases which include: a. Immunotherapy: Immune Checkpoint Inhibitors (ICIs): Drugs like Atezolizumab, Nivolumab, Durvalumab, and Pembrolizumab are being used to help the immune system target cancer cells.Especially beneficial for advanced or metastatic bladder cancer.Often used after chemotherapy fails, or sometimes as first-line in patients who can’t tolerate chemo.BCG (Bacillus Calmette-Guérin) therapy: Still the gold standard for non-muscle-invasive bladder cancer (NMIBC). Research is underway to improve or replace BCG, especially where there’s BCG resistance or shortage. b. Targeted Therapy: These drugs attack specific genetic mutations in cancer cells. FGFR Inhibitors: Erdafitini b: For bladder cancers with FGFR2 or FGFR3 mutations. Oral medication used in metastatic bladder cancer. Antibody-Drug Conjugates (ADC): Example: Enfortumab vedotin – targets Nectin-4 protein on cancer cells. Delivers chemo directly to the tumor cell, sparing healthy cells. c. Personalized Medicine & Genomic Testing: Tumor profiling helps identify specific mutations to guide targeted therapy. Precision medicine is leading to customized treatment plans. Example: Using molecular markers to predict BCG response or chemo resistance. d. Bladder Preservation Therapies: Instead of removing the bladder (cystectomy), new combinations of: Radiation, chemo. Immunotherapy are being used in selected patients with muscle-invasive bladder cancer, aiming to preserve bladder function.Future Directions in Bladder Cancer Treatment: Immunotherapy: Treatments such as Atezolizumab and Nivolumab are being used to stimulate the immune system to fight bladder cancer. These are particularly effective for advanced or metastatic cases where traditional therapies may have failed. Targeted Therapy: Drugs like Erdafitinib and Enfortumab vedotin are designed to target specific genetic mutations found in bladder cancer cells. These therapies are especially useful for patients with known genetic mutations or for those who have already undergone chemotherapy. Bladder-Sparing Therapy: For patients with muscle-invasive bladder cancer, a combination of radiation therapy, chemotherapy, and immunotherapy (known as trimodality therapy) is being explored. This approach aims to preserve the bladder while still effectively treating the cancer in carefully selected patients. Personalized Medicine: Through genomic profiling and molecular diagnostics, treatment plans can now be customized based on the unique characteristics of each patient’s tumor. This tailored approach improves the chances of success and minimizes unnecessary side effects. Cancer Vaccines (in clinical trials): New developments in mRNA-based and peptide-based vaccines are being tested to help prevent bladder cancer from recurring. These vaccines are designed to enhance the body’s immune response specifically against cancer cells.
(The writer is a youth motivator)