The bladder is a hollow organ in the lower abdomen that stores urine and cancer may occur in its lining. Tumors similar to bladder cancer can also form in the kidneys and the ureters (tubes that carry urine from the kidneys to the bladder). Annually, more than 70,000 are diagnosed with bladder cancer and almost 15,000 die from the disease. Unfortunately, many bladder cancers aren’t diagnosed until they become very large. Researchers are working on developing urine tests that would allow for earlier detection of bladder cancer.
Wellstar offers innovative advances in the fight against bladder cancer, including:
- Advanced medical oncologists with special interest in bladder cancer who practice state-of-the-art care in a collegial atmosphere.
- Expert surgical teams offering experience in complex bladder surgery.
- The entire spectrum of diagnostic and interventional treatments, from cystoscopies to intravenous pyelograms to CT scans.
- A Tumor Board, which holds weekly meetings of a multidisciplinary team, for review of complex cases.
- Clinical trials - making novel therapies available to patients.
- Blood in urine or "hematuria" – urine might appear dark yellow, bright red or cola colored. Or blood might be detected in microscopic examination of urine. Most patients with bladder cancer do not have symptoms other than hematuria.
- Frequent urination
- Painful urination
- Urinary tract infection
- Abdominal pain
It's not clear what causes bladder cancer, but doctors have identified factors that may increase your risk of bladder cancer. Risk factors include:
- Increasing age. The risk of bladder cancer increases as you age. Bladder cancer can occur at any age, but it's rarely found in people younger than 40.
- Smoking. Smoking cigarettes, cigars or pipes may increase your risk of bladder cancer by causing harmful chemicals to accumulate in your urine. When you smoke, your body processes the chemicals in the smoke and excretes some of them in your urine. These harmful chemicals may damage the lining of your bladder, which can increase your risk of cancer.
- Exposure to certain chemicals. Your kidneys play a key role in filtering harmful chemicals from your bloodstream and moving them into your bladder. Because of this, it's thought that being around certain chemicals may increase your risk of bladder cancer. Chemicals linked to bladder cancer risk include arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products. Smokers who are exposed to toxic chemicals may have an even higher risk of bladder cancer.
- Previous cancer treatment. Treatment with the anti-cancer drug cyclophosphamide (Cytoxan) increases your risk of bladder cancer. People who received radiation treatments aimed at the pelvis for a previous cancer may have an elevated risk of developing bladder cancer.
- Chronic bladder inflammation. Chronic or repeated urinary infections or inflammations (cystitis), such as may happen with long-term use of a urinary catheter, may increase your risk of bladder cancer.
- Personal or family history of cancer. If you've had bladder cancer, you're more likely to get it again. If one or more of your immediate relatives have a history of bladder cancer, you may have an increased risk of the disease, although it's rare for bladder cancer to run in families. A family history of hereditary non-polyposis colorectal cancer (HNPCC), also called Lynch syndrome, can increase your risk of cancer in your urinary system, as well as in your colon, uterus, ovaries and other organs.
Bladder Cancer Prevention
It is important not to smoke in order to avoid bladder cancer. It’s also important to drink water throughout the day to flush out toxic substances and eat a diet rich in vegetables and fruits.
Help reduce your risk
- If you smoke, please consider getting help to quit through one of WellStar’s tobacco cessation programs. WellStar physicians know that not smoking is one of the most important things a person can do to avoid cancer.
- Take caution with chemicals. If you work with chemicals, follow all safety instructions to avoid exposure.
Tests and screenings
- Your Wellstar doctor may perform urinanalysis to look for abnormal red cells in the urine, which could indicate a sign of bladder cancer.
- Cystoscopy. During cystoscopy, a doctor inserts a narrow tube (cystoscope) through the urethra. The cystoscope has a lens and fiber-optic lighting system, allowing the doctor to see the inside of the urethra and bladder.
- TURBT (transurtheral resection of bladder tumor). During cystoscopy, a doctor may pass a special tool through the urethra and into the bladder in order to collect a small cell sample (biopsy) for testing or to remove the entire tumor as treatment. TURBT is usually completed under general anesthesia
- Urine cytology. A sample of urine is analyzed under a microscope to check for cancer cells in a procedure called urine cytology.
- Imaging tests. Imaging tests allow a doctor to examine the structures of your urinary tract. You may receive a dye, which can be injected into a vein. An intravenous pyelogram is a type of X-ray imaging test that uses a dye to highlight the bladder and ureters. A computerized tomography (CT) scan is a type of X-ray test that allows your doctor to better see your urinary tract and surrounding tissues.
