Bladder cancer is the sixth most common cancer in the United States effecting about 53,200 each year. When found early the chances for a cure are very high.
The ways in which bladder cancer develops is only partly understood. However perhaps the main substances that can cause bladder cancer is cigarette smoke which is estimated to cause 50 percent of all bladder cancer cases in the United States. Additionally, long-term exposure to chemical compounds such as paints and solvents has been estimated to cause another 20 to 25 percent of bladder cancer cases.
Symptoms and Severity
More than 90 percent of all bladder cancers originate in the urothelium which lines the inside of the bladder. The majority of bladder tumors are confined to the urothelium and have not invaded the bladder muscle.
Image below illustrates tumors in the bladder.
Symptoms often include blood in the urine. This eventually occurs in nearly all bladder cancer cases. In the majority of cases, the blood is visible during urination. In some cases, it my be invisible except under a microscope, requiring a urine sample to be discovered. Blood in the urine does not confirm the presence of bladder cancer. Blood in your urine can mean many different things, including; urinary tract infection or kidney stones rather than from cancer. Other symptoms of bladder cancer may include frequent urination and pain upon urination.
If bladder cancer is suspected Dr. Alarcon will conduct a thorough medical history and a physical examination, including asking you about past exposure to known causes of bladder cancer, such as cigarette smoke or chemicals. Other diagnostic tools include various types of urine samples(urinalysis) and radiological imaging of the kidneys, ureter and bladder to check for problems in these organs. Dr. Alarcon will also perform a cystoscopy, which allows him direct viewing inside of the bladder. This is most commonly performed in the office under local anesthesia or light sedation. Looking through the cystoscope, Dr. Alarcon can examine the bladder’s inner surfaces for signs of cancer.
If tumors are present, an additional procedure will scheduled to remove very small samples of tissue of any suspicious-looking areas of the bladder. The removed tissue is sent to a pathologist for examination. Pathologists are specialists who interpret changes in body tissues caused by disease. If bladder cancer is found, the pathologist who examines the tissue will grade the tumor according to how much cells differ in appearance from normal cells.
There are different types of treatment for patients with bladder cancer based on the volume and extent of known cancer.
Surgery: Transurethral Resection, which is a minimally invasive procedure for very low levels of cancer. Segmental cystectomy is surgery to remove part of the bladder. 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. A Radical Cystectomy is surgery to remove the entire bladder and any lymph nodes that contain cancer. This surgery may be done when the bladder cancer invades the muscle wall, or when cancer involves a large part of the bladder. Sometimes, when the cancer has spread outside the bladder and cannot be completely removed, surgery to remove only the bladder may be done to reduce urinary symptoms caused by the cancer. When the bladder must be removed, Dr. Alarcon will create another way for urine to leave the body.
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 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. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Bladder cancer may be treated with intravesical (into the bladder through a tube inserted into the urethra) chemotherapy. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
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.