Bladder Cancer

Symptoms
Common symptoms of bladder cancer include:

  • Blood in the urine (making the urine slightly rusty to deep red)
  • Pain during urination
  • Frequent urination, or feeling the need to urinate without results

Fortunately, these symptoms are not always sure signs of bladder cancer. Infections, benign tumors, bladder stones, or other problems also can cause these symptoms. However, if you experience these symptoms, you should see a physician for diagnose and treatment as soon as possible. People with symptoms like these could see their family physician or a set an appointment with a NEIU urologist.

A dipstick test of the urine can help detect cancer and other problems in both the kidneys and the bladder. The test shows the presence of blood and other specific substances in the urine and can be done at routine physician visits. If the abnormality is confirmed, your NEIU physician may suggest a thorough evaluation of the entire urinary tract such as X-rays, further urine tests and a special bladder examination by the urologist called cystoscopy.

Bladder Cancer Treatment Your physician develops a treatment plan to fit your special needs. Treatment depends on the type of bladder cancer, the stage of the disease, and the grade of the tumor. Grading tells how closely the cancer cells resemble normal cells and gives an idea of how fast the cancer is likely to grow. Low-grade cancers usually grow and spread more slowly than high-grade cancers. Your physician will consider other factors, including age and general health.

Methods of Treatment
Men and women with bladder cancer have many treatment options. It may be surgery, radiation therapy, chemotherapy, or biological therapy. Some patients might get a combination of therapies.

Your NEIU physician is the best person to describe treatment choices and discuss the expected results of treatment.

NEIU participates in clinical trials and you may want to talk to your physician about taking part in a research study of new treatment methods. Clinical trials have proven to be an important option for people with all stages of bladder cancer.

Surgery is a common treatment for bladder cancer. The type of surgery depends largely on the stage and grade of the tumor. The physician can explain each type of surgery and discuss which is most suitable for the patient:

  • Transurethral resection: The physician may treat early (superficial) bladder cancer with transurethral resection (TUR). During TUR, the physician inserts a cystoscope into the bladder through the urethra. The physician then uses a tool with a small wire loop on the end to remove the cancer and to burn away any remaining cancer cells with an electric current called fulguration. After TUR, other therapies may be recommended.
  • Radical cystectomy: For invasive bladder cancer, the most common type of surgery is radical cystectomy. The physician also chooses this type of surgery when superficial cancer involves a large part of the bladder. Radical cystectomy is the removal of the entire bladder, the nearby lymph nodes, part of the urethra, and the nearby organs that may contain cancer cells.
  • Segmental cystectomy: In some cases, the physician may remove only part of the bladder in a procedure called segmental cystectomy. The physician chooses this type of surgery when a patient has a low-grade cancer that has invaded the bladder wall in just one area.

Sometimes, when the cancer has spread outside the bladder and cannot be completely removed, the surgeon removes the bladder but does not try to get rid of all the cancer. This can lead to other options, which your NEIU physician can explain.

Radiation therapy uses high-energy rays to kill cancer cells. Like surgery, radiation therapy is local therapy. It affects cancer cells only in the treated area.

A small number of patients may have radiation therapy before surgery to shrink the tumor. Others may have it after surgery to kill cancer cells that may remain in the area. Sometimes, patients who cannot have surgery have radiation therapy instead.

Your NEIU physician uses two types of radiation therapy to treat bladder cancer:

  • External radiation: is when radiation is aimed at the tumor area. On average you would be treated five days a week for five to seven weeks as an outpatient. This schedule helps protect healthy cells and tissues by spreading out the total dose of radiation. Treatment may be shorter when external radiation is given along with radiation implants.
  • Internal radiation: The physician places a small container of a radioactive substance into the bladder through the urethra or through an incision in the abdomen. The patient stays in the hospital for several days during this treatment. To protect others from radiation exposure, patients may not be able to have visitors or may have visitors for only a short period of time while the implant is in place. Once the implant is removed, no radioactivity is left in the body.

Some patients with bladder cancer receive both kinds of radiation therapy.

Chemotherapy uses drugs to kill cancer cells. The physician may use one drug or a combination of drugs.

For patients with superficial bladder cancer, the physician may use intravesical chemotherapy after removing the cancer with TUR. This is local therapy. The physician inserts a tube through the urethra and puts liquid drugs in the bladder through the catheter. The drugs remain in the bladder for several hours. They mainly affect the cells in the bladder. Usually, the patient has this treatment once a week for several weeks.

If the cancer has deeply invaded the bladder or spread to lymph nodes or other organs, the physician may give drugs through a vein. This treatment is called intravenous chemotherapy. It is systemic therapy, meaning that the drugs flow through the bloodstream to nearly every part of the body. The drugs are usually given in cycles so that a recovery period follows every treatment period.

A patient may have chemotherapy alone or combined with surgery, radiation therapy, or both. Usually chemotherapy is an outpatient treatment given at the hospital, clinic, or at a physician's office. However, depending on which drugs are given and the patient's general health, the patient may need a short hospital stay.

Biological therapy uses the body's natural ability (immune system) to fight cancer. Biological therapy is most often used after TUR for superficial bladder cancer. The goal is to prevent the cancer from coming back.

The physician may use intravesical biological therapy with BCG solution. BCG solution contains live, weakened bacteria. The bacteria stimulate the immune system to kill cancer cells in the bladder. The physician uses a catheter to put the solution in the bladder. The patient must hold the solution in the bladder for about 2 hours. BCG treatment is usually done once a week for 6 weeks.

Cancer Screening
The purpose of cancer screening is to detect potentially life-threatening diseases as early as possible, at a point when treatment is easier and cure more likely.

Urine screening can detect cancer and other problems in both the kidneys and the bladder. It consists of a dipstick test for the presence of blood and other specific substances in the urine and is often performed at routine physician visits. If the abnormality is confirmed by the examination of urine under the microscope, a thorough evaluation of the entire urinary tract is performed.