New York Health
Urology Centers

Urologic Cancer – Bladder Cancer

What is bladder cancer?

Bladder cancer affects the balloon-shaped organ in the pelvis that holds urine. It usually begins to form in the cells that line the bladder, causing them to grow abnormally, leading to a tumor. Bladder cancer is more common in men and in those greater than 55 years old.

While the exact cause of bladder cancer is uncertain, it has been linked to risk factors such as:

  • A personal and/or family history of bladder cancer
  • Smoking
  • Chronic bladder inflammation
  • Birth defects
  • Chemical exposure (e.g., arsenic, industrial dye chemicals)
  • Parasitic infection
  • Certain medications
  • Prior chemotherapy or radiation therapy

What are the symptoms for bladder cancer?

Bladder cancer symptoms may include:

  • Frequent urination
  • Painful urination
  • Back pain
  • Hematuria (blood in the urine) could be obvious with red- or cola-colored urine or blood that is only found during a microscopic examination of the urine
  • Pelvic pain

What are the types of bladder cancer?

The type of bladder cancer depends upon the sort of cell in which the tumor began. Treatment also varies according to the type of bladder cancer.

Bladder cancers are categorized according to how far they have spread into the bladder wall:

  • Non-invasive cancers are still within the surface walls of the bladder and have not spread to the deeper layers.
  • Invasive cancers have gone into deeper layers of the bladder wall. As such, they are more difficult to treat and more likely to spread.
  • Superficial, non-muscle invasive cancers include both non-invasive tumors and invasive tumors that have not penetrated the muscle layer of the bladder.

The types of bladder cancer include:

  • Adenocarcinoma forms within cells of the mucus-secreting glands within the bladder. Adenocarcinoma is rare in the United States, and almost all adnenocarcinomas are invasive.
  • Squamous cell carcinoma (SCC) is more commonly found in parts of the world where the schistosomiasis parasitic infection is the primary cause of bladder infections. Squamous cells appear in the bladder as a response to the infection. Over time they may become cancerous. SCC is generally an invasive cancer.
  • Transitional cell carcinoma (TCC), which is also known as urothelial carcinoma, occurs in the cells that line the bladder, expanding and contracting when the bladder fills and empties. They also line the inside of the uterus and urethra. TCC is considered the most common type of bladder cancer in the U.S.

How is bladder cancer diagnosed?

A bladder cancer diagnosis may be confirmed through:

  • Cytoscopy involves a thin tube with a camera being inserted into the urethra to examine the urethra and bladder. The physician may take a sample (biopsy) for testing during this procedure.
  • Urine cytology analyzes a urine sample for the presence of cancer cells.
  • Imaging tests such as intravenous pyelogram, a special type of X-ray, or a computed tomography (CT) scan may be used to view the urologic tract.

Once the diagnosis is confirmed, additional tests may be required, including:

  • Bone scan
  • Magnetic resonance imaging (MRI)
  • Chest X-ray
  • CT scan

Next, the stage of the bladder cancer is determined based upon:

  • How invasive the cancer is
  • If the cancer is present in the lymph nodes
  • If the cancer has spread (metastasized) to other organs
  • Tumor size

The stages of bladder cancer are:

  • Stage 0: Cancer cells are found only on the inner lining of the bladder. This is also referred to as superficial cancer or carcinoma in situ.
  • Stage I: Cancer cells are found deep in the lining of the bladder, but have not invaded the bladder muscle.
  • Stage II: Cancer cells are present in the muscle layer of the bladder.
  • Stage III: Cancer cells have spread through the bladder muscle into the tissues around the bladder, such as the prostate or the uterus.
  • Stage IV: Cancer may have spread to lymph nodes and other organs in the body.

How is bladder cancer treated?

Treatment for bladder cancer depends on several factors such as:

  • Overall health
  • Cancer stage
  • Treatment preferences
  • Type of cancer

Treatments for Early-Stage Bladder Cancer

If the growth is small and has not penetrated the wall of the bladder, one of the following options may be recommended:

  • Immunotherapy helps the immune system fight cancer cells by inserting a specific type of medication into the bladder
  • Segmental cystectomy to remove cancer-infested portion of the bladder
  • Transurethral resection of the bladder tumor (TURBT) burns away cancer cells with a high-energy laser or electrical current

Treatments for Invasive Bladder Cancer

If the cancer has moved to the deeper layers of the bladder walls, treatments could include:

  • Radical cystectomy to completely remove the bladder and the surrounding lymph nodes utilizing traditional, laparoscopic or robotic surgery
  • Surgery to create a new exit in the body for urine following a radical cystectomy using a tube or a section of the intestine

Bladder Cancer Chemotherapy

Chemotherapy may be used to shrink a tumor before surgery or destroy any cancer cells that remain after surgery. Chemo, as it’s commonly called, can be administered intravenously through a vein in the arm or intravesically through direct injection into the bladder. Chemotherapy is also used in certain cases with radiation therapy if surgery isn’t an option.

Radiation Therapy for Bladder Cancer

Radiation therapy uses high-energy beams that target cancer cells through a machine that moves around the body to direct the beams in exact locations. Radiation therapy is commonly used after surgery to destroy any remaining cancer cells.