Editing Bladder (section)

===Cancer===
{{main|Bladder cancer}}

[[File:Bladder Cancer.jpg|thumb|231x231px|Cross-section of the male [[genitourinary system]] showing a cancer within the bladder. When a cancer occurs it is most likely to be a [[transitional cell carcinoma]].]]
[[Cancer]] of the bladder is known as [[bladder cancer]]. It is usually due to cancer of the [[urothelium]], the cells that line the surface of the bladder. Bladder cancer is more common after the age of 40, and more common in men than women;<ref name="Davidsons2018cancer">{{cite book|title=Davidson's principles and practice of medicine|editor1-last=Ralston |editor1-first=Stuart H. |editor2-last=Penman |editor2-first=Ian D. |editor3-last=Strachan |editor3-first=Mark W. |editor4-last=Hobson |editor4-first=Richard P. |date=2018 |publisher=Elsevier |isbn=978-0-7020-7028-0 |edition=23rd|pages=435–6|section=Urothelial tumours}}</ref> other risk factors include [[smoking]] and exposure to [[dye]]s such as [[aromatic amine]]s and [[aldehydes]].<ref name="Davidsons2018cancer" /> When cancer is present, the most common symptom in an affected person is [[haematuria|blood in the urine]]; a physical [[medical examination]] may be otherwise normal, except in late disease.<ref name="Davidsons2018cancer" /> Bladder cancer is most often due to cancer of the cells lining the ureter, called [[transitional cell carcinoma]], although it can more rarely occur as a [[squamous cell carcinoma]] if the type of cells lining the urethra have changed due to chronic inflammation, such as due to stones or [[schistosomiasis]].<ref name="Davidsons2018cancer" />

Investigations performed usually include collecting a sample of urine for an inspection for malignant cells under a microscope, called [[cytology]], as well as [[medical imaging]] by a [[CT urogram]] or [[ultrasound]].<ref name="Davidsons2018cancer" /> If a concerning lesion is seen, a flexible camera may be inserted into the bladder, called [[cystoscopy]], in order to view the lesion and take a [[biopsy]], and a [[CT scan]] will be performed of other body parts (a [[Full-body CT scan|CT scan of the chest, abdomen and pelvis]]) to look for additional {{wt|en|metastatic}} lesions.<ref name="Davidsons2018cancer" />

Treatment depends on the cancer's [[tumour staging|stage]]. Cancer present only in the bladder may be removed surgically via [[cystoscopy]]; an injection of the [[chemotherapy|chemotherapeutic]] [[mitomycin C]] may be performed at the same time.<ref name="Davidsons2018cancer" /> Cancers that are [[tumour grade|high grade]] may be treated with an injection of the [[BCG vaccine]] into the bladder wall, and may require surgical removal if it does not resolve.<ref name="Davidsons2018cancer" /> Cancer that is invading through the bladder wall may be managed by complete surgical removal of the bladder ([[radical cystectomy]]), with the ureters diverted into a segment of part of [[ileum]] connected to a [[stoma bag]] on the skin.<ref name="Davidsons2018cancer" /> Prognosis can vary markedly depending on the cancer's stage and grade, with a better prognosis associated with tumours found only in the bladder, that are low grade, that do not invade through the bladder wall, and that is {{wt|en|papillary}} in visual appearance.<ref name="Davidsons2018cancer" />