What are the common symptoms of bladder cancer. How is bladder cancer diagnosed and treated. What are the risk factors for developing bladder cancer. What are the different types of bladder tumors. How can bladder cancer be prevented or detected early.

Understanding Bladder Cancer: Types, Symptoms, and Risk Factors

Bladder cancer is a serious condition that affects thousands of people each year. It occurs when abnormal cells in the bladder begin to grow and divide uncontrollably, forming a tumor. To better understand this disease, it’s crucial to explore its various aspects.

Types of Bladder Tumors

Bladder tumors can be categorized into two main types: benign (non-cancerous) and malignant (cancerous). While benign tumors don’t spread to other parts of the body, malignant tumors can metastasize, making them more dangerous.

Benign bladder tumors include:

• Fibromas: Originating in the connective tissue of the bladder wall
• Hemangiomas: Comprised of a mass or lump of blood vessels in the bladder wall
• Inverted papillomas: Developing on the bladder lining with a smooth surface
• Leiomyomas: Originating in the muscle layer of the bladder wall
• Lipomas: Originating in the fat cells surrounding the bladder
• Neurofibromas: Originating in the nerve tissue of the bladder
• Papillomas: Originating in the urothelial cells lining the bladder and urinary tract

Malignant bladder tumors, or bladder cancer, can be further classified based on their cell type and invasiveness. The most common type is transitional cell carcinoma, which begins in the cells lining the inside of the bladder.

Common Symptoms of Bladder Cancer

Recognizing the symptoms of bladder cancer is crucial for early detection and treatment. Some common signs include:

• Blood in the urine (hematuria)
• Increased urinary frequency and urgency
• Difficulty urinating
• Pain or burning sensation during urination
• Lower back pain
• Pelvic pain

It’s important to note that these symptoms can also be caused by other conditions, so a proper medical evaluation is necessary for an accurate diagnosis.

Risk Factors for Bladder Cancer

Several factors can increase a person’s risk of developing bladder cancer:

• Smoking: The most significant risk factor, responsible for about half of all bladder cancer cases
• Age: The risk increases with age, with most cases occurring in people over 70
• Gender: Men are more likely to develop bladder cancer than women
• Exposure to certain chemicals: Especially those used in the dye, rubber, leather, textiles, and paint industries
• Chronic bladder inflammation: Such as recurrent urinary tract infections or bladder stones
• Personal or family history of bladder cancer
• Certain genetic mutations

Understanding these risk factors can help individuals take preventive measures and seek early medical attention if they’re at higher risk.

Diagnosis and Staging of Bladder Cancer

Accurate diagnosis and staging of bladder cancer are crucial for determining the most effective treatment plan. Healthcare providers use various methods to diagnose and assess the extent of the disease.

Diagnostic Procedures

The following procedures are commonly used to diagnose bladder cancer:

• Cystoscopy: A thin, tube-like instrument with a light and lens is inserted through the urethra to examine the bladder’s interior
• Urine cytology: Examination of urine samples under a microscope to look for cancer cells
• Imaging tests: Such as CT scans, MRIs, or ultrasounds to visualize the bladder and surrounding structures
• Biopsy: Removal of tissue samples for examination under a microscope

How is cystoscopy performed? During a cystoscopy, the urologist inserts a cystoscope through the urethra into the bladder. This allows for direct visualization of the bladder lining and the ability to take tissue samples if necessary. The procedure is typically done under local anesthesia and takes about 15-30 minutes.

Staging Bladder Cancer

Once bladder cancer is diagnosed, it’s important to determine its stage. The stage indicates how far the cancer has spread and helps guide treatment decisions. The TNM system is commonly used for staging:

• T (Tumor): Describes the size and extent of the main tumor
• N (Nodes): Indicates whether the cancer has spread to nearby lymph nodes
• M (Metastasis): Shows if the cancer has spread to other parts of the body

Based on these factors, bladder cancer is typically staged from 0 to IV, with higher numbers indicating more advanced disease.

Treatment Options for Bladder Cancer

The treatment of bladder cancer depends on various factors, including the stage of the disease, the patient’s overall health, and personal preferences. Several treatment options are available, often used in combination for the best outcomes.

Surgical Interventions

Surgery is a common treatment for bladder cancer. The type of surgery depends on the stage and grade of the tumor:

• Transurethral resection of bladder tumor (TURBT): Removal of the tumor through the urethra
• Partial cystectomy: Removal of part of the bladder
• Radical cystectomy: Removal of the entire bladder and possibly surrounding tissues

What is the recovery time after a radical cystectomy? The recovery time after a radical cystectomy varies, but patients typically spend 5-7 days in the hospital. Full recovery can take 6-8 weeks, during which time patients learn to manage their new urinary diversion system.

