Bladder cancer is another type of cancer that we treat, and is currently the 5th most common type of cancer diagnosed each year. Bladder cancer risk also increases with age, with most patients over the age of 55, and an average age of 73 at diagnosis. Men are also 3-4 times more likely to have bladder cancer. The biggest risk factor for developing bladder cancer is smoking, both current and former smokers. One more reason to quit! Other less common risk factors are working in dye factories or in rubber/leather/textiles/paint products.

The most common symptom of bladder cancer is blood in the urine, and most often this is painless. Occasionally other less specific symptoms will be noted, such as, frequency/urgency and burning with urination. The key here is to let your doctor know if you see blood in the urine. Your doctor has several tests to help diagnose the cause, including urinalysis, cytology (pap smear type test), urine culture (to rule out infection), and now we are using several newer genetic marker type urine tests to aid in diagnosis. You will also require an office based cystoscopy test where the inside of your bladder is inspected with a small scope.

If a tumor is seen, then a minimally invasive procedure to remove the tumor will be carried out under anesthesia, typically in an outpatient setting. For many patients, this procedure will be all that is required to treat the cancer. However, patients that are diagnosed with bladder cancer will require lifelong monitoring with an occasional cystoscopy test due to the high percentage of recurrence with these tumors. Sometimes x-ray tests are also needed to complete your evaluation. Depending on the stage of the cancer, there are several treatment options that will be discussed, including sometimes a combination of:

● Minimally invasive repeat resection of the bladder tumor

● “In the bladder” chemotherapy

● Robotic removal of the bladder

● Radiation therapy

● IV chemotherapy/immunotherapy

Sometimes after treatment, especially if the bladder is removed, the patient will learn alternative ways to rid the body of urine. All of this would be discussed ahead of time and we have postoperative resources to use if needed to help educate the patient.

The keys with bladder cancer are:

● Early detection – let your doctor know if you see blood in the urine

● Evaluation to diagnose and stage the cancer will be required

● Treatment can be as simple as resection or more involved where the bladder is removed

● Additional treatments may be required

● Long term monitoring will be required

My next blog will cover Kidney Cancer.