Bladder Cancer

Bladder Cancer

A cancer diagnosis is always life-changing, but the good news about bladder cancer is that it's common and treatable, with many innovative techniques.

Signs and Symptoms of Bladder Cancer | Types of Bladder Cancer | Causes of Bladder Cancer | Diagnosis for Bladder Cancer | Bladder Cancer Treatments
| Support Services for Bladder Cancer

Bladder cancer is a type of cancer that originates in the cells of the bladder, which is the organ responsible for storing urine. It occurs when abnormal cells in the bladder begin to multiply uncontrollably, forming a tumor. Bladder cancer is commonly categorized into different types based on the specific cells affected, such as transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma.

Signs & Symptoms of Bladder Cancer

Early attention to symptoms is the best way to find and treat bladder cancer. The earlier bladder cancer is found, the easier it is to treat — and the better your chance of being cured. These are some of the early symptoms of bladder cancer.

• Blood in your urine that may be pink or deep red, depending on the amount or may appear in clots
• Change in urinary habits such as urinating more often than normal, feeling an urgent need to urinate, having trouble urinating, feeling burning, discomfort, or pain, or a weak stream of urine.
• Pelvic or back pain

Advanced Bladder Cancer Symptoms

• Chronic bone pain
• Swelling of the feet and/or ankles
• Weight loss or sudden loss of appetite
• Lower back pain on one side

Types of Bladder Cancer

There are several different types of bladder cancer. The type of bladder cancer is determined by where the affected cells originate. Bladder cancer can be characterized by invasive or non-invasive based on whether they’ve spread into the bladder wall. Depending on the type of cancer, the doctor will be able to develop a treatment plan.

• Non-invasive bladder cancer: cancer cells are found in the inner layer of the cells but haven’t grown into the deeper layers.
• Invasive bladder cancer: cancer cells that have grown into the deeper layers of the bladder wall, making them more likely to spread and more difficult to treat.
Based on how the cancer cells grow, there are two subtypes for bladder cancer, papillary carcinomas, and flat carcinomas.

Urothelial Carcinoma

The most common type of bladder cancer, urothelial carcinoma, is also referred to as transitional cell carcinoma (TCC). TCC is a papillary or flat tumor that grows into the deeper layers of the bladder’s cell walls.

Additional Types of Bladder Cancer

Although these types of bladder cancer are rare, they include the following:

• Squamous cell carcinoma: makes up only about 1 – 2% of all bladder cancers in the US and is typically invasive. Usually developing in the bladder lining, it’s the response to chronic irritation and inflammation most likely from an infection.
• Adenocarcinoma: considered very rare, this bladder cancer begins in the cells that make up the mucus-secreting glands in the bladder and are typically invasive.
• Small cell carcinoma: beginning in the neuroendocrine cells, it makes up less than 1% of all bladder cell cancers in the US. Known for growing very quickly, it can be treated effectively with chemotherapy.
• Sarcoma: starting in the muscle layer of the bladder wall, it tends to form in openings between the ureters and urethra. They can also develop in the bladder itself, however. Bladder sarcomas are the most common kind of genitourinary sarcomas.

Causes and Risks Factors of Bladder Cancer

The causes of bladder cancer still remain unknown; however, researchers do know that some cases are related to gene mutations. These mutations can happen over a person’s lifetime. Additional risks for bladder cancer can include the following:

• Tobacco use
• Age and gender: people over the age of 55 are more at risk of developing bladder cancer, especially men.
• Exposure & prior radiation: people who’ve worked with industrial chemicals or environments where harmful chemicals were present add to the risk of development such as radon and asbestos. People who’ve received poor radiation or chemotherapy are at a higher risk as well.
• Health & cancer history: people who have a history of developing bladder infections, bladder stones, and kidney stones are in a higher risk of developing bladder cancer. Having cancer in any area of the urinary tract can increase your chances of developing cancer. Bladder cancer has a very high recurrence rate as well.
• Inherited genetic syndrome: conditions such as Cowden syndrome, Lynch syndrome, or other genetic syndromes can increase the risk of developing bladder cancer.