Non-Surgical Treatments

In addition to surgery, other treatment modalities may be used:

• Intravesical therapy: Medications are placed directly into the bladder
• Chemotherapy: Use of drugs to kill cancer cells throughout the body
• Radiation therapy: High-energy beams to destroy cancer cells
• Immunotherapy: Stimulates the body’s immune system to fight cancer cells
• Targeted therapy: Uses drugs that target specific abnormalities in cancer cells

These treatments may be used alone or in combination, depending on the individual case.

Living with Bladder Cancer: Coping Strategies and Support

A diagnosis of bladder cancer can be overwhelming, affecting not only physical health but also emotional and mental well-being. Developing effective coping strategies and seeking support are crucial for navigating this challenging journey.

Emotional and Psychological Support

Dealing with bladder cancer can trigger a range of emotions, including fear, anxiety, and depression. It’s important to address these feelings and seek support when needed:

• Counseling or therapy: Professional mental health support can help patients process their emotions and develop coping mechanisms
• Support groups: Connecting with others who have similar experiences can provide valuable emotional support and practical advice
• Mind-body techniques: Practices such as meditation, yoga, or deep breathing exercises can help manage stress and improve overall well-being

How can joining a support group benefit bladder cancer patients? Support groups offer a safe space for patients to share their experiences, learn from others, and feel less isolated. They can provide practical tips for managing side effects, coping with emotional challenges, and navigating the healthcare system.

Lifestyle Adjustments

Making certain lifestyle changes can help improve quality of life during and after bladder cancer treatment:

• Dietary modifications: A balanced diet rich in fruits, vegetables, and whole grains can support overall health and recovery
• Regular exercise: Physical activity, as approved by healthcare providers, can help maintain strength and reduce fatigue
• Smoking cessation: Quitting smoking is crucial for reducing the risk of cancer recurrence and improving treatment outcomes
• Stress management: Developing healthy ways to manage stress, such as hobbies or relaxation techniques

These lifestyle adjustments can contribute to better physical and emotional well-being during the cancer journey.

Advances in Bladder Cancer Research and Treatment

The field of bladder cancer research is continuously evolving, with new discoveries and treatment approaches emerging regularly. Staying informed about these advancements can provide hope and potentially new options for patients.

Emerging Therapies

Several promising areas of research are showing potential in improving bladder cancer treatment:

• Immunotherapy advancements: New immune checkpoint inhibitors and combination therapies are being studied to enhance the body’s ability to fight cancer
• Targeted therapies: Drugs that target specific genetic mutations or proteins involved in cancer growth are under investigation
• Gene therapy: Techniques to modify genes within cancer cells or deliver genes to enhance the immune response are being explored
• Nanoparticle drug delivery: This approach aims to improve the effectiveness of drugs while reducing side effects

What is the potential impact of immunotherapy on bladder cancer treatment? Immunotherapy has shown promising results in some patients with advanced bladder cancer, leading to durable responses and improved survival rates. Ongoing research aims to expand its effectiveness to more patients and earlier stages of the disease.

Clinical Trials

Clinical trials play a crucial role in advancing bladder cancer treatment. They offer patients access to new therapies before they become widely available and contribute to the development of improved treatment options. Patients interested in participating in clinical trials should discuss this option with their healthcare team.

Prevention and Early Detection of Bladder Cancer

While not all cases of bladder cancer can be prevented, there are steps individuals can take to reduce their risk and increase the chances of early detection.

Risk Reduction Strategies

Several lifestyle choices and habits can help lower the risk of developing bladder cancer:

• Quit smoking: This is the most important step in reducing bladder cancer risk
• Limit exposure to chemicals: Use protective equipment when working with potentially harmful substances
• Stay hydrated: Drinking plenty of water may help flush out harmful substances from the bladder
• Eat a healthy diet: A diet rich in fruits and vegetables may have protective effects
• Exercise regularly: Physical activity is associated with a lower risk of many types of cancer, including bladder cancer

How does quitting smoking affect bladder cancer risk? Quitting smoking can significantly reduce the risk of bladder cancer. Studies have shown that the risk begins to decrease within a few years of quitting and continues to drop over time, although it may take up to 20-30 years to reach the level of a never-smoker.

Screening and Early Detection

Currently, there are no widely recommended screening tests for bladder cancer in the general population. However, individuals at high risk may benefit from certain screening approaches:

• Urine cytology: Examining urine samples for cancer cells
• Urine biomarker tests: Detecting specific substances in the urine that may indicate the presence of bladder cancer
• Regular check-ups: Discussing any urinary symptoms with a healthcare provider promptly

Early detection is crucial for improving treatment outcomes, so it’s important to be aware of potential symptoms and seek medical attention if they occur.

