Bladder Cancer

The bladder is the organ located in the lower abdomen where urine is stored temporarily after it has been produced in the kidneys and transported by way of tubes called ureters. The bladder’s wall is multi-layered, and cancer usually arises in the innermost lining, spreading outwardly to the external walls. There are three types of bladder cancer that are typically identified: urothelial carcinoma, squamous cell carcinoma, and adenocarcinoma. Treatment choices may depend on which type the patient has.

Risk Factors

  • Age: The likelihood of getting bladder cancer increases with age.
  • Gender: Males develop bladder cancer two to three times more often than females, according to the National Cancer Institute.
  • Smoking or tobacco use
  • Occupation: exposure to certain chemicals
  • Medical treatment with arsenic or cyclophosphamide
  • Personal history of bladder cancer
  • Family history

Symptoms

Those who suffer from bladder cancer may experience a combination of the following symptoms:

  • Painful urination
  • Blood in the urine
  • Frequent urination
  • Back or abdominal pain
  • Loss of appetite and weight loss

Detection and Diagnosis

If a patient has a number of symptoms or risk factors, the following tests can diagnose bladder cancer. The sooner cancer is diagnosed the easier it is to treat.
A patient's first option is a physicial exam. The physician examines the abdomen and pelvis for lumps or swelling. He or she may also conduct a rectal or vaginal exam.

A urinalysis and urine culture will examine a sample of the patient’s urine for infection or blood.

Urine cytology checks for cancer cells from what has been “washed” from the bladder.

During cytology, dye is injected into the patient's bloodstream and a CT scan completed to obtain images of the bladder and other abdominal pelvic organs, including the kidneys.

During a cystoscopy physicians insert a long thin camera, called a cystoscope, into the bladder through the urethra to be able to look closely at the bladder lining. If anything appears abnormal, a sample may be removed using the cystoscope. An examination of the biopsy sample under a microscope may diagnose cancer.

Blue Light Cystoscopy with Cysview® is an optical imaging agent used to help detect papillary bladder cancer. The imaging solution (Cysview) is delivered into the bladder about an hour prior to the cystoscopy so that it can be absorbed by cancerous tissue. Surgeons switch the scanner to a mode called "blue light" to help reveal hard-to-see tumors.

By using Blue Light Cystoscopy with Cysview®, surgeons can detect and remove more cancerous tumors for better disease management

GW Hospital is the first hospital in Washington, D.C. to offer Blue Light Cystoscopy with Cysview®.

Additional studies, such as X-rays, CAT scans and magnetic resonance imaging (MRI) may be needed to detect cancerous growth by taking internal pictures of the body.

Treatment Options

Surgery is the most common form of treatment for all types and stages of bladder cancer. Superficial, noninvasive tumors can be removed in a cystoscopic procedure, while some tumors may require partial bladder removal (partial cystectomy). Cancers that invade the bladder muscle, and superficial cancers that extend over much of the bladder may require removal of the bladder (radical cystectomy), surrounding lymph nodes and cancerous structures.

Immuno therapy is often used with patients who have non-muscle invasive disease to decrease recurrence of tumors and their progression to muscle invasive disease.

Chemotherapy is the use of powerful drugs to kill cancer. It is usually given before surgery or radiation therapy.

Radiation therapy is an alternative for people unable to undergo surgery. High-energy radiation rays can reduce tumors and kill cancer cells.

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