Urinary bladder cancer (UBC) is one of the most well-known cancers affecting men with a ratio of 1:26 and women with a ratio of 1:80 worldwide during their lifetime. Moreover, it is a disease that predominantly affects older adults and resulting in a major medical concern with the increasing population in the old age group.

Bladder: Anatomy & Physiology:

The urinary bladder is a hollow muscular organ in the lower abdomen most of which lies behind the pubic bone of the pelvis. But when it is filled with urine, it expands to the lower part of the abdomen. The main function of the bladder is to store urine that is made in the kidneys and travels down to it through a tube called Ureters, allowing urination to be infrequent and controlled. The ureters from both the kidneys open into the urinary bladder. The bladder forms a low-pressure reservoir that gradually stretches out as urine fills it. In males, the Prostate Gland is located adjacent to the base of the bladder where the urethra joins the bladder. From time to time, the muscular wall of the bladder contracts to expel urine through the urinary passage (urethra) into the outside world. The bladder can contain up to 400-600ml or about 2 cups of urine.

The bladder consists of three layers of tissue. The innermost layer of the bladder, "mucosa" stays in contact with the urine stored in the bladder and consists of several strata of specialized cells called "transitional cells," that are only found in the urinary system of the body. The same cells also develop the inner lining of the ureters, kidneys, and a part of the urethra. These cells also prevent the urine from going into the deeper tissue layers by developing a waterproof lining within these organs. These cells are also termed urothelial cells, and the mucosa is termed urothelium.

The middle layer is a thin lining known as the "lamina propria" and forms the boundary between the inner "mucosa" and the outer muscular layer. This layer has a network of blood vessels and nerves and plays a vital role in the occurrence of bladder cancer.

The outer layer of the bladder (the "muscularis") comprises the "detrusor" muscle. This is the thickest layer of the bladder wall. Its main function is to relax slowly as the bladder fills up to provide low-pressure urine storage with a then to contract to compress the bladder and expel the urine out during the act of passing urine. Beyond these three layers of the urinary bladder, there is a thick lining of fat that acts as a protective layer for the bladder and isolates it from the organs such as the rectum and the muscles and bones of the pelvis.

Bladder Cancer:

Bladder cancer begins when the urothelial cells tend to grow and multiply in an uncontrollable and abnormal manner in the urinary bladder. This invasive disease starts to reflect in the innermost layer of the bladder i.e., mucosa and may go to the deeper layers of the bladder as it continues to grow. Sometimes it may also remain limited to the mucosa for a longer period. Bladder cancer can be categorized based on the appearance of its cells under the microscope (histological type). Type of bladder cancer helps to determine the proper treatment for the disease. Noninvasive bladder cancers occur in the inner layer of cells (transitional cell epithelium) but do not penetrate into deeper layers. Invasive cancers penetrate into the deeper layers such as the muscle layer. Invasive cancers are more difficult to treat.

Types:

The common types of bladder cancer are as follows:

i. Urothelial Carcinoma : (Previously known as "transitional cell carcinoma")
ii. Adenocarcinoma Of the Bladder
iii. Squamous Cell Carcinoma

In all type of bladder cancer, people mostly suffer from Urothelial Carcinoma which is strongly associated with smoking.

Symptoms:

i. Bleeding in the urine( hematuria)
ii. Burning sensation during urination(dysuria)
iii. Distended bladder

Ayurveda & Bladder cancer

Ayurveda is a personalized, patient-centred medical approach that is basically developed on the concept of the union of body, mind, soul and senses and idealizes the promotion of health and prevention of disease, but also to diagnose and treat conditions. Ayurveda believes in nutritious and a balanced diet and uses complex plant-based formulations for pharmacologic prevention and treatments.

Herbs that could be used to prevent Bladder Cancer

1. Amla
2. Garlic
3. Turmeric
4. Holy Basil
5. Ginger

Prevention

The best way to prevent bladder cancer is to avoid exposure to agents that cause the disease. People who do not smoke are three to four times less likely to get bladder cancer as compared to smokers. Continuing to smoke after the diagnosis of bladder cancer portends a poorer outcome and increases the chance of the disease coming back after treatment. We should not avoid or ignore any primary symptoms of Bladder cancer and any kind of abnormalities in the process of urination.