Bladder Cancer
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What You Should Know About Bladder Cancer
Bladder cancer is a common cancer which is highly treatable when diagnosed early. Find out what to look for.
Overview
What is Bladder Cancer?
The bladder is the organ that stores and eliminates urine. Bladder tumors can arise from the bladder wall as well as the urethra. Treatment for bladder tumors vary and depend on the grade (low or high) and depth of tumor invasion of the bladder wall. The most common type of bladder cancer is urothelial carcinoma.
Tumors may be classified based on their growth patterns as either papillary tumors (wart-like lesion attached to a stalk) or non-papillary tumors (solid lesions with a broad base). Non-papillary tumors are less common (10%) but tend to be more invasive.
Bladder cancer rarely occurs in people younger than 40 and rates are higher among those who live in the northern half of the United States.
Symptoms
What are the symptoms of Bladder Cancer?
Bladder cancer can exist without any of the symptoms listed below, although it is more common to experience one or more of them. The presence of these symptoms does not necessarily indicate cancer.
- Blood in the urine
- Lower urinary tract symptoms: urinary frequency, urinary urgency
- Bladder pain
- Difficulty passing your urine
Cause
What causes Bladder Cancer?
The biggest risk factor for bladder cancer is smoking as well as environmental exposure to certain chemicals and genetic factors.
Women who received radiation therapy to treat cervical cancer have a fourfold increased risk of bladder cancer. Those who took the chemotherapy drug cyclophosphamide (Cytoxan) may be at nine times greater risk.
Diagnosis
How is Bladder Cancer diagnosed?
What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:
- During your visit, your doctor will ask you questions regarding your medical history and will perform a physical exam including the pelvis and rectum.
Other tests that may be performed during or after your visit:
- Urinalysis: This evaluates for any blood in the urine or infection
- Labs: Urine culture and cytology may be obtained. A urine cytology evaluates the urine cells for evidence of cancer on a microscopic level. Blood work to assess kidney function may also be obtained.
- Imaging: This will be either a CT scan or MRI scan depending on your history and kidney function. These tests allow us to evaluate the urinary tract and assess for any spread of disease.
- Cystoscopy: This is a procedure performed in the office where the physician inserts a small scope into the urethra to evaluate the urethra, prostate (for males) and bladder
Treatment
How is Bladder Cancer treated?
The choice of treatment for bladder cancer is based on the grade and stage of the tumor, severity of symptoms, likelihood of recurrence, and the presence of other medical conditions. Unlike other cancers, bladder tumors tend to recur.
Depending on the stage, treatment may include:
Superficial (T1):
- Tumor resection: Removes tumor through a scope, with follow-up cystoscopies (scope tests) to detect regrowth.
- Intravesical therapy: Medicine is administered through a catheter, typically given weekly for six weeks and possibly followed by a series of periodical booster treatments.
Invasive (T2-T4):
- Surgery: Removal of the bladder and lymph nodes. For men this may involve removing the prostate and bladder; for women this may involve removing the ovaries, uterus, and bladder, and possibly a portion of the top part of the vagina. The urinary stream is diverted into either an isolated bowel segment (called an ileal conduit) or a substitute bladder made from a segment of bowel (called a neobladder).
- Chemotherapy: With T2 and T3 cancers, chemotherapy is sometimes advised before bladder removal.
- Radiation therapy may also be recommended.
Patients with low-grade Upper Tract Urothelial Cancer, called UTUC, may have the option of receiving JELMYTO, a targeted, tissue-sparing prescription medication.
Patients with non-muscle invasive bladder cancers may be treated with IV Infusion Therapy.