Bladder cancer is the sixth most common form of cancer and increased incidences of bladder cancer have been linked with type 2 diabetes.

In 2011 bladder cancer and diabetes have been in the news as a correlation between bladder cancer and people taking the diabetes drug Actos (pioglitazone) was found.

What is bladder cancer?

Bladder cancer occurs when tumors grow in the bladder. Bladder cancer is categorised into two main types, described below.

Non-muscle invasive bladder cancer

Non-muscle invasive bladder cancer describes tumour which grow in the lining of the bladder but away from adjoining muscles of the bladder.

This form is the most common affecting about 70% of incidences of bladder cancer.

Muscle invasive bladder cancer

Muscle invasive bladder cancer occurs when a tumour grows amongst the muscles around the bladder.

This form is more serious as there is a greater chance of the cancer spreading to other parts of the body.

Symptoms of bladder cancer

The most common symptom of bladder cancer is blood in the urine, known as haematuria (or hematuria).

Haematuria can be noticed as red or brown coloured urine or you may notice streaks or clots of blood in the urine. Sometimes blood in the urine may first be noticed by a urine test.

Blood in the urine does not mean you have bladder cancer, and in most cases it won’t be, however, if you notice blood in your urine do not ignore it and make sure you mention the symptom to your doctor.

Other symptoms of bladder cancer can include:

feeling a particularly urgent need to urinate
experiencing a burning sensation when passing urine

The above symptoms may also be a sign of a urinary tract infection It is advisable to inform your doctor of these symptoms.

Causes and risk factors

Smoking over an extended period of time is known to increase the risk of bladder cancer. It is the largest risk factor for bladder cancer.

The risk of bladder cancer increases with age, with cases of bladder cancer in people under 40 years old being rare, and bladder cancer is generally more common in men.

Use of occupational chemicals in textiles, printing and production of plastics were found to increase risks of bladder cancer so many of the substances linked to cancer were banned during the 1970s and 80s.

Undergoing radiotherapy near the pelvis could increase your risk of bladder cancer.

Treatment

Treatment for bladder cancer will depend on the type and extent of the cancer. In early and non-muscle invasive bladder cancer, the cancer can be removed without needing to remove the bladder. The procedure carried out is called transurethral resection of a bladder tumour (TURBT).

In more developed forms of the cancer, including muscle invasive bladder cancer, either surgery, involving the removal of the bladder, is needed or radiotherapy.

Chemotherapy can help to prevent the reappearance of cancers.

Bladder cancer and Actos (pioglitazone)

Reviews of studies have shown an increase in risk of bladder cancer in people taking Actos (pioglitazone) for over 24 months.

The risks are thought to be approximately double compared with people not taking Actos. The risk of contracting bladder cancer on Actos are estimated at about 0.15% compared with 0.07% amongst people not taking Actos.

People taking the drug are advised to contact their doctor immediately if they recognise any of the symptoms of bladder cancer.