Bladder Cancer

Bladder cancer originates in the bladder, that balloon-shaped pelvic organ that stores urine. Typically, it begins in the cells that line the inside of the bladder, and it usually affects older adults, though it can happen at any age.

Most bladder cancers are caught at an early stage, when it’s highly treatable. If the bladder cancer hasn’t invaded the bladder’s muscular layer, it’s considered to be “superficial.” Superficial, non-invasive bladder cancer typically can be treated by less-invasive measures. However, it’s also subject to recur. Bladder cancer survivors are encouraged to undergo follow-up testing for years after treatment—just in case.

Symptoms may include

  • Blood in urine or urine that is dark yellow, bright red or cola-colored. Urine could appear normal, however, with traces of blood found only during microscopic examination. This is the most common symptom of all.
  • Frequent urination
  • Painful urination
  • Back pain
  • Pelvic pain

Make an appointment with a doctor if any of these signs or symptoms worry you.

Causes

Bladder cancer affects men more than women, but it still quite common in general. In the United States, it is the fourth most common cancer in men and ninth among women. Bladder cancer is also more common among caucasians.

It has been linked to parasitic infection, chemical exposure, radiation, certain chemotherapy drugs, and smoking. Or, the cause may never be revealed. The cancer develops when normal cells begin to grow and divide in an abnormal fashion. They develop mutations that cause them to keep growing but never die. These cells come together and form tumors.

Types of Bladder Cancer

  • Transitional cell carcinoma – This occurs in the cells that line the inside of the bladder. The transitional cells expand when your bladder is full and contract when the bladder is empty. These same cells line the insides of the ureters and urethra, so tumors could form in those places as well. This is the most common type of bladder cancer in the United States.
  • Squamous cell carcinoma – These cells appear in your bladder as a response to infection or irritation. Over time, they can become cancerous. In parts of the world where schistosomiasis (a parasitic infection) is more common, this type of cancer is more prevalent. It is rare in the United States.
  • Adenocarcinoma – Also rare, this cancer begins in the cells that make up mucus-secreting glands in the bladder.

Some bladder cancers can include more than one type of cell. The type and origin will determine the treatment. You and your doctor will discuss every available option to find the one best for you.

Diagnosis and Treatment

A urine test will lead the doctor to perform more tests, such as imaging studies and a cytoscopy. A cytoscopy allows the doctor to look into the bladder with a scope, in the hopes of viewing a tumor.

If a tumor is discovered, a small piece of tissue is taken for biopsy. Or, the urologist may decide to perform “TURBT,” or trans-urethral resection of a bladder tumor.

TURBT is minimally invasive and can be performed as an outpatient surgery, though sometimes a one- or two-day hospital stay may be necessary. During TURBT, the urologist uses a resectoscope to carefully shave the tumor off the bladder wall. The tumor is saved and sent to a pathologist for further analysis.

If it’s determined that the tumor did not invade the bladder wall, TURBT may be all that is necessary to cure the cancer. Sometimes, the urologist will treat the bladder with mitomycin, a chemotherapy drug, after the resection. This seems to reduce the risk of recurrence.

TURBT with mitomycin is a generally well-tolerated procedure and side effects seem to be minimal. However, pathology will determine what, if any, additional measures are needed.