Bladder Cancer

What is bladder cancer?

Bladder cancer is abnormal growth of the cells that line the inside of the bladder. The growth is called a bladder tumor.

A tumor may be either invasive and grow into the muscular wall of the bladder, or it may be noninvasive. A noninvasive tumor is usually a small, wartlike growth that has not yet grown into the bladder wall. When a tumor is invasive, the cancer cells spreads into the bladder wall and then can spread to other organs through the bloodstream and lymphatic system.

Bladder cancer affects men more often than women. Bladder tumors are most likely to happen in white men over the age of 50.

As with other forms of cancer, a cure is most likely if the cancer is treated before it spreads to other parts of the body. This is why it is important to find cancer as early as possible. See your healthcare provider as soon as you notice any symptoms that concern you.

What is the cause?

In most cases, bladder tumors happen after the cells lining the urinary tract have been exposed to cancer-causing chemicals in the urine for many years. Chemicals in the urine can come from:

• Cigarette smoking.
• The workplace, such as from rubber, aniline dye, some textiles, and, rarely, hairdressing supplies. Leather workers, rubber workers, painters, dry cleaners, truck drivers, and aluminum workers are at risk. If you are exposed to any of these chemicals and are a smoker, your risk increases greatly.
• Overuse of pain medicines that contain phenacetin. These medicines are no longer available in the US.

What are the symptoms?

Symptoms of bladder cancer may include:

• blood in the urine
• pain when you urinate
• frequent need to urinate
• trouble starting to urinate
• lower back pain

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Your urine will be tested to check for blood or infection. Your provider may also look for abnormal cells in the urine.

You may have an exam called a cystoscopy. During this exam your provider passes a slim, flexible, lighted tube called a cystoscope through the urethra and into the bladder to look inside your bladder. (The urethra is the passageway that carries urine from your bladder to outside the body.) During the exam your provider will probably take a sample of urine to check for any abnormal cells under the microscope. Your provider will also probably remove a small piece of tissue from the bladder. This is called a biopsy. The tissue is examined in the lab to see if it is cancerous.

You may also have the following tests:

• CT scan, which is a series of X-rays taken from different angles and arranged by a computer to show thin cross sections of organs inside your belly
• ultrasound scan, which uses sound waves and their echoes passed through your body from a small device held against your skin to create pictures of the kidneys

If cancer is found, you will have more tests to see if cancer cells have spread into the bladder wall, to nearby lymph nodes, or to other parts of the body. For example, you might have a chest X-ray or bone scan.

How is it treated?

Treatment of a bladder tumor depends first on whether it is invasive. If it is found early and is noninvasive, your healthcare provider will try to scrape it or destroy the tumor by burning it with a high-frequency electrical current passed through a cystoscope. This procedure is called resection or fulguration. For small tumors this may be the only treatment that is needed. Another possible procedure involves putting chemicals or other medicines, such as chemotherapy, into the bladder to destroy the cancer cells. These treatments should not cause any problems for you.

Large tumors that have grown into the muscle of the bladder wall must be surgically removed. Sometimes all or part of the bladder is removed. This type of surgery is called a cystectomy. If all of the bladder is removed, your provider will create a new way for urine to pass out of your body through an opening in your belly (a urostomy). Your provider will create a pouch to collect urine inside your body, or a bag will be attached to the opening outside your belly.

Other treatments for invasive tumors include:

• radiation therapy, which uses high doses of radiation to shrink the tumor and kill cancer cells
• chemotherapy, which uses anticancer drugs to help destroy cancer cells that may have spread beyond the bladder

How can I take care of myself?

• Follow the full course of treatment prescribed by your healthcare provider.
• If all of your bladder is removed, keep the opening in your belly clean to prevent infection. Drain or empty the bladder pouch or bag before it gets too full.
• Eat a healthy diet and get regular exercise and rest.
• Try to reduce stress and take time for activities that you enjoy. It may help to talk with a counselor about your illness.
• Don’t smoke.
• For more information on cancer, contact national and local organizations such as:
  • American Cancer Society, Inc.
    Phone: 800-ACS-2345 (800-227-2345)
    Web site: http://www.cancer.org
  • National Cancer Institute
    Phone: 1-800-4CANCER, or 1-800-422-6237 (TTY: 1-800-332-8615)
    Web site: http://www.cancer.gov

How can I help prevent bladder cancer?

• If you smoke, stop smoking.
• Take protective measures when you are likely to be exposed to industrial chemicals.
• Drink lots of fluids.