Carcinoma of the bladder is primarily caused by the exposure to carcinogens, particularly aromatic amines and polycyclic aromatic hydrocarbons found in tobacco smoke and industrial chemicals.
Chronic irritation of the bladder mucosa due to urinary tract infections, bladder stones, or catheterization can also contribute to the development of bladder cancer.
A family history of bladder cancer or genetic predisposition may also increase the risk of developing bladder cancer.
Histological Types of Bladder Carcinoma
Transitional Cell Carcinoma (TCC): 90% of bladder cancers are TCC, which arises from the transitional epithelium of the bladder. It can be further classified into papillary and invasive forms.
Squamous Cell Carcinoma (SCC): 5% of bladder cancers are SCC, which arises from the squamous epithelium of the bladder.
Adenocarcinoma: 1% of bladder cancers are adenocarcinomas, which arise from the glandular epithelium of the bladder.
Small Cell Carcinoma: 1% of bladder cancers are small cell carcinomas, which are highly aggressive and are often associated with smoking.
Clinical Features and TNM Classification
Clinical Features:
Hematuria (blood in the urine)
Dysuria (painful urination)
Frequency and urgency of urination
Nocturia (urination at night)
TNM Classification:
T (Tumor):
T0: No evidence of tumor
T1: Tumor is superficial and limited to the bladder mucosa
T2: Tumor invades the bladder muscle
T3: Tumor invades the perivesical tissue
T4: Tumor invades the pelvic wall or adjacent organs
N (Node):
N0: No lymph node metastasis
N1: Metastasis in a single lymph node
N2: Metastasis in multiple lymph nodes
M (Metastasis):
M0: No distant metastasis
M1: Distant metastasis present
Diagnostic Evaluation
Urine Analysis: Microscopic examination of the urine for blood, cells, and casts
Cytology: Examination of urine cytology for abnormal cells
Imaging: CT scan, MRI, or ultrasound to assess the extent of the tumor and lymph node metastasis
Cystoscopy: Direct visualization of the bladder with a cystoscope
Biopsy: Tissue sampling for histopathological examination
Management of Carcinoma of Bladder
Surgery: Radical cystectomy (removal of the bladder and surrounding tissues) is the primary treatment for early-stage bladder cancer.
Chemotherapy: Intravesical chemotherapy (instillation of chemotherapy into the bladder) may be used for superficial bladder cancer.
Radiation Therapy: External beam radiation therapy may be used for invasive bladder cancer.
Immunotherapy: Immunotherapy may be used for advanced bladder cancer.
Homoeopathic Therapeutics for Carcinoma of Bladder
Arsenicum album: For symptoms of anxiety, restlessness, and insomnia
Carbo vegetabilis: For symptoms of fatigue, weakness, and loss of appetite
Ignatia amara: For symptoms of emotional distress, anxiety, and depression
Lachesis: For symptoms of pain, inflammation, and bleeding
Phosphorus: For symptoms of fatigue, weakness, and loss of appetite
Sabadilla: For symptoms of pain, inflammation, and bleeding