Basic Facts about Urachal Cancer
Urachal cancer is a rare form of cancer that can sometimes involve the bladder, but does not arise from the urothelium and is therefore not bladder cancer in the usual sense. The disease arises from malignant transformation of rests of enteric epithelium in the urachus, an embryonic structure located between dome of the bladder and the umbilicus. Urachal cancer can occur at any site along the urachal tract. The most common locations are the umbilicus and the dome of the bladder.
Urachal cancer can exist for some years without any symptoms. Sometimes the first symptom is haematuria (blood in the urine), but this can have many other causes.
The diagnosis of Urachal cancer can be difficult, and unfortunately there are no specific symptoms. The cancer often progresses silently, and because the most common presentation involves blood in the urine, it is commonly confused with conventional bladder cancer initially.
Urachal cancer does not seem to respond to the usual chemotherapy treatments for bladder cancer, but there seems to have been more success using chemotherapy regimens used for colon cancer. Surgery is the mainstay of treatment for clinically localized disease, and has been shown to be more successful when the entire urachal remnant and bladder dome are taken “en bloc” including the belly button.
The prognosis for patients with metastatic or recurrent disease is poor, with median survivals reported in the range of 1 to 2 years. There are anecdotal reports of long-term survival with bowel cancer regimens, but these are clearly exceptional.