The Role of Multidisciplinary Care in Bladder Cancer Management

Effective management of bladder cancer often requires a team approach, bringing together specialists from various medical disciplines. This multidisciplinary care ensures that patients receive comprehensive, coordinated treatment tailored to their individual needs.

Key Team Members

A typical bladder cancer care team may include:

• Urologist: Specializes in diseases of the urinary system and performs surgical procedures
• Medical oncologist: Manages chemotherapy and other systemic treatments
• Radiation oncologist: Administers radiation therapy
• Pathologist: Examines tissue samples to diagnose and stage cancer
• Radiologist: Interprets imaging studies
• Oncology nurse: Provides patient education and coordinates care
• Nutritionist: Offers dietary guidance during treatment
• Social worker or psychologist: Provides emotional support and practical assistance

How does multidisciplinary care benefit bladder cancer patients? Multidisciplinary care ensures that all aspects of a patient’s treatment are considered and coordinated. This approach can lead to more comprehensive treatment plans, better management of side effects, and improved overall outcomes.

Collaborative Treatment Planning

In a multidisciplinary approach, team members collaborate to develop a comprehensive treatment plan. This may involve:

• Regular team meetings to discuss complex cases
• Sharing of expertise across disciplines
• Consideration of the latest research and clinical trials
• Coordination of various treatment modalities
• Addressing the patient’s overall well-being, including physical, emotional, and social needs

This collaborative approach ensures that patients receive the most appropriate and effective care based on their individual circumstances.

Bladder Tumors | University of Miami Health System

An abnormal growth that develops in the bladder is known as a bladder tumor. Some bladder tumors are benign (noncancerous), while others are malignant (cancerous). Malignant bladder tumors – also known as bladder cancer – can spread (metastasize) into other parts of the body.

Types of benign bladder tumors include:

• Fibromas: originate in the connective tissue of the bladder wall
• Hemangiomas: comprised of a mass or lump of blood vessels of the bladder wall
• Inverted papillomas: develop on the lining of the bladder and have a smooth surface
• Leiomyomas: originate in the muscle layer of the bladder wall
• Lipomas: originate in the cells in the fat layer that surrounds the bladder
• Neurofibromas: originate in the nerve tissue of the bladder
• Papillomas: originate in the urothelial cells, which make up the lining of the bladder and urinary tract

What are the symptoms of a bladder tumor?

• Back pain
• Blood in the urine (hematuria)
• Difficulty urinating
• Increased urinary frequency and urgency
• Pain in the pelvis
• Pain while urinating

The urologists at the Desai Sethi Urology Institute are experts in treating both benign and malignant tumors of the bladder.

Treatments

Surgery

In most cases, your urologist will recommend that you undergo surgery to remove the bladder tumor.

Tests

Cystoscopy

A tool called a cystoscope is inserted through the urethra (tube that transmits urine from the bladder) directly into the bladder to check for abnormalities like tumors or stones. This thin, tube-like instrument has a light and a lens for viewing. It can also have a tool to remove (biopsy) suspicious tissue samples. Pathologists review these samples with a microscope to look for signs of cancer.

Digital Rectal or Vaginal Exam

Your healthcare provider inserts a gloved finger into the rectum or vagina, which allows them to check for lumps or other abnormalities.

Laboratory Tests

A urine sample is checked for blood, chemicals, bacteria, and cells. The urine may be examined microscopically to look for cancer cells, or grown in a culture to check for infection.

Bladder Tumor Marker Studies

These tests look at cellular characteristics and substances released by bladder tumor cells into the urine.

Bladder Biopsy

Tissue samples can be taken from the bladder using a needle or during surgery if not removed with cystectomy. Pathologists review these samples with a microscope to look for signs of cancer or abnormal tissue.

Why Choose UHealth?

Leading experts in urology care. At the Desai Sethi Urology Institute, our team of recognized surgeons, researchers, technologists, and nurses has expertise in every subspecialty of urologic care, including urologic oncology and urologic reconstruction. You receive treatment from an experienced team that can give you the latest therapies.

Leaders in robotic surgery treatment. We have some of the world’s most experienced robotic surgeons for urologic procedures. In fact, doctors come from all over the world to learn at our Urology Robotic Program — the #1 ranked program in South Florida. The University of Miami Health System was the first academic medical center in the world to get the da Vinci Xi robotic surgery system and has completed more than 5,000 robotic surgeries — procedures that offer less pain and scarring and a faster recovery.

