Bladder Cancer

Most often, bladder cancer begins in the cells of the bladder's inner layer after cells there begin to grow abnormally. The cancer can spread to the deeper layers of the bladder, where it is more difficult to treat.

What are the symptoms of bladder cancer?
One common sign is blood in the urine. This can be slight, occasional and painless. Other signs include irritation when urinating or a constant/urgent need to urinate. You may feel pain in your abdomen or lower back and experience fatigue or loss of appetite. However, any of these symptoms can also be caused by less serious, non-cancerous conditions. A visit to your doctor is vital whenever you experience blood in urine.

How is bladder cancer diagnosed?
You'll be asked to provide a urine sample, which will be examined for the presence of cancer cells. Your doctor can also look inside your bladder by inserting a very thin, flexible instrument called a cystoscope. If a suspicious area is found, a sample of that area can be taken for biopsy.

Another option is a type of imaging called a CT Urogram. You may be given an IV that contains a substance that will enhance X-ray visibility of your organs. This test allows an examination of the entire area, in case any abnormalities are found in nearby parts of the body.

What are the treatments for bladder cancer?
Multiple treatments are possible, depending on the stage of your cancer and your health:

Transurethral resection of a bladder tumor, also known as TURBT: This procedure involves inserting a small instrument with a small electrified loop of wire into the bladder. The doctor will guide this instrument over the tumor, removing the affected tissue. All the removed material will be examined to determine the exact type of bladder cancer and to determine whether any additional treatment is needed.
Surgery: All or part of the bladder is removed. If the entire bladder is removed, there are several possible alternate methods of storing and eliminating urine. These include an external ostomy bag or several possible internal structures, including a small reservoir for collecting urine made from part of the small intestine or a combination of the large and small intestines. Your doctor will choose the best approach based on your individual situation.
Chemotherapy: Chemotherapy is meant to treat cancer cells that may have spread beyond the bladder, or to shrink the tumor before surgery so it can be removed more easily. In the case of metastatic bladder cancer, chemotherapy may be chosen to extend and improve quality of life. It can also be given in combination with radiation. (See below)
Radiation: This can be a part of several stages of treatment. It might be used alone for people who cannot have surgery. More often, it is combined with chemotherapy, as the two treatments work together.
Immunotherapy: This treatment helps your body's immune system recognize and attack cancer cells.
Bladder preservation with Combined-Modality Therapy (CMT): This is a combination of TURBT, radiation and chemotherapy. The goal is to cure the cancer while leaving a functioning bladder in place. However, not all patients are a candidate. This approach is best for patients whose bladder tumors are small and appear to be completely eradicated by the TURBT.
Other therapies: Intravesical therapy involves placing medication directly into the bladder. This can be a form of chemotherapy or immunotherapy.

What are the risk factors for bladder cancer?
Bladder cancer is much more common among smokers. The cancer's incidence rises as you age; it's more common in older people. Some occupations that deal with certain chemicals (such as aromatic amines) are at higher risk. Caucasians are more likely to develop bladder cancer than are people of other races. Men are more likely than women to develop it. A previous history of bladder cancer, or a family history, is also linked to a higher risk, as is a history of frequent bladder infections.

What are some additional resources for learning about bladder cancer?
If you or your loved one is facing bladder cancer, CalvertHealth has a whole range of services designed to help you so you never take this journey alone. Please talk to your CalvertHealth provider, your Nurse Navigator, or check the service pages for information about treatments, services and support groups.