Can bladder cancer progress rapidly? Information on types, grades, and additional details
Bladder cancer, a disease that develops when cells in the bladder start to grow abnormally and form a tumor, is a common health concern. In the United States, it is estimated that around 83,730 people will receive a diagnosis of bladder cancer in 2023 [1].
Among these cases, certain types of bladder cancer are more likely to spread quickly and require aggressive treatment. These include high-grade urothelial carcinoma, enteric-type adenocarcinoma variants, and muscle-invasive bladder cancer.
High-Grade Urothelial Carcinoma
High-grade urothelial carcinoma, also known as transitional cell carcinoma, is the most common type of bladder cancer and is known for its aggressive growth and invasiveness [1][2]. This type of cancer is characterised by atypical cells that grow and spread quickly.
Enteric-Type Adenocarcinoma Variants
Some rare variants, like enteric-type adenocarcinoma, that transform from high-grade urothelial carcinoma exhibit exceptional aggressiveness and a high likelihood of spreading quickly, often requiring multimodal treatment including surgery, chemotherapy, and radiotherapy [1]. These variants show aggressive behavior with rapid local invasion and potential for early spread through perineural and lymphovascular invasion [1].
Muscle-Invasive Bladder Cancer
Muscle-invasive bladder cancer, tumors that invade the muscle layer of the bladder wall, are by definition more aggressive and more likely to spread beyond the bladder compared to non-muscle invasive types [3]. They require extensive treatment, often involving surgery, chemotherapy, and radiotherapy.
In summary, high-grade urothelial carcinoma with muscle invasion and its aggressive histological variants such as enteric-type adenocarcinoma are the bladder cancers most likely to spread quickly and require aggressive multimodal treatment [1][3].
While less than 1% of bladder cancers are small cell carcinomas, and approximately 1% are adenocarcinomas, these subtypes do not appear to rank significantly higher in terms of speed of spread compared to the aggressive types mentioned above [1].
Bladder cancer that spreads to another part of the body is called metastatic bladder cancer, or advanced bladder cancer. Treatment for bladder cancer may include surgery, immunotherapy techniques such as intravesical Bacillus Calmette-Guerin, targeted therapy, cystectomy, chemotherapy, radiation therapy, and participation in clinical trials.
It's important to note that rates of new cases of bladder cancer have been dropping in recent years [1]. Regular screenings and early detection can significantly improve the chances of successful treatment. If you experience symptoms such as blood in the urine, frequent urination, a feeling of needing to urinate even when the bladder is not full, pain or a burning feeling when urinating, often urinating at night, and pain in the lower back on one side of the body, it's crucial to consult a healthcare professional.
| Cancer Type | Characteristics | Likelihood to Spread Quickly | Notes | |-----------------------------------|------------------------------------------|--------------------------------------|-----------------------------------| | High-grade urothelial carcinoma | Most common; usually high proliferation | High | Main bladder cancer type[1][2] | | Enteric-type adenocarcinoma variant| Rare variant from urothelial carcinoma | Very high/aggressive | Associated with lymphovascular invasion[1] | | Muscle-invasive bladder cancer | Invades muscle layer of bladder wall | High | Requires surgery, chemo, radiotherapy[3] |
[1] American Cancer Society. (2022). Key Statistics for Bladder Cancer. Retrieved from https://www.cancer.org/cancer/bladder-cancer/about/key-statistics.html [2] National Cancer Institute. (2021). Bladder Cancer Treatment (PDQ®)–Patient Version. Retrieved from https://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq [3] National Cancer Institute. (2021). Bladder Cancer Prevention (PDQ®)–Health Professional Version. Retrieved from https://www.cancer.gov/types/bladder/hp/bladder-prevention-pdq
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