A top-ranked program for kidney and bladder cancer treatment. We offer advanced care for urologic cancers and are ranked among the top five kidney and bladder cancer programs in the country. Our urologists are dedicated to identifying cancer early so we can provide more effective treatment. We were the first — and only — medical center in South Florida to use enhanced Blue Light Cystoscopy with Cysview imaging technology to detect and identify bladder cancer. 

Bladder Cancer: Introduction | Cancer.Net

Approved by the Cancer.Net Editorial Board, 12/2021

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Bladder Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this entire guide.

About the bladder, renal pelvis, ureter, and urethra (urinary tract)

The bladder is a hollow organ in the pelvis that stores urine before it leaves the body during urination. This function makes the bladder an important part of the urinary tract. The urinary tract is also made up of the kidneys, ureters, and urethra. The renal pelvis is a funnel-like part of the kidney that collects urine and sends it into the ureter. The ureter is a tube that runs from each kidney into the bladder. The urethra is the tube that carries urine out of the body. The prostate gland is also part of the urinary tract.

The bladder, like other parts of the urinary tract, is lined with a layer of cells called the urothelium. This layer of cells is separated from the bladder wall muscles, called the muscularis propria, by a thin, fibrous band called the lamina propria.

Bladder cancer begins when healthy cells in the bladder lining—most commonly urothelial cells—change and grow out of control, forming a mass called a tumor. Urothelial cells also line the renal pelvis and ureters and urethra. Cancer that develops in the renal pelvis and ureters is also considered a type of urothelial cancer and is often called upper tract urothelial cancer. In most cases, it is treated in much the same way as bladder cancer and is described in this guide. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. Benign bladder tumors are very rare.

Types of bladder cancer

The type of bladder cancer depends on how the tumor’s cells look under the microscope. The 3 main types of bladder cancer are:

• Urothelial carcinoma. Urothelial carcinoma (or UCC) accounts for about 90% of all bladder cancers. It also accounts for 10% to 15% of kidney cancers diagnosed in adults. It begins in the urothelial cells that line the urinary tract. Urothelial carcinoma used to be called transitional cell carcinoma or TCC.

• Squamous cell carcinoma. Squamous cells develop in the bladder lining in response to irritation and inflammation. Over time, these cells may become cancerous. Squamous cell carcinoma accounts for about 4% of all bladder cancers.

• Adenocarcinoma. This type accounts for about 2% of all bladder cancers and develops from glandular cells.

There are other, less common types of bladder cancer, including micropapillary, plasmacytoid, sarcomatoid carcinoma of the bladder, and small cell bladder cancer, among others. Sarcomas of the bladder often begin in the fat or muscle layers of the bladder. Small cell bladder cancer is a rare type of bladder cancer that is likely to spread to other parts of the body.

Other ways of describing bladder cancer

In addition to its cell type, bladder cancer may be described as noninvasive, non-muscle-invasive, or muscle-invasive.

• Noninvasive. Noninvasive bladder cancer includes noninvasive papillary carcinoma and carcinoma in situ (CIS). Noninvasive papillary carcinoma is a growth found on a small section of tissue that is easily removed. This is called stage Ta. CIS is cancer that is found only on or near the surface of the bladder, which is called stage Tis. See Stages and Grades for more information.

• Non-muscle-invasive. Non-muscle-invasive bladder cancer typically has only grown into the lamina propria and not into muscle, also called stage I. Non-muscle-invasive cancer may also be called superficial cancer, although this term is being used less often because it may incorrectly suggest that the cancer is not serious.

• Muscle-invasive. Muscle-invasive bladder cancer has grown into the muscle of the bladder wall and sometimes into the fatty layers or surrounding tissues or organs outside the bladder.

It is important to note that non-muscle-invasive bladder cancer has the potential of spreading into the bladder muscle or to other parts of the body. Additionally, all cell types of bladder cancer can spread beyond the bladder to other areas of the body through a process known as metastasis.

If a bladder tumor has spread into the surrounding organs, such as the uterus, vagina, prostate gland, and/or nearby muscles, it is called locally advanced disease. Bladder cancer also often spreads to the lymph nodes in the pelvis. If it has spread into the liver, bones, lungs, lymph nodes outside the pelvis, or other parts of the body, the cancer is called metastatic disease. This is described in more detail in Stages and Grades.

Looking for More of an Introduction?

If you would like more of an introduction, explore this related item. Please note that this link will take you to another section on Cancer.Net.

• ASCO Answers Fact Sheet: Read a 1-page fact sheet that offers an introduction to bladder cancer. This free fact sheet is available as a PDF, so it is easy to print.

• Cancer.Net En Español: Read about bladder cancer in Spanish. Infórmase sobre cáncer de vejiga en español.

