Each year there are approximately 120,000 new cases of urinary bladder cancer in Europe. This makes it the fourth most common malignancy in men and the eighth most common in women. In the United States it is the second most common genitourinary malignant disease and the fifth most common cancer overall. It is estimated that more than 52,000 men and 17,000 women were diagnosed with bladder cancer in the US in 2011. Bladder cancer patients have access to effective therapies for the treatment of non-invasive tumors. However, up to 46% of bladder cancer will recur at first follow-up. Blue-light cystoscopy responds to the need for better diagnosis and treatment in order to reduce those recurrences.
Bladder cancer occurs when cells in the bladder start to grow out of control. Most bladder cancers develop on the inner layer of the bladder. Some can grow into the deeper bladder layers. As cancer grows through these layers into the wall of the bladder, it becomes harder to treat. The type of tissue which constitutes the lining of the bladder, where tumors initiate, is also found in the inner layers of the kidneys, ureters and urethra. So, similar cancers can occur in these areas, though much less frequently.
Diagnosing and treating bladder cancerThe most common initial sign of bladder cancer is macroscopic haematuria, which calls for radiological examination of the upper urinary tract and a cystoscopy. If confirmed, two distinct forms of bladder cancer can be identified. The first form is non-muscle invasive carcinomas. These account for 70% of all newly diagnosed bladder cancer cases. While most of these cases show a high potential to recur, they are generally unlikely to progress to more serious forms of bladder cancer. Essentially, the treatment will consist of transurethral resection (TUR; also: TURB, TURBT) of affected bladder areas followed by intravesical immunotherapy.
The second form of bladder cancer, making up the remaining 30%, is characterised by muscle-invasive tumours with an associated 5-year mortality rate of 50%. In these cases radical cystectomy (bladder removal), lymphadenectomy and/or chemotherapy are the recommended treatments.
- Cancer Facts & Figures 2011, American Cancer Society: Cancer Facts & Figures 2011, Atlanta: American Cancer Society, 2011.