Bladder Cancer

Bladder Cancer

Bladder cancer is a cancer that starts in the bladder, the body part that holds and releases urine. The exact cause of bladder cancer in uncertain. However, several things may make you more likely to develop it, 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

Diagnosing Bladder Cancer

Your doctor will perform a detailed history and physical examination, including a rectal and pelvic exam. Tests that may be done to look for bladder cancer include:

• CT scan: x-ray imaging that show detailed views of the abdominal and pelvic organs
• Urinalysis: a test performed in the doctor’s office used for finding blood in the urine
• Urine Cytology: detailed microscopic evaluation of the urine looking for cancer cells floating in the urine
• Cystoscopy: visualization of the inside of the bladder with an endoscope
• Bladder biopsy: usually done in the operating room, where suspicious areas are sampled to determine if cancer is present

Bladder Cancer Treatments

Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health.

Superficial bladder cancer:

Cancer in the lining of the bladder.

• Treatment usually involves removing the tumor through an endoscope.
• Subsequent treatment may include chemotherapy and/or immunotherapy treatments, which is medicine instilled into the bladder over a series of weeks. This helps to reduce the chance that the cancer may return.
• Routine follow up is needed to ensure that the cancer hasn’t returned. This usually involves repeat Cystoscopy in the office every 3-6 months for several years.

Muscle-Invasive bladder cancer:

Cancer that has grown into the wall of the bladder.

• If the bladder cancer has progressed, and has grown into the wall of the bladder, much more aggressive treatment is warranted.

Radical Cystectomy:

Complete removal of the bladder.

• This is major surgery, usually involving a hospital-stay of up to a week. The lymph nodes around the bladder are also removed to determine if the cancer has begun to spread.
• If you are a male, the prostate is removed along with the bladder.
• If you are a female, the uterus and ovaries are removed, if still present.

Once the bladder is removed, the options for removing the urine are:

• Ileal Conduit: A small section of your small bowel is used to create an ostomy on your abdomen for urine to drain into a bag. This is the most common type of diversion, and offers greatest ease of use and lowest risk.
• Neobladder: A larger section of your small bowel is used to create a reservoir in which to hold your urine inside you body. It is attached to the urethra, and the patient continues to urinate much in the same way as you do now. While a more attractive option for some patients, it is not for everyone and comes with it’s own set of drawbacks. Ask your urological surgeon if this option is right for you.
• Robotic Surgery for Bladder Cancer: at Urology Centers of Alabama, the physicians continue to lead the forefront in robotic surgery for various urological diseases. With an expanded robotics program for the treatment of bladder cancer with robotic radical cystectomy. Specially trained robotic surgeons at Urology Centers of Alabama are among the nations’ most experienced in the field of bladder cancer.
• Robotic surgery offers many advantages including:
• Much less blood loss, resulting in very seldom need for blood transfusions
• Less pain
• Shorter hospital stay
• Better cosmetic result
• Ask your urologist if robotic surgery might be an option for you.
• Radiation & Chemotherapy: If surgery is not an option for you, due to poor overall health, your doctor may recommend combination radiation and chemotherapy to kill the cancer.
• As with all treatments, side effects are possible. Be sure to ask your doctor the pros and cons to each option, to decide which is right for you.

Bladder Cancer Prognosis

How well a patient with bladder cancer does depends on the initial stage and response to treatment. The outlook for early bladder cancer is fairly good, while those with more advanced cancer at diagnosis lessens.

Call your physician if you have blood in the urine or other symptoms of bladder cancer. Early referral to a urologist is very important, in that early detection is key.