The next section in this guide is Statistics. It helps explain the number of people who are diagnosed with bladder cancer and general survival rates. Use the menu to choose a different section to read in this guide.

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Bladder Cancer – Statistics ›

Bladder cancer – stages, symptoms, diagnosis

Bladder cancer is a malignant formation on the wall of the bladder or its mucous membrane. The disease occupies the third position after oncourological pathology of the prostate and kidneys. In men, this disease is diagnosed three times more often than in women. Approximately 79% of cases are people aged 50-80 years. Mortality from complications of this disease is low – from three to eight percent (statistics from developed countries). Every year in our country, bladder cancer is diagnosed in more than 16,000 people. The number of sick people is increasing every year.

Anatomy of the urinary system

The urinary bladder (UB) is a hollow organ of the urinary system located in the small pelvis. It is a reservoir for the accumulation of urine, which is emptied through the urethra. The capacity of a man’s organ is 0.35-0.55 l; women – 0.25-0.45 liters. When the organ is full of 0.15-0.25 l, there is an urge to urinate. The faster the organ is filled, the stronger the irritating effect on muscle receptors occurs and the work of the urinary system becomes more frequent.

Cancer of the urinary tract: classification and stages

The urinary bladder (UB) is a hollow organ of the urinary system located in the small pelvis. It is a reservoir for the accumulation of urine, which is emptied through the urethra. The capacity of a man’s organ is 0.35-0.55 l; women – 0.25-0.45 liters. When the organ is full of 0.15-0.25 l, there is an urge to urinate. The faster the organ is filled, the stronger the irritating effect on muscle receptors occurs and the work of the urinary system becomes more frequent.

Cancer of the bladder: classification and stages

A malignant tumor of this organ is detected by histological examination, according to the degree of cell differentiation, the formation of secondary foci (metastases), and the nature of growth. These parameters are extremely important for planning a therapy strategy.

The morphology of malignant tumors is as follows: over 90% falls on the share of transitional cell tumors; up to 5% – squamous; adenocarcinoma and sarcoma – up to 2%; 1% – papilloma. The rarest bladder cancer is small cell and spindle cell carcinoma.

The degree of anaplasia is divided into low-, moderate- and highly differentiated neoplasms. One of the main roles is played by the involvement of different layers of the bladder wall in the tumorogenic action. For this reason, the disease is invasive in a high or low stage, or proceeds superficially.

And also the tumor is subdivided into papillary, infiltrative, flat, nodular, intraepithelial growth patterns. Perhaps the combined development of neoplasms – cancer simultaneously has several signs.

Bladder cancer is classified according to the international TNM system.

Stages:

• T – primary neoplasia.
• TX – Primary neoplasia not assessable.
• TO – primary neoplasia without any data.
• Ta – superficial papillary carcinoma.
• Tis – flat carcinoma in situ – stage zero neoplasia.
• T1 – cancer cells penetrate into the vessels.
• T2 – neoplasia of the muscular layer (T2a – cancer that proceeds superficially; T2b – cancer that has penetrated deep into the tissues).
• T3 – the pathology is transmitted to the paravesical tissue. At the same time: T3a – at the microscopic level; T3b – at the macroscopic level.
• T4a – penetration of cancer at any stage into neighboring organs – the uterus, vagina, prostate are affected.
• T4b – penetration of cancer cells into the pelvic bones, abdominal wall.
• N1-3 – Metastases occur in one (N1) or several (N2) pelvic lymph nodes.
• M1 – penetration of metastases into neighboring organs – liver cancer, lung cancer, stomach cancer; in certain cases – damage to the bones.

Cancer of the bladder: signs

The onset of cancer at the initial stage may not manifest itself in any way, pass even without weak signs. That is, the tumor is at the primary stage of development, but the patient does not feel it at all.

The first manifestation of cancer of this unpaired hollow organ is hematuria – the presence of blood in the urine. This symptom is subdivided into microhematuria – when the urine is periodically stained pink; and gross hematuria – urine acquires a clear bloody hue and may contain clotted blood. Blood clots can cause urinary retention; difficulty and frequent urination.

Too frequent urination can also be caused by tumor formation. When neoplasia is sufficiently developed and reaches several centimeters in size, it reduces the capacity of the bladder. Therefore, less urine accumulates in it, which is the reason for too frequent urination.

Against the background of the development of a neoplasm, pain in the pelvic area increases both during urination and at rest. The pains are often aching and rarely sharp. In the later stages, pain can be intense and prolonged. The condition is aggravated by progressive anemia and the general weakness caused by it.

