Bladder cancer is a common form of cancer that typically begins in the cells lining the interior of the bladder called urothelial cells. These urothelial cells can also be found in the ureters and the kidneys. While cancer in these cells can also affect the kidneys, bladder cancer is much more common.
Treatment for bladder cancer is generally highly effective. That is due in large part to the fact that most bladder cancers are detected in the superficial stage meaning it is confined to the lining of the bladder. Bladder cancer is much more dangerous once it becomes invasive. Even with superficial cancers, there is a chance of recurrence of bladder cancer, with most patients requiring follow-up testing for the remainder of their lives.
Several bladder cancer signs overlap with other common urological health conditions. The most common symptoms are:
- Blood in the urine, leading to a pink, red, or cola-colored appearance
- Frequent urination
- Pain during urination
- Back pain
Doctors can use several methods to evaluate a patient for bladder cancer. A urine test can sometimes reveal the presence of cancer cells in the bladder. Imaging tests can reveal cancer as well. In most cases, doctors find bladder cancer when using a scope to examine the bladder in patients presenting with the above symptoms.
Most common urinary issues call for urine samples or imaging tests that help with the early detection of bladder cancer.
Treatment for bladder cancer begins with a biopsy and removal of the bladder tumor which is the initial treatment. Further treatments vary depending on the aggressiveness of the cells (grade) and the stage of the cancer. In general, treatments include monitoring, further surgery, intravesical chemotherapy (medicine instilled into the bladder), chemotherapy, radiation therapy, or a combination of these treatment modalities.
Surgery for superficial (non-invasive) bladder cancer involves removal through a scope inserted into the bladder. In some cases of aggressive non-invasive cancer, immunotherapeutic or chemotherapeutic agents instilled into the bladder are used to reduce recurrences or progression to invasive cancer. In more advanced cases, surgery may be required to remove part or all of the bladder.
When the bladder is removed, doctors must create a urinary diversion. This will typically require major reconstructive surgery. There are several types of urinary diversion and the best choice will be determined by discussion of the options between the patient and their doctor.
Chemotherapy can be used before and/or after surgery in treating bladder cancer. Radiation therapy is sometimes used in tandem with chemotherapy and reserved for patients where surgery is a poor option. Immunotherapy can be effective in treating bladder cancer with medications that help the body’s immune system combat cancer.