Bladder Cancer

Bladder cancer is a disease that forms in the tissues of the bladder and develops when abnormal cells multiply without control. The inside of the bladder is lined with a layer of cells called urothelial or transitional cells – this is where the most common form of bladder cancer begins. It starts in the lining layer of the bladder and grows into the bladder wall. Once the cancer spreads from the urothelial cells to the inner layers of the bladder wall, it is referred to as invasive bladder cancer. The same type of cells also lines the kidneys, ureters, and urethra. Cancer can develop in the lining of any of these organs of the body’s urinary system.

The American Cancer Society estimates that 67,160 new cases of bladder cancer will be diagnosed in the United States this year.  It is a disease that is more common in men and more common among Caucasians than in African-Americans. Men are three times as likely to be diagnosed with bladder cancer. When bladder cancer is discovered and treated in its early stages, the chances for survival are very good.

Q: What is the bladder?

A: Located in the lower abdomen, this organ serves as a receptacle for urine – the waste product produced when the kidneys filter blood. The bladder can be described as an elastic bag; it has a small muscular wall that allows it to expand or contract as urine is stored or emptied. Urine passes from the kidneys into the bladder through tubes called ureters and out of the bladder through another tube called the urethra.

Q: Am I at risk?

A: Bladder cancer is most likely to occur in men over the age of 55. The occurrence rate in men is three times that of women, and the incidence rate for Caucasians is twice that of African-Americans. The cause of bladder cancer is not fully understood; however, its risk factors are known to include the following:
  • Exposure to carcinogens in the workplace, such as paints and solvents
  • Smoking:
    • Smokers develop bladder cancer two-to-three times as often as nonsmokers.
    • Smoking is estimated to be the cause of about 47% of bladder cancers in men and 37% in women.
  • People who feel that they may be at risk for developing bladder cancer should speak with their physician.

Q: What are the symptoms?
A: Common symptoms of bladder cancer include the following:

  • Blood in the urine
  • Pain during urination
  • Frequent urination
  • Feeling the need to urinate, but without actual results
  • Lower back pain

Since other health problems may cause these symptoms, it is important to consult your physician to receive an accurate diagnosis.

Q: How is bladder cancer diagnosed?

A: Once a patient experiences symptoms of bladder cancer, there are several types of tests that can be used to confirm or rule out a cancer diagnosis.  Some tools that physicians use to detect and diagnosis bladder cancer include:
  • Physical examination – The physician feels the abdomen and pelvis for tumors; the examination may include the rectum or vagina.
  • Urine tests –Laboratory examination of the urine for color, contents (i.e. sugar, protein, red blood cells, white blood cells), blood (hematuria), cancer cells (abnormal cellularity), and other signs of disease
  • Imaging tests – These tests allow a physician to visualize organs on a monitor or on film and may include MRI, X-ray, CT scan and/or ultrasound; a dye may be injected or swallowed to make the organs/tissues more visible during these procedures.
  • Cystoscopy – A thin, lighted tube (cystoscope) is inserted through the urethra into the bladder to detect abnormalities; the physician may excise as tissue sample (biopsy) for subsequent pathological examination – often the only method of definitively diagnosing bladder cancer.

Q: Do I have a choice of treatment?

A: A person with bladder cancer has several treatment options to consider when facing this disease.  Selection of a treatment option is dependent upon a number of factors, such as the stage of the disease, the type of bladder cancer cells, the patient’s age and general health, and any personal concerns the patient may have regarding the treatment process. Treatment options may include the following:
  • Surgery – depending upon the stage and grade of the tumor:
    • Transurethral resection
    • Radical cystectomy
    • Segmental cystectomy
  • Radiation therapy:
    • External radiation
    • Internal radiation
    • Chemotherapy
  • Biological therapy
    Your physician is the best person to discuss treatment choices and expected results. It is essential that you to confer with your physician in order to enable him or her to develop the most effective treatment plan – one that is specifically tailored to your needs.