What is it?
Bladder cancer is the most common site of cancer in the urinary system. While it can occur at any age, the average age of diagnosis is 65.
What are the Symptoms?
Bladder cancer may not present with any symptoms but may produce blood in the urine, sometimes seen only microscopically and detected on a standard urine test.
Other symptoms are:
- Urinary frequency, urgency, burning
- Painful urination
- Pain in the lower abdomen/pelvis
While these symptoms are not specific to bladder cancer, they need to be brought to the attention of your urologist for further evaluation.
Why does it occur?
Risk factors for bladder cancer:
- Radiation to pelvic organs
- Chemical/occupational exposure to aniline dye (chemical industry, painters, dry cleaners, textile industry)
- Chronic bladder infections
- Chemotherapy agents
How is it evaluated and why?
Bladder tumors are typically evaluated with multiple diagnostic tools that may include:
- Urine tests:
- Urine cytology: microscopic examination of the urine to identify tumors cells
- FISH (Florescent In Situ Hybridization): detects abnormal chromosomes associated with bladder tumors
- Cystoscopy: Short in office procedure using a small camera placed in to the urethra to visualize the inner lining of the bladder.
- Imaging: CT scan, Sonogram, MRI may be performed to evaluate the kidneys and additional anatomy of the urinary system
How is it treated?
Most bladder cancer can be biopsied or removed with a minimally invasive procedure in the office or operating room. An initial biopsy may remove the tumor entirely however your urologist while provide a comprehensive follow up plan as bladder tumors may recur.
Once appropriate staging of the disease has been performed, your urologist will discuss comprehensive treatment options which may include:
- Transurethral resection: This procedure occurs in the operating room where a small camera is inserted through the urethra and the tumor is removed/”scraped” out of the bladder. Many tumors in the bladder are superficial and can be treated in this manner.
- Cystectomy and urinary reconstruction: If the bladder tumor has invaded into the deep muscle layers of the bladder then the entire bladder may need to be removed to attain cure. This requires reconstruction of the urinary system and your urologist while discuss your options in detail.
- Radiation/Chemotherapy: After careful consideration, you and your doctor may decide that radiation and/or chemotherapy is the best option for you.
- Intravesical Therapy: Solutions of anti-tumor agents are instilled into the bladder to help prevent bladder tumors from recurring or progessing to more aggressive disease. These substances include BCG (a weakened bacterium) or mitomycin which may be used in conjuction with transurethral resection or given for several weeks after your biopsy.