Bladder Cancer Diagnosis
A procedure called a cystoscopy is usually used to diagnose bladder cancer. During a cystoscopy, the physician (a urologist) inserts a thin, lighted tube (cystoscope) into the bladder through the urethra to examine the internal lining of the bladder. The procedure enables the urologist to remove small samples of any abnormal appearing areas of the bladder and examine them under the microscope. When bladder cancer is diagnosed, the urologist will want to learn the extent of the cancer, as well as how aggressive it is.
It might be necessary to perform additional tests such as:
- Computerized tomography (CT) scans
- Magnetic resonance imaging (MRI)
- An intravenous pyelogram (IVP), a procedure which involves the injection of dye into the blood. When the dye (contrast) travels through the kidneys and ureters, it allows them to be visualized with X-rays (fluoroscopy).
Bladder cancer stages
When bladder cancer is diagnosed, your Wellstar physician will categorize it by the current stage: Stage I, Stage II, Stage II or Stage IV. Each stage describes how large the tumor is and whether the cancer has spread to other parts of the body. You should talk to your Wellstar physician to understand each stage, and what it means for your treatment plan.
Bladder Cancer Treatment
Your team of specialists in urology, medical oncology, surgery, radiation oncology, radiology and pathology will work together to assess your best course of bladder cancer treatment. Your treatment will be tailored to your specific type of bladder cancer, and it may involve a combination of surgery, radiation and chemotherapy.
Bladder Cancer Surgery
If you are diagnosed with early-stage bladder cancer and it has not invaded the wall of the bladder, your doctors might recommend:
- TURBT (transurethral resection of bladder tumor): This procedure is often used to remove bladder cancers that are confined to the inner layers of the bladder. During TURBT, a doctor passes a small wire loop through the urethra and into the bladder. The loop is used to remove cancer cells with an electric current. In some cases, a high-energy laser may be used instead of electric current
If your cancer has invaded the deeper layers of the bladder wall, your surgeon might recommend:
- Segmental cystectomy or partial cystectomy: In this procedure, a surgeon removes only the portion of the bladder that contains cancer cells. Segmental cystectomy may be an option if your cancer is limited to one area of the bladder that can easily be removed without harming bladder function.
- Radical cystectomy: A procedure to remove the entire bladder, as well as surrounding lymph nodes. In men, radical cystectomy typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy involves removal of the uterus, ovaries, and part of the vagina.
Medical oncology and chemotherapy
Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life. Adjuvant chemotherapy (after surgery) is administered in certain circumstances when the patient is at high risk for recurrence. Neoadjuvant therapy (before surgery) is also an accepted approach to delivering chemotherapy.
Instillation of the chemotherapy drug, mitomycin, or the immunotherapy drug, BCG, into the bladder can reduce the incidence of superficial cancer recurrences, but no single drug has been confirmed to reduce progression of superficial cancer to invasive bladder cancer. This means that multiple small new cancers can be prevented but progression to a more invasive bladder cancer may occur despite treatment.
Radiation therapy in bladder cancer is used for cure and improving symptoms. Patients who are not surgical candidates can still potentially be cured through radiation and chemotherapy.
At Wellstar, radiation is administered by radiation oncologists in consultation with medical oncologists and surgeons.
Ongoing Care for Bladder Cancer
Cancer care at Wellstar is more than advanced technology, clinical research, and highly specialized physicians and nurses. It includes an array of supportive care services to improve the patient experience before, during and after treatment. All of these services are available within the WellStar system, including:
- Counseling services for individuals, couples and families.
- Nutrition services, which allow cancer patients to stay strong through treatment and eat healthier foods that lower cancer risk.
- Physical therapy centers, which allow many rehab options and lymphedema therapy.
- Smoking cessation programs, which offer support to patients who need to come off cigarettes and nicotine. Special services are offered to those who have made prior attempts.
- Retail stores that offer wigs, mastectomy bras and other cancer support products.
- Genetic counseling services, which offer patients and family members who are at high risk to be tested for genetic abnormalities after meeting with a certified genetic counselor.
- Health Place, which offers programs for cancer patients to regain strength and fight fatigue after chemotherapy or radiation therapy.
Wellstar offers caring and compassionate hospice care for patients and their families in one of Georgia’s oldest hospice programs serving Bartow, Cherokee, Cobb, Douglas and Paulding counties. Our certified palliative care physicians and certified registered nurses are dedicated to providing compassionate, quality care in various settings, including home hospice, inpatient hospice nursing homes, assisted living facilities and nursing homes.