Bladder Cancer

Original Editor - User Name
Top Contributors - Khloud Shreif

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (16/01/2024)

Clinically Relevant Anatomy

The bladder wall is composed of four layers, each with its unique structure and function.

1. The innermost layer is the urothelium, also known as transitional epithelium, which lines the bladder, kidneys, ureters, and urethra. This layer consists of specialized cells termed urothelial or transitional cells.
2. Surrounding the urothelium is the lamina propria, a connective tissue layer that provides support and structure.
3. Surrounding the lamina propria is the detrusor muscle or muscularis propria. This layer is made up of smooth muscle fibers arranged in various longitudinal and circular patterns, which are responsible for the bladder's contraction and expansion.
4. Serosa is the outermost layer of the bladder wall formed from the peritoneum. This is followed by a layer of fatty connective tissue that separates the bladder from other nearby organs.

Mechanism of Injury / Pathological Process

Bladder cancer (BC a) begins when cells in the bladder undergo genetic mutations. That cause cells to grow and divide uncontrollably, overriding the mechanisms that normally regulate their growth and death. The uncontrolled growth of these mutated cells leads to the formation of a tumor, a mass of cancerous cells. In the bladder, these tumors typically start in the urothelial cells lining the inside of the bladder.

The initial step in the development of bladder cancer involves the loss of genetic material on chromosome 9, known as loss of heterozygosity (LOH). This leads to the inactivation of tumor suppressor genes, contributing to the transformation of normal bladder cells into cancerous ones. Specifically, deletions in both the long arm (9q) and short arm (9p) of chromosome 9 are linked to early stages of bladder cancer, such as dysplasia and carcinoma in situ (CIS), which can progress to more invasive cancer. A key region on 9p21, responsible for encoding important tumor-suppressing proteins (p14ARF, p15, and p16), and is often completely deleted in transitional cell carcinoma, a common type of bladder cancer, leading to the loss of these critical tumor suppressor genes. This genetic alteration plays a significant role in the onset and progression of bladder cancer.

Clinical Presentation

Patient with bladder cancer usually is presented with hematuria that is visible or even by microscobbic that is the most common presentation.

Risk Factors

• Geographic location
• age
• gender
• Cigarette smoking, estimated to be responsible for half of all BCa cases
• Chronic bladder inflammation, and previous cancer treatments.

Diagnostic Procedures

add text here relating to diagnostic tests for the condition

Outcome Measures

add links to outcome measures here (see Outcome Measures Database)

Management / Interventions

add text here relating to management approaches to the condition

Differential Diagnosis

add text here relating to the differential diagnosis of this condition

Resources

add appropriate resources here