Bladder Cancer

Transitional cell carcinoma is the most prevalent type of bladder cancer. The disease occurs when a tumor grows in the cells that pad the inside of the bladder (transitional or urothelial cells). Other kinds of bladder cancer include squamous cell carcinoma and adenocarcinoma.

The most common symptom of bladder cancer is blood in the urine (hematuria) that causes the urine to change color. Other symptoms may include, among others: urine frequency, burning, or painful urination, and sometimes also back or pelvic pain.

Diagnosis

To diagnose bladder cancer, patients usually undergo a series of tests and procedures:

  • Urine tests- the first step is checking for blood in the urine. Another process may involve checking the urine under the microscope (urine cytology) for cancer cells.
  • Cystoscopy- a specialist passes a cystoscope through the urethra. The cystoscope is a slim device with a light and a camera. It allows seeing the inside of the urethra and bladder. Thus, examining them for any sign of disease.
  • Trans Urethral Resection of a Bladder Tumor (TURBT). During this procedure, the surgeon performs a biopsy, and the pathologist checks it for cancerous cells. It also can surgically treat bladder cancer by removing any abnormal areas of tissue.
  • X-ray exams to scan the urinary system. During these procedures, the specialist injects dye into the patient’s bloodstream (Intravenous pyelogram), or the ureters (Retrograde pyelogram) and uses X-rays to study the color as it passes through the urinary tract.

A bladder tumor can spread locally into the bladder muscle, regionally to nearby lymph nodes, and systemically to other organs. Common spreading might occur to the bones, lungs, or liver. To learn whether cancer has spread, the doctor might recommend imaging tests. They may include CT, MRI, bone scan, or chest X-ray, or a PET CT scan.

Treatment

Treatment options for bladder cancer include chemotherapy, either directed to the bladder (intravesical chemotherapy), or systemic. Other treatment options include radiotherapy or surgery (TURBT or cystectomy).

The medical team might also recommend combinations of treatments, for example, chemotherapy before radiotherapy or surgery to shrink tumor size. Another example includes a combination of chemo with radiation (chemoradiation) before surgery. For some patients with advanced or metastatic bladder cancer, there is also the option of immunotherapy.

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