Bladder cancer is a common type of cancer that starts in the cells of this cell, a hollow, muscular organ in your lower abdomen that stores urine.
This type of cancer usually begins in the cells (urothelial cells) lining the inside of the bladder. These cells are also found in the kidneys and the tubes (ureters) that connect the kidneys to the bladder. This applies to both men and women. While urothelial cancer can occur in the kidneys and ureters, it is much more common in this cell.
Most cases of this cancer are diagnosed at an early stage when it is highly treatable. However, even early-stage cancers can return after successful treatment. Therefore, individuals with this type of cancer often need follow-up tests for many years to check for recurrence.
Symptoms Cancer in the bladder may include:
Blood in urine (hematuria), which may make urine appear bright red or cola-colored, though sometimes the urine looks normal, and blood is only found with a lab test.
Frequent urination.
Painful urination.
Back pain.
Diagnosing Bladder Cancer
Cystoscopy: This procedure allows doctors to look inside using a cystoscope, a thin tube with a camera. The cystoscope is inserted through the urethra to examine for signs of disease. Cystoscopy can be performed in a doctor’s office or a hospital.
Biopsy: During cystoscopy, a doctor might use a special tool to take a tissue sample (biopsy) from the bladder for testing. This procedure is called transurethral resection of bladder tumor (TURBT) and can also be used to treat this cancer.
Urine Cytology: A urine sample is examined under a microscope to check for cancer cells.
Imaging Tests: Imaging tests like CT urogram or retrograde pyelogram are used to visualize the urinary tract.
CT Urogram: Involves injecting a contrast dye into a vein, which flows into the kidneys, ureters, and bladder. X-rays provide detailed images of the urinary tract.
Retrograde Pyelogram: Uses a catheter to inject contrast dye, allowing X-ray images of the upper urinary tract.
Determining Cancer Spread
If cancer is confirmed, additional tests may be done to check if it has spread to lymph nodes or other parts of the body. These tests include:
CT Scan
MRI
PET Scan
Bone Scan
Chest X-ray
Staging and Grading Cancer
Cancer Stages: Stages range from 0 to IV. Lower stages indicate cancer confined to the inner layers, while stage IV indicates cancer spread to lymph nodes or distant organs.
Cancer Grades: Cancers are classified by how abnormal the cells look under a microscope:
Low-Grade: Cells look more like normal cells and tend to grow slowly.
High-Grade: Cells look very abnormal and grow more aggressively.
Treatment Options
Surgery:
TURBT: Removes cancer from the inner layers without abdominal incisions.
Cystectomy: Removes part or all of the bladder. Radical cystectomy may also involve removing surrounding organs.
Neobladder Reconstruction: Creates a new bladder from intestine tissue, allowing normal urination.
Ileal Conduit: Uses a piece of intestine to create a passage for urine to a urostomy bag outside the body.
Continent Urinary Reservoir: Creates an internal pouch to store urine, emptied with a catheter.
Systemic Chemotherapy: Given intravenously, often before or after surgery.
Intravesical Chemotherapy: Administered directly into the bladder for localized treatment.
Radiation Therapy: Uses high-energy beams to destroy cancer cells, sometimes combined with chemotherapy.
Intravesical: BCG therapy stimulates the immune system to attack cancer cells in the bladder.
Systemic: Given intravenously for advanced cancer.
Targeted Therapy: Focuses on specific weaknesses in cancer cells to kill them, used for advanced cancer.
Bladder Preservation: Combines TURBT, chemotherapy, and radiation to avoid bladder removal. If cancer persists, a radical cystectomy may be needed.
Post-Treatment Follow-Up
Cancer in the bladder can recur, so regular follow-up tests are essential. These may include cystoscopy every three to six months initially, then annually if no recurrence is detected. Other tests may also be scheduled based on the cancer’s aggressiveness.
When to see a doctor If you notice discolored urine and are concerned it might contain blood, schedule an appointment with your doctor for an evaluation. Also, see your doctor if you have other symptoms that worry you.