Sometimes the tumor is located in such a way that it does not allow urine to pass from the upper urinary tract (the flow of urine from the kidneys to the organ is difficult), this leads to the development of chronic renal failure. In this case, a biochemical blood test will show an increased content of urea and creatine.

But not all signs are direct symptoms of bladder cancer. Many of them relate to other diseases of the pelvic organs: cystitis, urethritis, the presence of stones in the urinary system, a benign tumor of the prostate. The similarity of the symptoms of the initial periods leads to the fact that patients are engaged in prolonged self-medication, and this aggravates the overall clinical picture.

Causes

Doctors have not come to a generally accepted etiology of this disease, but have identified sources of risk that contribute to tumor formation:

Rare urination and prolonged stasis of urine. An increased content of metabolites in the urine has a tumorigenic effect, which can provoke a malignant change in the transitional epithelium.

Diseases of the pelvic organs. Prostate adenoma, prostatitis, urolithiasis, chronic cystitis – these pathologies can also cause prolonged stasis of urine, which will negatively affect the epithelium.

Infectious diseases. The influence of human papillomavirus infections as a cause of neoplasms remains questionable. Of the parasitic infections, urogenital bilharziasis provokes active carcinogenesis.

Professional factor. This risk affects people who regularly come into contact with substances such as xylene derivatives, phenols, phthalates, anti-cancer drugs, etc. Often these are painters, health workers, workers in the chemical, oil and gas production and processing sectors.

“Household” carcinogens. This risk group includes smokers who suffer from bladder cancer two to three times more than those who do not suffer from this addiction. And also chlorinated drinking water belongs to the category of carcinogens – it increases the likelihood of disease by more than one and a half times.

In some cases, tumor formation can be genetically determined and caused by hereditary factors.

Cancer of the urinary tract: diagnosis

Detection of tumor formation in the main organ of the urinary system is a complex clinical and laboratory study with instrumental examination included. Here, hematuria is detected by urinalysis; visual microscopic analysis reveals atypical cells; culture finds or excludes infection; a test for the detection of a tumor agent is carried out; a blood test ascertains anemia, confirming blood loss. And also held:

• Transabdominal (superficial) ultrasound. This diagnosis is able to detect neoplasia larger than 5 mm, located in most cases on the side of the cystic walls. Research efficiency: neoplasia up to 5 mm — 37%; tumor with a diameter of more than 5 mm – 83%.
• Transrectal or transvaginal scanning is done to diagnose tumors in the neck of an organ. In some cases, endoluminal echography is performed. This is a study using an ultrasound device inserted into the bladder through a natural opening. Accuracy of determining pathology – 94%.
• Urethrocystoscopy – biopsy of the urethral mucosa. This is a mandatory diagnostic procedure. Reveals the number, size, growth rate, location of tumor formation.
• CT high quality x-ray images. They make it possible to obtain more detailed data and find small neoplasms that cannot be determined by echographic examination. And also tomography can reveal the depth of the introduction of malignant tumors.
• MRI – high-precision images obtained by magnetic resonance imaging. The most informative type of diagnosis of bladder cancer.
• Endoscopy allows you to visually detect the appearance of neoplasia, its size and location. In addition, this examination makes it possible to take a biopsy and carry out morphological confirmation of bladder cancer.
• There is an x-ray diagnostics: in case of tumor formation, a cystographic examination is performed, which reveals the deformation of the borders of the bladder wall. This allows you to determine the growth of the neoplasm.
• With the help of pelvic phlebography and lymphadenography, the involvement of the veins of the pelvic region and lymph nodes is revealed.
• Distant metastases are detected by ultrasound examination of the abdominal and pelvic organs; chest x-ray, skeletal scintigraphy.

Therapy

Tumor formation in the bladder can be conditionally ungrouped.

• Non-muscle invasive (superficial) cancer.
• Invasive cancer – penetration of metastases deep into the muscle layers.

Therapy at the initial stage of the course of the disease can do without surgical methods. In this case, chemotherapy is used with the use of one or a group of cytostatics; treatment with immunological drugs. The purpose of these groups of drugs depends on the size, location and progression of malignancy.

Non-muscle invasive cancer: treatment

Transurethral resection of the bladder (TUR). A surgical operation in which special equipment is inserted through the urethra. The impact on the tumor is made by resection, laser, electrocoagulation.

Intravesical (local) chemotherapy. The method consists in introducing an antitumor drug into the organ cavity. The course of local chemical therapy is from 6 to 8 weekly intravesical installations. It is an effective method for preventing the recurrence of this cancer.

Penetrating bladder cancer: methods of therapy

Cystectomy. This is a surgical operation to excise a fragment of the bladder or an entire organ. The degree of intervention is determined by the course of the cancer.

