Bladder Cancer
Bladder cancer affects more than 57,000 men and 18,000 women yearly in the United States. About 16,000 people die each year from this disease. Bladder cancer is a growth that forms on the wall of the bladder and slowly grows larger and deeper until it can escape the bladder and cause metastatic disease. It is most commonly found in smokers (current, former or even second-hand smokers) or those who have been exposed to certain chemicals. Sometimes it can be a genetic mutation, so even if you don’t smoke you can still get bladder cancer.
It is generally a superficial tumor that can be treated easily and with minimal invasive methods. However, it does have a high rate of recurrence- so close monitoring after treatment is required.
Symptoms:
Blood in the urine is the most common symptom. Usually, it is microscopic blood picked up only by a urine test. But sometimes you can see the blood with the naked eye as well.
Other symptoms may include:
- Bladder pain
- Frequency or urination
- Urgency of urination
- Retention of urination
Risk Factors:
- Smokers- current, former and second-hand smokers. Please quit smoking- the sooner you quit the less chance of cancer you will have
- Exposure to chemicals- cleaning supplies, dry cleaners, Agent Orange, arsenic
- Recurrent UTI
- Chronic catheters in the bladder
- Some parasitic bladder infections
Evaluation and Diagnosis:
Urinalysis is the best screening test. Any blood in the urine will trigger a urology consultation and evaluation
Urine cytology- a specialized urine test to look for cancer cells
Cystoscopy- a small camera placed inside the bladder to evaluate for growths
*a cystoscopy is the only reliable way to find a bladder tumor. Imaging studies are unreliable and usually miss a bladder tumor
CT Scan- isn’t very accurate for bladder cancers but can determine if the cancer has spread outside the bladder
TURBT- transurethral resection of the bladder tumor. This is the procedure that will definitively tell you if the growth you have is cancer. Once a growth is seen, you will go under general anesthesia and Dr. Shaba can place a camera inside the bladder and scrape the growth off. It will be sent to pathology to confirm. Over 90-95% of lesions in the bladder seen on office cystoscopy are bladder cancer.
Treatment:
TURBT (transurethral resection of bladder tumor) is the treatment in most cases. Once diagnosed with a growth, the tumor will be scraped off under general anesthesia. This will be done with a small camera without any incisions on the skin.
Usually, the TURBT is the only treatment you will need. More treatment may be recommended depending on the type and depth of the tumor.
If the pathology shows no cancer, then you likely will just be monitored with urine tests and possible office cystoscopy over time.
If the cancer is low grade, then the TURBT is the treatment. You will need monitoring every 3 months with office cystoscopy for 2 years then space these out over time.
If the cancer is high grade, Dr. Shaba may recommend BCG treatments in addition to the monitoring with cystoscopy. BCG is a chemical put in your bladder weekly to prevent recurrence.
If the cancer has penetrated the muscle layer, then the treatment becomes much more invasive. Invasion to the muscle layer usually involves chemotherapy and surgical removal of the bladder and surround tissue. This only happens in 5-10 percent of the cases.
For more information please visit: https://www.urologyhealth.org/urology-a-z/n/non-muscle-invasive-bladder-cancer
https://www.urologyhealth.org/urology-a-z/m/muscle-invasive-bladder-cancer
