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URINARY HEALTH
Bladder Cancer
Bladder Cancer Definition
Bladder Cancer - cancerous tumor in the bladder(organ holding urine) that usually starts from the cells lining the bladder (transitional cells). These tumors may be classified based on the way they grow:
- Papillary tumors - wart-like and attached to a stalk
- Nonpapillary tumors - much less common but more invasive with typically worse outcomes
- Squamous cell bladder cancer
- Cigarette and tobacco smoke
- Alcohol abuse
- Previous cancer, especially cervical cancer
- Chemical exposure at work and environment
Bladder cancers are classified on their aggressiveness and total spread in stage from 0-4
- Stage 0 -- Non-invasive tumors restricted only to bladder lining
- Stage I -- Tumor spreads through the bladder lining, but not to the muscle layer of the bladder
- Stage II -- Tumor spreads into the muscle layer of the bladder
- Stage III -- Tumor spreads into tissues surrounding the bladder
- Stage IV -- Tumor metastasizes to neighboring lymph nodes or to distant sites
Bladder cancer symptoms can resemble symptoms of many other conditions. They are
- Bloody and red urine
- Painful urination
- Increase in urinary frequency and urgency and incontinence
- Abdominal pain
- Anemia, lethargy and fatigue
- Bone pain or tenderness
- Weight loss
Bladder Cancer Tests and Diagnosis
Tests for bladder cancer include
- Physical examination
- Abdominal CT scan
- Bladder biopsy
- Cystoscopy (examining inside the bladder with a camera)
- Intravenous pyelogram - IVP
- Urinalysis
- Urine cytology
- Scans for other parts of the body to monitor cancer spread
Bladder Cancer Medical Treatments
Treatment depends on the stage, severity and symptoms of the cancer as well as the condition of the patient.
- Stage 0 or 1 bladder cancer - treatments include surgical removal of tumor with chemotherapy or immunotherapy directly into the bladder. Patients with stage 0 or 1 bladder cancer can be cured nearly 100% but recurrences occur often and have to be monitored
- Stage 2 or 3 bladder cancer - removal of the entire bladder, followed by chemotherapy and radiation. Survival rates for people with stage III tumors are less than 50%
- Stage 4 tumors - cannot be cured by surgery because removing the bladder will not cure the other parts of the body to which the cancer has spread. In stage 4 patients, chemotherapy, radiation and optimal diet may be the only option, although stage 4 patients rarely survive
Chometherapy - drugs that kill healthy and tumor cells
Immunotherapy - medication that causes the immune system to attack and kill the tumor cells.
Immunotherapy for bladder cancer is usually performed using the Bacille Calmette-Guerin vaccine (commonly known as BCG).
Transurethal resection of the bladder (TURB) - surgical procedure performed under general or spinal anesthesia used to treat
stage 0 or I bladder cancer where a cutting instrument is inserted through the urethra to remove the bladder tumor.
Bladder Removal (radical cystectomy) - patients with stage II or III bladder cancer may need to have their bladder removed.
Patients who have the entire bladder removed will receive chemotherapy after surgery to decrease the risk of the cancer coming back.
Radical cystectomy (men) - typically the removing of the bladder, prostate, and seminal vesicles.
Radical cystectomy (women) - typically the removal of the bladder, urethra, uterus, and the front wall of the vagina.
Urinary diversion surgery - surgical procedure to create an alternate method for urine storage.
Ilean Conduit - surgically created urine reservoir that drains urine from the kidneys.
Contintnt Urinary Reservoir - an alternate method of storing urine in an internal pouch.
Orthopedic Neobladder - surgery where a segment of bowel is folded over to make a pouch (a neobladder) that is attached to the place
in the urethra where the urine normally empties from the bladder.