Bladder cancer is a disease in which cancer cells grow in the bladder. The bladder, which is located in the lower abdomen, is a hollow organ with flexible muscular walls. Its primary function is to store urine until a person is ready to urinate.
Cancer occurs when cells in the body (in this case bladder cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue, called a growth or tumor, forms. The term cancer refers to malignant tumors, which can invade nearby tissue and spread to other parts of the body. A benign tumor does not invade or spread.
There are three main types of cancer that affect the bladder. They are named for the type of cell that becomes cancerous:
Transitional cell (urothelial) carcinoma—accounts for more than 90% of bladder cancers
Squamous cell carcinoma—accounts for about 4% of bladder cancers
Adenocarcinoma—accounts for about 1%-2% of bladder cancers
Bladder diverticuli: an area of weakness in the bladder wall through which some of the lining of the bladder is forced out
Metastasis from another cancer
Blood in the urine (hematuria)
Frequent urination, or feeling the need to urinate without being able
Lower back pain
Weight loss, bone pain, or abdominal pain in advanced cases
These symptoms may be caused by other less serious health conditions, such as bladder stones or infection. If you are experiencing any of these symptoms, see your physician.
Your doctor will ask about your symptoms and medical history, and perform a physical exam. During the exam, your doctor will feel the abdomen and pelvis for abnormalities. The physical exam may include a rectal or vaginal exam.
Urine cytology—a sample of urine is examined under a microscope to look for cancerous or precancerous cells
Urine culture—a sample of urine is cultured to look for signs of infection (ie, bacteria)
—a procedure in which a doctor looks into the bladder through the urethra using a cystoscope (a slender tube with a lens and light)
—a test that uses sound waves to examine the bladder
Bone scan—a type of gamma-ray that uses a computer and a special gamma-rays detector to make pictures of the bone if metastases is suspected
—removal of a sample of bladder tissue to test for cancer cells
Once bladder cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what parts of the body. Treatments for bladder cancer depend on the stage of the cancer. The stages of bladder cancer are as follows:
Stage 0: Cancer cells are found only on the surface of the inner lining of the bladder.
Stage 1: Cancer cells are found deep in the inner lining of the bladder; no lymph nodes are involved.
Stage 2: Cancer cells have spread to the muscle of the bladder; no lymph nodes are involved.
Stage 3: Cancer cells have spread through the muscular wall of the bladder to the layer of tissue surrounding the bladder
possibly to the reproductive organs including the prostate glands; no lymph nodes are involved.
Stage 4: Cancer cells extending outside the bladder to the wall of the abdomen or to the wall of the pelvis without lymph node involvement
have spread to one or more lymph nodes and other parts of the body.
Treatment options include the following:
Surgery involves removal of cancerous cells and nearby tissue. Types of surgery to treat bladder cancer include transurethral resection and cystectomy.
Transurethral resection—This is done for early stage or superficial bladder cancer. A cystoscope is placed into the bladder through the urethra. At the end of the cystoscope is a small wire loop, which is used to remove cancer cells. Also, fulguration (using electrical current to burn away remaining cancer cells) can be done during this procedure.
(surgical removal of all or part of the bladder)—This is done when bladder cancer is invasive. Segmental (partial) cystectomy is the removal of part of the bladder, while radical cystectomy is the removal of the entire bladder and nearby lymph nodes. In men, the prostate is usually also removed. In women, the uterus, ovaries, part of the vagina, and the fallopian tubes may be removed as well. When the bladder is removed, a form of urinary diversion must be created to store the urine.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms, including pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. For bladder cancer, chemotherapy is often administered directly into the bladder, called intravesical chemotherapy.
Biologic Therapy (Immunotherapy)
Biologic therapy is the use of the body’s immune system to fight cancer. Substances made by the body or in a laboratory are administered directly into the bladder to help boost, direct, or restore the body’s defenses against the cancer.
This type of therapy is used only for superficial low-grade cancers that have been resected transurethrally.
The following steps can reduce your risk of getting bladder cancer:
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a