Bladder Cancer

What is bladder cancer?

Bladder cancer is a disease in which cancer cells form in the tissue of the bladder.  There are three types of bladder cancers.  These are transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma.  These cancers are defined as superficial bladder cancer if they’re confined to the lining of the bladder or invasive bladder cancer if they have spread beyond the lining of the bladder.

What are risk factors for bladder cancer?

Cigarette smoking is the major risk factor for bladder cancer.  There are other risk factors that increase a person’s risk for bladder cancer.

• Age – The majority of bladder cancers occur in people over the age of 60
• Male – Men are four times as likely to get bladder cancer than women
• Race – Whites are twice as likely to get bladder cancer compared to African Americans and Hispanics.
• Exposure to environmental substances – such as rubber, certain dyes and textiles, paint and hairdressing supplies
• Treatment with certain drugs
• Personal history of bladder cancer
• Infection with Schistosoma haematobium (parasite found in many developing countries)
  

What are prevention strategies for bladder cancer?

The exact cause of bladder cancer is not known, but there are risk factors for bladder cancer.  It is beneficial to reduce risk factors.

• Smoking – It is important to avoid smoking.  If you smoke, it is important to quit smoking. Click here for more information.
• Environmental substances – It is important to avoid environmental substances that are linked to bladder cancer, such as rubber, certain dyes and textiles, paint and hairdressing supplies.  If avoidance is not possible, such as working in an industry with these chemicals, it is important to follow necessary safety standards.
• Diet – It is important to eat a diet low in fat and high in fruits and vegetables.  Studies indicate this may be a protective factor, as it is with other cancers.
  

Is screening available?

There are no established national screening guidelines for bladder cancer.  If a person is experiencing symptoms that may indicate bladder cancer, they should discuss this with their doctor.

What are the symptoms of bladder cancer?

The following are symptoms of bladder cancer.  However, they can also be an indication of other conditions.

• Blood in the urine;
• Pain during urination;
• Frequent urination or the need to urinate without being able to do so.

If you have any of the above, it is important to see your healthcare provider as soon as possible.

How is bladder cancer diagnosed?

If bladder cancer is suspected, your doctor will take a medical history and conduct a physical exam.  Diagnostic tests will be conducted.  Your doctor will discuss with you which tests will be performed.

• Cystoscopy – A thin tube is inserted through the urethra into the bladder to check for abnormal areas.
• Biopsy – This is often done during a cystoscopy and involves removing cells or tissue for examination under a microscope by a pathologist.
• Urinalysis – This is done to check the color and content of the urine.
• Urine cytology – Examines the urine under a microscope to check for abnormal cells
• Intravenous pyelogram (IVP) – An x-ray is taken of the urinary tract, after dye is injected into the bloodstream.
• Other Imaging tests – Computed Tomography (CT) scan, Magnetic resonance imaging (MRI), ultrasound, bone scan or Positron Emission Tomography (PET) scan.
  

What is staging?

Staging describes the extent of the cancer.  It determines if the cancer has spread and if so, what parts of the body are affected.  Staging a cancer is important to assist the doctor to determine the appropriate course of treatment and assess an accurate prognosis. 

The most common staging system is the TNM.

• T – size of the tumor
• N – degree to which regional lymph nodes are involved
• M – the absence or presence of distant metastases

Once the TNM has been determined, then a stage of I, II, III or IV is assigned.

• Stage I – cancers are small and local and usually curable
• Stage II & III – typically these are locally advanced and could involve the lymph nodes
• Stage IV – cancer has metastasized and can be inoperable
  

What are treatment options?

The main treatment options for bladder cancer are surgery, radiation therapy, immunotherapy and chemotherapy.  Your treatment will depend on factors such as stage of the cancer.

What clinical trials are available?

Clinical trials are studies that seek to find better ways to prevent, screen, diagnose and treat a disease such as cancer.  Clinical trials test new approaches to treatment, such as, new drugs, new approaches to surgery or radiation therapy, or a combination of treatments.

Learn more about clinical trials.

What questions should I ask my doctor?

It is often helpful to make a list of questions before an appointment.  This will help you to remember what the doctor says.  Patients and care givers can write notes or ask if they may use a tape recorder.  Sometimes it is helpful to have a family member or friend at the appointment to take notes, ask questions or just listen.  Below are a few suggested questions a patient may ask their doctor.

Will you please write down the type of cancer that I have?

What stage is my cancer and what does that mean?

What are my treatment options?

What treatment do you recommend and why?

What are the risks and benefits of each treatment?

What are possible side effects of treatment?

How will you help manage my side effects?

How will treatment affect my normal activities?

Are there specific things I must do to get ready for treatment?

Are there other things I can be doing to help with my treatment, such as diet and exercise?

What are resources that I can turn to learn more about my cancer and help me deal with it?

Make an appointment

Resources

American Cancer Society – www.cancer.org, 1-800-ACS-2345

American Foundation for Urologic Disease - www.afud.org

Cancer Care, Inc. - www.cancercare.org, 1-800-813-HOPE

National Cancer Institute - www.cancer.gov, 1-800-4CANCER