Diagnosis for Bladder Cancer

Diagnostic imaging and labs can detect bladder cancer in its early stages. If you have symptoms that indicate potential bladder cancer, your doctor will perform certain exams and tests to be sure. Diagnosing bladder cancer starts with a complete medical history and physical examination, which may include a rectal or vaginal exam to check for the presence of tumors large enough to be felt. You may also have one or more of the following diagnostic tests:

• Urine Cystoscopy: The most common way to check for bladder cancer, your urine is collected and tested in a lab for blood, certain chemical levels, and signs of infection.
• Urine Cytology Test: For this test, your doctor looks at your urine in a lab under a microscope and checks the cells to see if any of them look like they are cancerous or precancerous.
• Bladder Tumor Marker Tests: These tests are used to look for markers or substances released by bladder cancer cells into your urine.
• Cystoscopy: This procedure lets your doctor look at the inside of your bladder by sliding a thin, flexible tube with a tiny camera lens and light in it (cystoscope) through your urethra into your bladder. If your doctor sees anything that looks like cancer, a small piece of the tissue may be taken out, or biopsied, for testing.
• Bladder Biopsy: A procedure in which tissue samples are removed, usually during a cystoscopy, for examination under a microscope to determine if cancer or other abnormal cells are present.
• Intravenous Pyelogram (IVP): In this test, a contrast dye is injected into a vein in your arm or hand. As the dye moves through and outlines your kidney, ureters, and bladder, your doctor takes a series of x-rays to find tumors, abnormalities, kidney stones, or any blockages.

Bladder Cancer Treatments

The INTEGRIS Cancer Institute's Multidisciplinary urology clinic brings together physicians including medical oncologists, urologists, radiation oncologists and radiologists to provide specialized care in a multidisciplinary environment.

Your treatment plan will be based on a variety of factors such as age, overall health, medical history and the stage of the disease. Several types of treatment may be used for bladder cancer. Sometimes more than one of these treatments may be used. Getting two or more treatments is called combination treatment and may include:

• Surgery: Surgery is a common treatment for bladder cancer. In some cases, the surgeon removes only the tumor, or tumors. Other times, part of the bladder or the whole bladder may be removed. Sometimes surgery cures the cancer.
• Chemotherapy: Chemotherapy uses strong medicines to kill cancer cells and is often used when bladder cancer has spread to other parts of your body. It may be delivered internally, directly into your bladder (intravesical), or injected into your bloodstream to kill cancer cells throughout your body.
• Intravesical Therapy: This treatment is used to treat early-stage, superficial bladder cancer. During intravesical therapy, medicines are put directly into your bladder. This may be immunotherapy medicines, which make your body’s immune system fight the cancer, or chemotherapy medicines.
• Radiation Therapy: Radiation therapy uses high-energy rays to kill or shrink cancer cells. Internal radiation or external radiation, or both, may be used to treat bladder cancer. Radiation can be given alone or with chemotherapy, which can cure some people and leave them with a bladder that still works.
• Internal Radiation (brachytherapy, implant radiation): A radiation implant is placed into your bladder for a direct effect on cancer cells.
• External Radiation: A machine directs high levels of radiation are directly to the bladder cancer from outside the body.

Support Services for Bladder Cancer

At INTEGRIS, we offer a wide variety of support programs and services along with the Troy and Dollie Smith Wellness Center to help patients with breast cancer and their loved ones manage the physical and emotional effects of a cancer diagnosis and treatment. Support services for bladder cancer include:

• Mind, body therapies including acupuncture, massage, and yoga
• Research and clinical trials
• Nutrition consultations
• Pastoral care, spiritual support, and relaxation techniques
• Resource Room
• Clinical social work services
• Counseling
• Patient navigation and survivor care planning
• Multi-disciplinary clinic coordination
• Cancer screenings
• Patient and family support groups

The better news is that you have the depth and breadth of INTEGRIS Health and the INTEGRIS Cancer Institute behind you, with the region's foremost collection of therapies, physicians and specialists.

We're here for you every step of the way, from the first diagnosis and staging to treatment and even beyond – with rehabilitation designed specifically for cancer survivors. We know this can be a challenging time, so please ask your physician about any concerns or questions you might have.