Bladder cancer is the most common cancer of the urinary system.
Bladder cancer is cancer involving the lining of the bladder and may be “superficial,” which tends not to spread (metastasize) outside of the bladder. “Invasive” bladder cancer tends to involve the muscle of the bladder wall, commonly spreads to other parts of the body and is lethal.
Cigarette smoking (first and second hand exposure) is the most common risk factor in the development of this type of urinary cancer. However, non-smokers can develop this cancer, as well. Exposure to certain chemicals in various industries has also been linked to this type of cancer.
Symptoms of Bladder Cancer
Bladder cancer is usually NOT associated with any particular symptoms early on. The usual presentation is painless gross hematuria (blood in the urine that is seen by the individual), or microscopic hematuria (blood in the urine identified by a lab test).
Less commonly, bladder cancer may be associated with urinary urgency (sudden need to urinate), frequent urination, dysuria (painful urination), abdominal/flank pain, weight loss and fatigue.
Evaluation and Treatment
Patients with a history of hematuria (blood in the urine) are usually evaluated with a urine culture to rule out any infection of the urinary system that may cause the hematuria.
Radiographic imaging is performed to evaluate the entire urinary system: kidneys, ureters (tubes that drain urine from the kidney to the bladder) and the bladder itself. The most common imaging study is a CT scan of the abdomen and pelvis termed a “CT urogram or CT IVP.” Other radiographic tests are used in specific cases and include ultrasound and magnetic resonance imaging (MRI).
The final test undertaken is a visible inspection of the bladder using a small camera in a procedure called a “cystoscopy.”
After a diagnosis of bladder cancer is determined, courses of treatment are developed.
For most patients, bladder cancer is deemed “superficial” and does not typically invade other locations within the body. It is usually not lethal. However, the condition tends to be recurrent, thus requiring frequent monitoring and periodic surgical treatment.
Recurrent “superficial” bladder cancer may also be treated by installing anti-cancer therapies directly into the bladder via a small catheter inserted into the bladder during a typical office visit.
If bladder cancer is deemed “invasive” into the muscle layer of the bladder, the treatment of choice is removal of the bladder and formation of an alternate pathway for urine to travel out of the body. This type of bladder cancer can be lethal, thus an early and accurate diagnosis is essential.
With newer surgical techniques, removal of the bladder may be performed in a minimally-invasive manner using the daVinci Robotic Surgery System, or via conventional open surgery.