Bladder Cancer

Introduction
Bladder Cancer is cancer that starts in the part of the body that holds and stores urine. It is the fifth most common cancer with 73,510 cases and 14,880 deaths in the United States in 2012. The exact cause is unknown, however there are several risk factors including: cigarette smoking, chemical exposure at work, chemotherapy, radiation treatment, and long-term infection.

Symptoms

  • Blood in the urine
  • Painful urination
  • Urinary frequency and urgency
  • Weight loss

 

Diagnosis
Your doctor will perform a detailed history and physical exam.

Other tests include:
Urinalysis: office test used for finding blood in the urine
Urine Cytology: microscopic evaluation of urine looking for abnormal cells
Cystoscopy: office procedure detailing inside of bladder
CT scan: detailed imaging of the abdominal and pelvic organs
Bladder biopsy: Done in the operating room where areas are sampled to determine if cancer is present

Treatment
Treatment depends on the stage and grade of the cancer, overall health, and severity of symptoms. Grade refers to microscopic appearance of the cancer.

Superficial bladder cancer is cancer that affects the lining of the bladder. Treatment involves removing the tumor through an endoscopic approach. Patients may require subsequent treatment with chemotherapy or immunotherapy. These treatments are placed into the bladder directly through a catheter. Once the cancer is treated, patients will need periodic surveillance with cystoscopy and CT scan to ensure the cancer has not returned

Muscle invasive bladder cancer is cancer that has spread to the muscle of the bladder or beyond. Treatment involves surgically removing the entire bladder as well as pelvic lymph nodes. Patients may receive chemotherapy before or after surgery. This is major surgery and involves a week-long hospital stay. In addition, the prostate is removed in male patients and the uterus and ovaries are removed in female patients. Also, the urine made from your kidneys must be rerouted either through an ileal conduit or a neobladder. An ileal conduit is a small section of small bowel that is used to create a ostomy on the abdomen for urine to drain into a bag. A neobladder is a larger section of small bowel used to create a reservoir to hold urine and is attached to the urethera.

Prognosis
The prognosis of bladder cancer depends on the initial stage and grade. Patients with non-aggressive superficial bladder cancer do very well, however patients with advanced disease tend to do worse.

Resources
Bladder Cancer Advocacy Network
Bladder Cancer WebCafe