Bladder cancer diagnosis and treatment
Bladder cancer diagnosis and treatment is driven by several variables. The most important determinant is if the cancer stays within the bladder, or metastasizes outside the bladder. Invasive bladder cancer commonly spreads to other parts of the body and is much more difficult to treat.
How is bladder cancer diagnosed?
In its early stages, bladder cancer has very few notable symptoms. In many cases, the first sign of possible cancer is finding blood in the urine. If blood is visibly seen, it is called gross hematuria. Blood that is not seen by the eye, but is found during a lab test is called microscopic hematuria. When blood is present, additional testing will be recommended.
Other symptoms may include: back, abdominal or flank pain, urinary conditions such as urgency, frequency and painful urination, as well as weight loss and fatigue.
When diagnosing or ruling out bladder cancer, normal protocol can include:
- Urine cytology (blood test): – Screen for bladder cancer cells.
- Cystoscopy: A scope that is inserted through the urethra into the bladder to visually scan for abnormal lesions or tumors.
- CT scan: This imaging is used to stage the cancer and to see if the cancer has spread beyond the bladder.
- Radiographic imaging – Performed to evaluate the entire urinary system: kidneys, ureters, and bladder. 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).
Patients with a history of 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.
Bladder cancer treatment options
For many patients, their bladder cancer is “superficial” meaning it stays inside the bladder and has not invaded other parts of the body. In most cases, this type of bladder cancer is not life threatening. However, it can be recurrent, requiring frequent monitoring, specific treatments and possible surgical treatment.
Recurrent “superficial” bladder cancer may also be treated by installing anti-cancer therapies directly into the bladder via a small catheter. This treatment option is called BCG Immunotherapy and can be performed during an office visit.
If the bladder cancer is “invasive” meaning it has moved deep into muscle layers within the bladder, or has spread outside the bladder, more aggressive treatment options are applied. This may include removal of the bladder in conjunction with oncological treatments. 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. Invasive bladder cancer can be lethal, thus an early and accurate diagnosis is essential.
Bladder cancer treatment varies depending on the stage and grade of the cancer:
- Low grade tumor – A local re-section of the bladder tumor can be done.
- Higher grade tumor – Chemotherapy is used to treat the tumor.
- Cancer that has progressed – The bladder may need to be partially or fully removed.
If you have a family history of bladder cancer, or are experiencing symptoms associated with this condition, contact Urology Austin to schedule an appointment.