Page 217 - Urological Health

The urinary system is intimately linked with our reproductive organs. In men, this includes the
prostate, seminal vesicles and the vas deferens (tubes which transfers the sperm from the testes). In
women, this includes the vagina, uterus, fallopian tubes and ovaries. Take a look at Figure 1 for a
diagram of both anatomies).
Because the urine is stored in the bladder and is in contact with the urothelium (this is the tissue
layer that lines most of the organs in the urinary system, including the bladder) for a long time, it’s
more likely for cancers to occur in the bladder. However, these same cancers can occur in the lining
of the ureters and the kidneys and spread into the bladder (although this is rare).
All these organs are supplied with blood which travels to them through arteries and returns in
veins.What leaks out between the arteries and veins during exchange of nutrients in the capillaries (the
tiniest of vessels wrapped around the cells) is called lymph, which is blood lacking cells. This lymph
fluid is collected by lymphatic vessels which are filtered by lymph nodes. The lymph nodes house the
body’s immune cells and help fight infection. Abnormal cancer cells can enter the lymphatics and get
trapped in these filters (lymph nodes).

Risk factors

You are at risk for developing bladder cancer if:
UNDER REVIEW
• You are exposed to carcinogens: smokers, petro chemical workers, dye handlers. The most
common risk factor is smoking. If you continue to smoke after being diagnosed with
superficial bladder cancer, you have a chance of cancer recurrence and cancer
progression to muscle invasive disease.
• You have been previously treated with pelvic radiotherapy or chemotherapy.
• If you have chronic bladder infections.
• If your bladder is not working properly.

• If you have high-risk superficial bladder cancer, your cancer may spread to the muscle
wall of your bladder. It’s important for you to follow your doctor’s instructions and to go to
your follow-up appointments. These visits may include bladder check cystoscopies
(where the lining of your bladder is checked using a camera that goes into the bladder
through the urethra) and intravesical therapies (when medications are put in the
bladder). High-risk superficial bladder cancer means:
– Your cancer is flat and hidden in the normal urothelial lining (carcinoma in situ,
or CIS).
– You have cancer cells in your urine.
– Your intravesical therapy has failed.
– There are signs that the tumour is spreading to a layer above the muscle (lamina
propria).
– If this is the case, your bladder would need to be removed (especially if if is not
working properly).

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