Bladder

Overview

Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation.

Risk Factors

People who smoke have an increased risk of bladder cancer. Being exposed to certain chemicals and having chronic bladder infections can also increase the risk of bladder cancer.

Symptoms

Symptoms of bladder cancer can mimic those of a urinary tract infection (blood in the urine, lower abdominal pain, frequent urination and burning on urination). For this reason it is very important to seek medical attention if you develop these symptoms.

Diagnosis

Diagnosis of bladder cancer includes urine tests to look for cancer cells under a microscope and an examination to look in the bladder called cystoscopy. This is a very simple procedure done in the office with local anesthesia. The bladder is examined with a telescope by placing a small catheter inside through the urethra.

If bladder cancer is found a biopsy is then scheduled. Often times either a CT scan or MRI of the abdomen is performed to determine the stage of the cancer.

Treatment

Surgery

One of the following types of surgery may be recommended:

Transurethral resection (TUR) with fulguration
Surgery in which a cystoscope (a thin lighted tube) is inserted into the bladder through the urethra. A tool with a small wire loop on the end is then used to remove the cancer or to burn the tumor away with high-energy electricity.

Radical cystectomy
Surgery to remove the bladder and any lymph nodes and nearby organs that contain cancer. This surgery may be done when the bladder cancer invades the muscle wall, or when superficial cancer involves a large part of the bladder.

Partial cystectomy
This surgery may be done for patients who have a low-grade tumor that has invaded the wall of the bladder but is limited to one area of the bladder. Because only a part of the bladder is removed, patients are able to urinate normally after recovering from this surgery.

Urinary diversion
Surgery to make a new way for the body to store and pass urine.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. For bladder cancer, regional chemotherapy may be intravesical (put into the bladder through a tube inserted into the urethra). Combination chemotherapy is treatment using more than one anticancer drug.

Biologic therapy

Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

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