Bladder Cancer

Most bladder cancers derive from the cells of the bladder’s inner lining. These cells can be damaged by toxins from cigarettes or other chemicals that accumulate in the urine and trigger cancer growth.

Bladder cancers fall into two main categories: (1) the more common low-grade, non-invasive bladder cancers that rarely spread outside the bladder and (2) potentially life-threatening high-grade and/or invasive bladder cancers.

Blood in the urine is the most commonly associated symptom of bladder cancer. It occurs in the vast majority of cases and should always be evaluated by a doctor. Other symptoms include painful urination, urinary urgency, back or abdominal pain, loss of appetite and loss of weight.

Treatments for Bladder Cancer

The initial evaluation is often performed in the office and treatment begins with outpatient surgery.

  • Treatment of non-invasive cancers often includes both surgery to remove the tumor(s) and medical therapy placed directly into the bladder.
  • For invasive cancers, removal of the bladder and construction of one of several types of reservoirs for the urine is often required.
  • For advanced disease, an approach incorporating tumor removal and chemotherapy administered to the whole body provides the best results.

Bladder Removal
When bladder cancer tumors become invasive, the whole organ may need to be removed. We use the most advanced reconstruction techniques to improve your quality of life and avoid the need for external equipment.

Chemotherapy
This well-known cancer treatment uses medicines taken intravenously or by mouth to kill cancer cells throughout the body. Chemotherapy may be given before surgery to shrink tumors, or after to fight cancer cells that have potentially spread.

Cystectomy
Our surgeons use the daVinci® surgical system to perform minimally-invasive surgery to remove cancer cells from the bladder. This advanced approach means less blood loss and faster recovery time.

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What Is Bladder Cancer?

The bladder is the organ that stores urine before it leaves the body. The bladder lining consists of transitional cells. Nearly 95% of all bladder cancers start from these cells (transitional cell carcinoma). Bladder cancer is a malignant tumor in this organ and may be small or large, growing deep into the bladder muscle, and it may spread (metastasize).

The other two types are squamous carcinoma and adenocarcinoma. These tumors are usually larger and often go into the bladder wall and may metastasize.

Bladder cancer develops most often in people older than 50. Men have bladder cancer more often than women do.

What Causes Bladder Cancer?

Many things can cause bladder cancer, most often cigarette smoking. Usually the exact cause is unknown. Chemicals used at jobs in dye, textile, tire, rubber, and petroleum industries are another cause.

What Are the Symptoms of Bladder Cancer?

Very small cancers usually cause no symptoms, but blood in the urine, burning when urinating, or needing to urinate small amounts are possible symptoms.

Larger tumors cause more symptoms, such as pain low in the belly or losing weight.

How Is Bladder Cancer Diagnosed?

The health care provider will do an examination and order a urine test to see if the urine shows blood, signs of infection, or abnormal (cancerous) cells.

The health care provider may also order blood tests and tests of the kidneys and liver function.

X-rays of the bladder and urinary tract, ultrasound or computed tomography (CT) scans, and cystoscopy (using a lighted tube to see inside the bladder) may also be done. If abnormal areas are found, a piece of tissue (biopsy specimen) is taken for study under a microscope.

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How Is Bladder Cancer Treated?

Surgery is needed to remove the cancer. The operation depends on the type of cancer and whether it has spread.

A small or large tumor is removed by endoscopy (using a lighted tube inserted into the bladder). For a very large cancer, the whole bladder may need to be taken out (radical cystectomy). After this operation, urine will empty out through a pouch through the skin (urostomy), which needs special care.

Pain pills, radiation treatment, and anticancer medicine (chemotherapy) may also be needed.

DOs and DON’Ts in Managing Bladder Cancer:
  • DO take pills as your health care provider prescribes.
  • DO resume normal activities (including sexual relations) after surgery or other treatment when your health care provider says you can.
  • DO call your health care provider if you had surgery and have new symptoms of infection (back pain, fever, and vomiting).
  • DO call your health care provider if you have blood in your urine; you feel the need to urinate frequently, with urgency, or with hesitancy; or if urination is painful.
  • DO call your health care provider if you have pain or trouble with erections after surgery.
  • DO call your health care provider if you have excess bleeding, fever, and chills after cystoscopy.
  • DON’T smoke.
  • DON’T be frustrated if superficial cancer returns. The cancer can be controlled with close follow-up care and tumor removal.
  • DON’T miss follow-up health care provider appointments, including cystoscopy every few months for the first year.
FOR MORE INFORMATION

Contact the following sources:

  • The American Cancer Society
    Tel: (800) ACS-2345 (227-2345)
    Website: http://www.cancer.org
  • The National Cancer Institute Cancer Information Service
    Tel: (800) 4-CANCER (422-6237)

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor