Bladder cancer most often begins in the cells (urothelial cells) that line the inside of your bladder, a hollow muscular organ in your lower abdomen that stores urine. Most bladder cancers are diagnosed at an early stage, when the cancer is highly treatable. But even early-stage bladder cancers can come back after successful treatment. For this reason, people with bladder cancer typically need follow-up tests for years after treatment to look for bladder cancer that recurs. Bladder cancer found in its early stages has an excellent response to treatment. Your health care team will guide you through your cancer treatment and outline your options.
Signs & Symptoms
The most common symptom is blood in the urine. This may be either microscopic (seen only on urine tests) or gross (seen with the naked eye).
Three types of bladder cancer may form:
- Papillary tumors stick out from the bladder lining on a stalk. They tend to grow into the bladder cavity, away from the bladder wall, instead of deeper into the layers of the bladder wall.
- Sessile tumors lie flat against the bladder lining. Sessile tumors are much more likely than papillary tumors to grow deeper into the layers of the bladder wall.
- Carcinoma in situ (CIS) is a cancerous patch of bladder lining. The patch may look almost normal or may look inflamed.
Each type of tumor can be present in one or more areas of the bladder and more than one type can be present at the same time.
Diagnosis & Treatment
Diagnosis involves imaging of the kidneys and ureters which is usually performed with a CT scan of the abdomen and pelvis with IV contrast. Sometimes, an MRI or ultrasound is used in place of a CT if the patient’s kidneys do not function normally. A cystoscopy is performed to evaluate the bladder for tumors. This is performed in the office with a local anesthetic. The urine is also examined for cancer cells. This is called cytology.
There are several treatment options that your physician can discuss with you.
- Transurethral resection (TUR)
- Removal of a bladder tumor using a cystoscope.
- Intravesical therapy
- Placement of liquid medication directly into the bladder to help destroy cancer cells or reduce the likelihood of recurrence.
- Use of intravenous medications to destroy cancer cells.
- Use of beams of energy to destroy cancer cells.
- Removal of the bladder.