Radical cystectomy. The technique provides for a complex ectomy of organs, namely: the bladder; a fragment of the serous membrane of the abdominal cavity or tissue of the parietal space of the pelvis; prostate; paired organ of the male reproductive system. In women, a complex ectomy of the bladder is performed; uterus and its neck, appendages; anterior wall of the vagina. A mandatory procedure for cystectomy is the removal of pelvic lymph nodes.

The removed organ is replaced by ureterocutaneostomy – implantation of the ureters into the skin; urine diversion according to the Bricker method; orthopedic bubble from the tissue of the small intestine or stomach.

If necessary, the ectomy is enhanced by remote or contact laser treatment, chemotherapy, general or intravesical immunological therapy. If the patient refuses surgery, radical treatment with ionized radiation is prescribed.

Cancer of the bladder: preventive measures

Prevention of bladder cancer includes a wide range of measures. These are: complete exclusion of alcoholic beverages and cigarettes; increased physical activity – increased walking; a healthy diet with the inclusion of the required amount of vegetables and fruits; exclusion from the diet of chlorinated water and other carcinogens; maximum limitation of UV radiation.

At the slightest hint of signs of the disease, for example: increased urination, you should immediately contact a qualified specialist and undergo a diagnostic examination. A malignant neoplasm must be detected at an early stage – the effectiveness and success of treatment directly depends on this. Early diagnosis in some cases helps to avoid surgical intervention. Remember: cancer is a complex disease that needs to be detected in a timely manner.

Symptoms, diagnosis, stages and treatment of bladder cancer

icindekiler

• What are the symptoms of bladder cancer?
• What are the risk factors for developing bladder cancer?
• Diagnosis of bladder cancer
• Stages of bladder cancer
• Bladder Cancer Treatment

Bladder cancer is one of the most common types of cancer in the world. Bladder cancer, which affects hundreds of thousands of people, is more common in men. This disease can occur at any age, but more often affects older people.

Bladder cancer is a malignant tumor that affects the tissues of the inner wall of the bladder, which is one of the organs of the urinary system. Transitional cell carcinoma is the most common type of bladder cancer, accounting for 90% of all cases.

The bladder is a hollow muscular organ located in the lower abdomen that collects urine. Tumor formation begins with the growth of cancer cells in the tissue that lines the inside of the bladder. Although a bladder tumor is most often found in the bladder, it can also occur in other parts of the urinary system.

What are the symptoms of bladder cancer?

The most common symptom of bladder cancer is blood in the urine. In 80% of patients with bladder cancer, there is blood in the urine or otherwise hematuria.

Other symptoms that are most common in bladder cancer:

• Blood in the urine ( hematuria )
• Frequent urge to urinate
• Frequent visits to the toilet
• Sensation of incomplete emptying of the bladder
• Need to push when urinating
• Pain when urinating

These symptoms are not sufficient to establish a diagnosis of bladder cancer. Some of these symptoms may also be due to other problems in the body.

What are the risk factors for bladder cancer?

Risk factors that can cause bladder cancer to multiply are:

Smoking: When you smoke cigarettes, chemicals accumulate in your urine. This may increase the risk of developing cancer. When you smoke, your body processes the chemicals in the smoke and some of them are excreted in the urine. These harmful chemicals can damage the lining of the bladder.

Age: The risk of developing cancer increases with age. Cancer can occur at any age but is rare in people under the age of 40.

Gender : Bladder cancer is more common in men than in women.

Chemical Exposure: The kidneys filter harmful chemicals from the blood and excrete them into the bladder. The accumulation of these chemicals in the bladder is thought to increase the risk of bladder cancer. Exposure to arsenic and chemicals used in the manufacture of paints, rubber, leather and textiles poses a risk of cancer.

Previous cancer treatment: treatment with an anticancer drug (cyclophosphamide). Previous treatment with an anticancer drug may increase the risk of developing cancer.

Chronic inflammation of the bladder: prolonged use of a urinary catheter creates a risk of tumor formation in the bladder. Repeated infections or inflammation of the urinary tract (cystitis) can increase your risk of developing bladder cancer.

Personal or family history of cancer: people who have had bladder cancer in the past have a higher risk of developing cancer again. There is also a risk in those who have a first-degree relative with a history of cancer.

Bladder Cancer Diagnosis

There are several tests and procedures used to diagnose bladder cancer.

Cystoscopy: To perform a cystoscopy, the doctor inserts a small, narrow tube (cystoscope) into the urethra. Thanks to the cystoscope urologist has the opportunity to examine the urethra and bladder from the inside and examine the affected areas.

