Bladder Cancer

Each year, nearly 55,000 people in the United States learn that they have bladder cancer. We insist to help patients with bladder cancer and their families and friends better understand this disease. We hope others will read it as well to learn more about bladder cancer.

 This booklet discusses symptoms, diagnosis, treatment, and rehabilitation. It also has information to help patients cope with bladder cancer.

Most cancers are named for the part of the body or type of cells in which they begin. About 90 percent of bladder cancers are transitional cell carcinomas, cancers that begin in the cells lining the bladder. Cancer that is confined to the lining of the bladder is called superficial bladder cancer. After treatment, superficial bladder cancer can recur; if this happens, most often it recurs as another superficial cancer.

In some cases, cancer that begins in the transitional cells spreads through the lining of the bladder and invades the muscular wall of the bladder. This is known as invasive bladder cancer. Invasive cancer may grow through the bladder wall and spread to nearby organs.

Bladder cancer cells may also be found in the lymph nodes surrounding the bladder. If the cancer has reached these nodes, it may mean that cancer cells have spread to other lymph nodes and to distant organs, such as the lungs. The cancer cells in the new tumor are still bladder cancer cells. The new tumor is called metastatic bladder cancer rather than lung cancer because it has the same kind of abnormal cells that were found in the bladder.

Symptoms:

Some common symptoms of bladder cancer include:

1. Blood in the urine (slightly rusty to deep red in color).

2.  Pain during urination.

3.  Frequent urination, or feeling the need to urinate without results.

When symptoms occur, they are not sure signs of bladder cancer. They may also be caused by infections, benign tumors, bladder stones, or other problems. Only a doctor can make a diagnosis. (People with symptoms like these generally see their family doctor or a urologist, a doctor who specializes in diseases of the urinary system.) It is important to see a doctor so that any illness can be diagnosed and treated as early as possible

Diagnosis and Staging:

To find the cause of symptoms, the doctor asks about the patient's medical history and does a physical exam. The physical will include a rectal or vaginal exam that allows the doctor to check for tumors that can be felt. In addition, urine samples are sent to the laboratory for testing to check for blood and cancer cells.

 The doctor may use an instrument to look directly into the bladder, a procedure called cystoscopy. This procedure may be done with local or general anesthesia. The doctor inserts a thin, lighted tube (called a cystoscope) into the bladder through the urethra to examine the lining of the bladder. The doctor can remove samples of tissues through this tube. The sample is then examined under a microscope by a pathologist. The removal of tissue to look for cancer cells is called a biopsy. In many cases, performing a biopsy is the only sure way to tell whether cancer is present. If the entire cancer is removed during the biopsy, bladder cancer can be diagnosed and treated in a single procedure. A patient who needs a biopsy may want to ask the doctor some of the following questions:

1. Why do I need to have a biopsy?

2.  How long will it take? Will I be awake? Will it hurt?

3.  What side effects can I expect?

4.  How soon will I know the results?

5.  If I do have cancer, who will talk with me about treatment?

6. When?

Once bladder cancer is diagnosed, the doctor will want to learn the grade of the cancer and the stage, or extent, of the disease. Grade is important because it tells how closely the cancer resembles normal tissue and suggests how fast the cancer is likely to grow. Low-grade cancers more closely resemble normal tissue and are likely to grow and spread more slowly than high-grade cancers.

Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The stage of bladder cancer may be determined at the time of diagnosis, or it may be necessary to perform additional tests. Such tests may include imaging tests--CT scan, MRI, sonogram, IVP, bone scan, or chest x-ray.