Urologic Cancer

Bladder Cancer

What is it?

Cancer is a disease in which cells in an area of the body begin changing and multiplying out of control. The multiplying cells may form a lump of tissue (tumor). With time the cancer cells destroy healthy tissue. They may spread to other parts of the body.

What is the cause or symptoms?

Why cells become cancerous is not clear. But bladder cancer is strongly linked to cigarette smoking. The longer a person smokes and the more a person smokes, the greater that person's changes of developing bladder cancer.

In most cases, blood in the urine is the first sign of bladder cancer. Sometimes there is enough blood to change the color of the urine. Or the urine may be very pale yellow-red or, less often, darker red. In other cases, the color of the urine is normal but small amounts of blood can be found by urine tests that were done because of other symptoms or as part of a check-up.

But blood in the urine does not mean you have bladder cancer. Much more often it is caused by other things, such as infection, benign tumors, or stones in the kidney or bladder.

Having to urinate more often, feeling pain or burning when going, or feeling as if you need to go right away even when the bladder is not full can be symptoms of bladder cancer. But these problems are more often caused by something other than cancer. Bladder cancers that have grown large enough may cause more symptoms, such as lower back pain or being unable to urinate.

How is it diagnosed?

Cancer may have been suspected when you or your doctor found blood in your urine. When blood is found in urine, an evaluation is done to rule out possible cancer. A diagnosis of cancer may be made based on the results of this evaluation, which may include these tests:

Urine cytology - a sample of urine is examined under a microscope for cancer cells.

CT scan or intravenous pyelogram - a series of special x-rays are taken of your kidneys and bladder.

Cystoscopy - the doctor closely examines the inside of your badder with a special telescope-like instrument called a cystoscope that is inserted through your urethra. Samples of tissue may be taken for later study.

What can be done about it?

Once cancer has been diagnosed, the next step is to choose the best way to treat it. To help do this, your doctor checks how deep the cancer has grown and whether it has spread (the cancer stage) and what the cancer cells look like (the cancer grade).

There are three stages: Superficial Stage - the tumor is confined to the bladder lining and submucosal layer of the bladder; Invasive Stage - the tumor has begun to grow into the muscle or fat layers of the bladder; and Metastatic Stage - cancer cells from the main tumor have spread to other areas of the body.

The grade of the bladder cancer is found by looking at cancer cells under a microscope. The grade is based on what the cancer cells look like and how many cells are multiplying. The higher the grade the more uneven the cells are and the more cells are multiplying. Knowing the grade can help your doctor predict how fast the cancer will grow and spread.

Knowing the stage and grade helps your doctor decide which methods will best treat your cancer. After the stage and grade have been found, your doctor can discuss how to move forward with treatment. Following are some treatment options for bladder cancer:

  • Transurethral resection (TUR) - removal of a bladder tumor using a cystoscope
  • Intravesical therapy - placement of liquid medication directly into the bladder to help destroy cancer cells or keep them from returning
  • Chemotherapy - use of intravenous (IV) medications to destroy cancer cells
  • Radiation - use of beams of energy to destroy cancer cells
  • Cystectomy - removal of the bladder


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