Biopsy: During the cystoscopy, the urologist uses a special biopsy instrument. This procedure is sometimes called a transurethral resection of a bladder tumor (TURBT). TURBT is also used in the treatment of cancer.

Urinalysis: A urine sample is taken using a procedure called urine cytology. The sample taken is analyzed under a microscope.

Imaging tests: computed tomography (CT), urography and retrograde pyelography tests are used. With these imaging technologies, the structure of the patient’s urinary tract is examined.

Retrograde pyelography: is an X-ray examination used to examine the upper urinary tract in detail. A radiopaque contrast agent is injected into the ureters by inserting a thin tube (catheter) into the urethra and bladder. During this process, X-ray images are used to visualize the movement of matter and the function of the system.

Bladder cancer staging

Bladder cancer staging is determined by a series of findings and test results. The stage of the cancer is determined based on the results of all tests, physical examination, biopsy, and imaging.

According to the classification system of cancer (TNM classification) in the American NCCN guidelines of the American Cancer Association, there are 4 main stages of this type of cancer.

Stage 0

Unlike other types of cancer, bladder cancer is stage 0. At this stage, the cancer has not yet spread to the lymph nodes or distant organs. It is divided into two sub-stages.

• Stage 0a: There may be one or more papillary bladder tumors at this stage. The tumor is located in the superficial cells of the epithelial layer. (Does not grow deep)
• Stage 0is: at this stage, cancer cells do not grow into the bladder tissue as papillary growths, but form and grow linearly in the layer of superficial cells lining the bladder. This type of cancer is called carcinoma in situ. This type of cancer is very aggressive.

Stage 1

In this stage, the cancer has spread to the connective tissue subepithelial layer of the superficial epithelial layer, namely the subepithelial tissue. Does not affect the muscle layer.

No spread to lymph nodes or distant organs at this stage.

Stage 2

At this stage, the cancer has spread to the muscle layer. The cancer has not spread to the lymph nodes or distant organs.

Stage 3

There are two sub-stages at this stage.

• Stage 3A: The cancer has spread to fatty tissue, deep into the muscle layer, or to surrounding organs (prostate/vagina). There is no more than one metastasis in the regional lymph nodes. No metastases to distant organs or (>1) lymph nodes.
• Stage 3B: The cancer has metastasized to multiple lymph nodes in the pelvis or upper pelvis. There are no distant or lymph node metastases over the common iliac arteries.

Stage 4

• Stage 4A: The cancer has spread to distant lymph nodes above the iliac arteries. Metastases to organs are not observed.
• Stage 4B: The cancer has metastasized to organs such as bones, lungs and liver.

Bladder cancer treatment

There are several treatment options for bladder cancer, which is quite common. Methods of treatment after the examination should be selected together with a urologist.

Surgeons Medical treatment of bladder cancer: this is a method of removing the bladder or partial removal of tumor-affected tissue by surgery.

Intravesical chemotherapy: is a method of injecting a chemotherapy drug directly into the patient’s bladder cavity. It is generally preferred for cancers at risk of recurrence or progression to a later stage.

Artificial bladder: formation of an artificial bladder to remove urine from the body when removing a tumor-affected bladder.

Systemic Chemotherapy: is a whole-body treatment for cancer.

Immunotherapy: is a treatment method aimed at activating the immune system.

Radiotherapy: is preferred in cases where surgery is not possible.

Surgical treatment of bladder cancer

In the treatment of cancer, surgery is a very important treatment. Surgery for bladder cancer is performed by TUR surgery or cystectomy .

The purpose of the operation is to clear the bladder of cancer cells. The choice of method and variant of the operation is determined depending on the degree of spread of cancer.

> Surgeons Medical treatment Bladder cancer TURP ( TUR )

The most common bladder surgery is transurethral resection (TUR). After the tumor is detected by cystoscopy, an operation is performed to remove it by the TUR method. In this case, access to it is carried out through the urethra.

The TURP method to remove a bladder tumor is usually the first choice for early stage cancer. TURB surgery is preferred for bladder tumors that do not metastasize to the muscle layers.

A bladder cancer is removed through the patient’s urinary tract using a camera instrument with a scraping blade at the end.

TURB surgery has many advantages. It can be repeated with minimal risk and excellent results.

> Surgical treatment of bladder cancer by radical cystectomy

Radical cystectomy is an operation to remove all or part of the bladder affected by a malignant tumor. This method is preferred if the cancer can be removed without damaging the bladder.

Radical cystectomy also includes removal of the prostate and seminal vesicles in male patients. In men, removal of the prostate and seminal vesicles can cause erectile dysfunction. However, an experienced surgeon can separate the nerves needed for an erection.