There is no validated form of screening available for bladder cancer today. In the event of occupational risk, the employer may elect to conduct urine analyses for monitoring purposes.
The bladder is a hollow organ, its purpose is to store urine produced by the kidneys between micturition. Consequently, the mucous cells of the bladder wall are repeatedly exposed to urine and its (sometimes) toxic constituents. In response to this exposure, a cell may degenerate and multiply in an uncontrolled manner, thereby forming a tumor called a urothelial carcinoma. In most cases, these tumors form in the bladder, but they can also occur in the upper excretory tracts situated between the kidney and the bladder (the renal calyces, the pyelon and the ureter).
In the majority of cases, the cancer is in localized form, with no invasion of the muscle. In the other cases, the condition is metastatic (i.e., the spreads to the lymph nodes, lungs, bones, etc).
Although urothelial carcinoma is the most common type, other histologies
(i.e., the type of tissue affected by the condition), including epidermoid carcinomas or neuroendocrine carcinomas exist.
There is no validated form of screening available for bladder cancer today. In the event of occupational risk, the employer may elect to conduct urine analyses for monitoring purposes.
Generally, the last step in diagnosis is cystoscopy, a process
during which a urologist will insert an endoscope (similar to a camera)
via natural tracts to examine the patient’s bladder.
Tabacco use
(more than half of the cases)
Occupational exposure to certain chemical substances*
*aromatic amines used to manufacture cosmetics, pharmaceutical products, pesticides and plastics, and in the rubber industry; also present in tobacco
*Polycyclic aromatic hydrocarbons used in the production of tar, tires and textiles
The primary treatment of metastatic tumors is polychemotherapy.
If there is a favorable response to primary chemotherapy, immunotherapy using Avelumab is recommended for a year following the completion of chemotherapy.
If chemotherapy is not effective or if there is a relapse, immunotherapy using Pembrolizumab may be suggested.
New therapeutic classes, including conjugated antibodies and targeted therapies (for tumors with genetic anomalies) are being reviewed by medical authorities.
Smokers should consider the benefits of stopping.
Localized bladder cancer treatment involves the full range of oncological practitioners: urological surgeons, medical oncologists and radiotherapists. At localized stages, a number of modes of therapy will be combined: surgery + medical treatment by immunotherapy or chemotherapy +/- radiotherapy. It is essential to complete a full course of treatment to diminish the chances of relapse.
Urothelial carcinoma tends to have a high number of genetic mutations (non-hereditary, specific to the tumor). A number of treatments are being developed to target the most frequently occurring anomalies.
