Bladder lesions are abnormal areas found in the bladder, typically growths, or tumors. Most bladder tumors tend to be malignant, or cancerous. The main symptom of bladder cancer is blood in the urine, and they are more common in men, with around half thought to be caused by smoking. Bladder lesions can be diagnosed using urine tests, scans of the bladder, and cystoscopy, where an instrument like a telescope is inserted into the bladder. Surgical removal can be carried out using the cystoscope and sometimes this may cure the cancer, depending on how far it has spread.
Most tumors in the bladder arise from what are called transitional cells found in the bladder lining. Rarely, these abnormal growths are benign, or non-cancerous. The most common benign bladder tumor is known as a transitional cell papilloma, and it may cause blood to appear in the urine, in the same way as a malignant tumor. After being removed, transitional cell papillomas often come back, and some experts consider them to be a form of cancer even though they do not normally spread.
Frequently, a bladder lesion is found to be malignant, with what is called a transitional cell carcinoma being the type present in more than 90 percent of cases. Such malignant lesions are more often found in male smokers over the age of 50. Working with certain industrial chemicals, especially those that were once used in dye manufacture and are now banned in many countries, can also increase the risk.
The majority of malignant bladder lesions are superficial tumors which do not spread beyond the lining of the bladder. They can often be cured using a procedure called TURBT, or transurethral resection of a bladder tumor. A cystoscope is inserted into the bladder and the lesion, or lesions, are burned away using an electrically heated wire loop. Usually, after the TURBT procedure, a single dose of chemotherapy is fed into the bladder in the form of a liquid and sometimes radiotherapy and chemotherapy are administered later on, depending on the exact type of tumor. Superficial tumors are better removed, because in rare cases they may change into what are known as muscle invasive tumors.
About a fifth of malignant lesions are muscle invasive tumors, which spread beyond the bladder lining into the muscle of the bladder wall. Sometimes they may even extend right through the bladder wall and travel to other parts of the body. For muscle invasive tumors, more extensive surgery may be required to remove the whole bladder, in combination with chemotherapy and radiotherapy. A cure is usually only possible if the tumor is discovered early, before it has had a chance to spread too far, but the types of treatment described can also be used to help ease symptoms where disease is advanced.