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 Bladder cancer is the sixth most common cancer in the United States, with more than 53,000 newly diagnosed cases annually. The most common type of bladder cancer is known as transitional cell carcinoma and affects the inner lining of the bladder. Not surprisingly, hematuria is often one of the first symptoms that a patient with bladder cancer may have. However, as with all cancers, the diagnosis can be made only with a biopsy. At The Urology Clinic, we recognize the life-changing effect this diagnosis can have on a patient and take special care to counsel and treat each patient with an individualized plan.
Causes
There are many causes of bladder cancer and in many patients there may be no apparent cause. However, there are several factors that are strongly linked to bladder cancer and may include:
- Smoking (cigarettes, cigars, etc.)
- Exposure to certain industrial chemicals (Aniline dyes, industrial solvents, etc.)
- Chronic cystitis
- Exposure to cyclophosphamide
- Radiation (bladder exposure)
Evaluation
The evaluation begins with a detailed history and physical examination and may include the following:
- Urinalysis
- Urine cytology
- Urine FISH
- Basic Metabolic Panel (BMP)
- Complete Blood Count (CBC)
- Cystoscopy
- Hematuria protocol CT scan
- Bone scan
Treatment
The first step in treating bladder cancer involves accurate clinical staging. Staging is done by cystoscopy and biopsy to determine the aggressiveness of the tumor and whether it is isolated to the lining of the bladder or if it invades the bladder wall. Bladder cancers can occur in a wide spectrum of severity, and while some patients may only have “superficial” or “low grade” disease, others may have more aggressive cancers. As part of the decision-making process, we will discuss the cancer stage and cancer grade and what these mean for prognosis and treatment selection. The course of treatment is individualized to each patient and is influenced by stage of the disease, age, other medical problems, and urinary function. While bladder cancer can be readily treated, all patients are at risk of recurrence and so must be followed closely by their urologist with periodic surveillance cystoscopy. Options for treatment include the following:
- Transurethral resection of bladder tumor (TURBT)
- Intravesical therapy
- Radical cystectomy
- Partial cystectomy
- Chemotherapy
- Radiation therapy
Summary
Bladder cancer is the sixth most common cancer in America and may significantly impact a patient’s health and quality of life. The Urology Clinic offers a variety of treatment options and works to create individualized care plans that will give patients the best experience possible in the treatment of their disease.
Please see our page on Patient Resources for related discussion on this topic.
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