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Bladder cancer is the result of cells in the bladder changing and growing rapidly and uncontrollably. The mass that forms as a result of these cellular changes, called a tumor, can be harmless (benign), which means it is not likely to spread to other parts of the body. However, some tumors are deemed likely to spread (malignant) and cause significant health issues if left untreated.
Symptoms of bladder cancer
Not everyone with bladder cancer will have symptoms. What’s more, the symptoms may be indicative of conditions unrelated to bladder cancer, such as urinary tract infections, overactive bladders and kidney stones. However, if you experience any of these symptoms, you should bring them to your physician’s attention so that testing can be done. Some of the more common signs of bladder cancer are:
- Hematuria, otherwise known as blood in the urine
- Frequent urination at night
- Feeling the urge to urinate even when the bladder isn’t full
- A painful or burning sensation while urinating
- Having a weak urine stream
- Feeling the urge to urinate but not being able to do so
Diagnosing bladder cancer
Bladder cancer is typically diagnosed with a series of tests to determine if tumors are present in the bladder. Some of the tests involved in a bladder cancer diagnosis may include:
The most basic diagnostic test, urinalysis will show the level of sugar, protein and red and white blood cells in the urine. These markers may indicate cancer.
In this test, a urine sample is viewed under a microscope to determine the presence of cancer cells.
During an imaging test, X-rays, magnetic fields, radioactive substances or sound waves are used to create pictures of the inside of the body. A physician might order any of the following imaging tests to diagnose bladder cancer:
- Intravenous pyelogram (IVP) – A specialist will inject a special dye into a vein. The dye will move through the bloodstream and into the kidneys, then into the ureters and bladder. During this process, X-rays are taken of the urinary system. The resulting images may reveal tumors.
- Retrograde pyelogram – An alternative to IVP, this test uses a catheter to inject a dye. The catheter is inserted into the urethra and then into either the bladder or a ureter, where the dye is then released. The dye helps to make the lining of the urinary system easier to view on X-rays.
- Computed tomography (CT) scan – A CT scan makes detailed pictures of the body using X-ray technology and can help a specialist determine the size, shape and position of tumors in the urinary tract.
- Magnetic resonance imaging (MRI) scan – Similar to CT scans, MRIs are detailed images of the body’s interior structures. The difference is that MRIs use radio waves instead of X-rays to create the images. MRIs are often used to look for bladder cancer that has spread to nearby lymph nodes and tissues.
Many specialists recommend this procedure to detect bladder cancer. During cystoscopy, a long, thin, flexible tube with a light and a small video camera is inserted through the urethra and into the bladder. If any abnormal areas are seen at this time, the specialist will biopsy them for further testing.
Types of bladder cancer
If cancer cells are discovered through a diagnostic procedure, the next step is to determine the type of bladder cancer. There are five types of bladder cancer:
- Urothelial carcinoma – The most common form of bladder cancer that appears when a malignant tumor grows on the inner lining of the bladder
- Small cell carcinoma – A rare, aggressive form of bladder cancer that grows in the neuroendocrine cells
- Squamous cell carcinoma – Occurs when squamous cells develop in the bladder lining due to swelling or irritation
- Sarcoma – A rare type of bladder cancer that develops in the muscle cells of the bladder
- Adenocarcinoma – A rare form of bladder cancer that shares many commonalities with the gland-forming cells of colon cancer
Another way to classify bladder cancer is by its growth pattern. Bladder cancer can be noninvasive, non-muscle invasive or muscle invasive. Noninvasive bladder cancer is a tumor that only grows on the surface of the skin, while muscle invasive bladder cancer forms in deep muscle tissue. Non-muscle invasive bladder cancer falls somewhere in the middle.
Treating bladder cancer
Bladder cancer treatment varies from patient to patient depending on the size and stage of the cancer, the makeup of the tumor and the patient’s medical history. Generally, treatment may involve chemotherapy, radiation therapy, intravesical therapy or surgery.
There are several types of surgery that may be performed to treat bladder cancer. These include:
- Transurethral resection – This surgery is often completed for those in early-stage bladder cancer and involves the removal of cancer cells and nearby tissue.
- Segmental cystectomy – This surgery may be recommended for smaller tumors that have spread to only one part of the bladder. The tumor, the cancerous portion of the bladder wall and any nearby lymph nodes will be removed.
- Radical cystectomy – Often used for individuals with invasive or recurrent noninvasive bladder cancer, a radical cystectomy removes the urinary bladder. In men, this involves removing the prostate and seminal vesicles along with the bladder and surrounding lymph nodes. In women, the bladder, surrounding lymph nodes, uterus, ovaries and part of the vagina could be removed. Afterwards, the surgeon may perform a urinary diversion procedure so that the body can effectively store and pass urine.
Individuals with bladder cancer may also want to seek out clinical trials and immunotherapy, two promising avenues of treatment. Those curious about these groundbreaking options should look to a high-volume cancer center, such as Moffitt Cancer Center, for their treatment. We have specialists that specifically concentrate on urologic cancers, and our patients have access to a wide range of experts and treatment options under one roof.
Moffitt Cancer Center’s approach to bladder cancer
At Moffitt Cancer Center, the highly acclaimed multispecialty team of experts in our Genitourinary Oncology Program assesses every patient on a case-by-case basis at a collaborative tumor board discussion. This individualized approach to diagnosing and treating bladder cancer puts each patient center stage, where he or she receives the most comprehensive evaluations and treatment recommendations. It’s just one of the many ways in which Moffitt has distinguished itself as one of the best bladder cancer hospitals. At Moffitt’s Genitourinary Oncology Clinic:
- Each patient receives treatment plans that are precisely focused on the unique characteristics of his or her bladder cancer—an approach which results in more effective treatment, higher survival rates and improved quality of life.
- We use state-of-the-art technology in our surgical treatments, with the assistance of robotics and advanced laparoscopies, in order to keep procedures as minimally invasive as possible.
- We are constantly developing new therapies for bladder cancer and other urologic cancers, and are always striving to achieve the highest standard of cancer treatment excellence.
Moffitt is a National Cancer Institute-designated Comprehensive Cancer Center—a testament to our extensive research efforts and our robust clinical trials, which include cancer treatments unavailable anywhere else. Our team of bladder cancer specialists comprises renowned experts in all components of cancer research, from new drug studies to developing new surgical techniques and treatments.