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Do Bladder Cancer Symptoms Come And Go

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Changes In Your Bladder Habits

Bladder cancer and its signs and symptoms

Bladder habits can change subtly from day to day, but if you notice major changes in your bladder habits it can be a red flag. Some bladder habit changes can be a sign of other underlying health issues, so its never a bad idea to seek medical attention if youre concerned.

Some examples of changes in bladder habits that might be warning signs for bladder cancer include:

  • Having to urinate more often than usual
  • Pain or burning during urination
  • Feeling as if you need to urinate right away, even when your bladder isnt full
  • Having trouble urinating or having a weak urine stream
  • Having to get up to urinate many times during the night

Transurethral Resection Of A Bladder Tumour

If abnormalities are found in your bladder during a cystoscopy, you should be offered an operation known as TURBT. This is so any abnormal areas of tissue can be removed and tested for cancer .

TURBT is carried out under general anaesthetic.

Sometimes, a sample of the muscle wall of your bladder is also taken to check whether the cancer has spread, but this may be a separate operation within 6 weeks of the first biopsy.

You should also be offered a dose of chemotherapy after the operation. This may help to prevent the bladder cancer returning if the removed cells are found to be cancerous.

See treating bladder cancer for more information about the TURBT procedure

What Are The Different Types Of Bladder Cancer

Bladder cancer is divided into two subtypes:

  • papillary carcinoma

The subtypes have to do with how the tumors grow.

Papillary carcinomas grow in thin, finger-like projections, usually toward the center of the bladder. This is called noninvasive papillary cancer. A slow-growing, noninvasive papillary cancer may be referred to as PUNLMP, or papillary urothelial neoplasm of low-malignant potential.

Flat carcinomas dont grow toward the center of the bladder, but remain in the inner layer of bladder cells. This type is also called flat carcinoma in situ or noninvasive flat carcinoma.

If either type grows deeper into the bladder, its called transitional cell carcinoma.

Over 90 percent of bladder cancers are transitional cell carcinomas, also known as urothelial carcinoma. These are cancers that start in urothelial cells that line the inside of your bladder. The same type of cells can be found in your urinary tract. Thats why your doctor will examine your urinary tract for tumors.

Less common types are:

  • small cell carcinoma

Superficial bladder cancer means that there is cancer inside the lining of the bladder, but its early stage cancer that hasnt spread outside the lining.

The main treatment for superficial bladder cancer is TURBT or TUR , which is used to remove the entire tumor. That may be all you need at this time.

The tumor grade will help determine if you need further treatment.

Treatment and follow-up testing for superficial bladder cancer is generally successful.

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How Is Superficial Bladder Cancer Diagnosed

The road to diagnosis usually involves a number of tests, which may include:

  • Urine test : A pathologist will examine a sample of your urine under a microscope to look for cancer cells.
  • CT urogram: This is an imaging test that provides a detailed view of your urinary tract to check for signs of cancer. During the procedure, a contrast dye will be injected into a vein in your hand. X-ray images will be taken as the dye reaches your kidneys, ureters, and bladder.
  • Retrograde pyelogram: For this test, your doctor will insert a catheter through the urethra into your bladder. After contrast dye is injected, X-ray images can be taken.
  • Cystoscopy: In this procedure, the doctor inserts a narrow tube called a cystoscope through your urethra into your bladder. The tube has a lens so your doctor can examine the inside of your urethra and bladder for abnormalities.
  • Biopsy: Your doctor can take a tissue sample during a cystoscopy . The sample will then be sent to a pathologist for examination under a microscope.

If the biopsy confirms bladder cancer, other imaging tests may be used to determine if the cancer has spread. These may include:

If the cancer hasnt spread outside the lining of the bladder, the diagnosis is superficial, or stage 0 bladder cancer.

Next, the tumor is assigned a grade. Low-grade, or well-differentiated tumors, are similar in appearance to normal cells. They tend to grow and spread slowly.

What Are The Stages Of Bladder Cancer

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Bladder cancer can be either early stage or invasive .

The stages range from TA to IV . In the earliest stages , the cancer is confined to the lining of the bladder or in the connective tissue just below the lining, but has not invaded into the main muscle wall of the bladder.

Stages II to IV denote invasive cancer:

  • In Stage II, cancer has spread to the muscle wall of the bladder.
  • In Stage III, the cancer has spread to the fatty tissue outside the bladder muscle.
  • In Stage IV, the cancer has metastasized from the bladder to the lymph nodes or to other organs or bones.

A more sophisticated and preferred staging system is known as TNM, which stands for tumor, node involvement and metastases. In this system:

  • Invasive bladder tumors can range from T2 all the way to T4 .
  • Lymph node involvement ranges from N0 to N3 .
  • M0 means that there is no metastasis outside of the pelvis. M1 means that it has metastasized outside of the pelvis.

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Painful Sex During Treatment

Sex can become a painful experience while you undergo treatment for bladder cancer.

Some women may also experience vaginal dryness during certain cancer therapies, which can make sex uncomfortable and painful without lubrication.

Even though changes may happen to your body during your bladder cancer treatment, sex can still be an enjoyable experience with some adjustments.

Keep the lines of communication open with your partner and explore alternative techniques to penetrative intercourse. Consider asking your oncology team about specific recommendations that may work best for you.

Loss Of Appetite Common Symptom

If the idea of food makes you nauseous, you just have not been feeling hungry, or you have noticed significant weight loss, you may be experiencing a symptom of advanced bladder cancer. Because many health issues can cause you to lose your appetite, dont immediately assume the worst. Instead, talk to your doctor about your appetite loss if it doesnt go away.

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Your Gp Says Your Tests Are Normal

Your doctor may have arranged blood tests and, maybe, a chest X-ray. Normal results are reassuring usually, something will be out of kilter if youve got a Nasty lurking somewhere.

But basic tests dont totally give you the all-clear if your problem persists, you might need more detailed investigations.

If in doubt, of course, it is best to consult your GP. But do bear in mind that most symptoms are, thankfully, harmless. So chances are youll just get a dose of reassurance.

Do You Have To Be Seen For Bladder Cancer

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The presence of one or all of these signs does not mean you have cancer, but you should be seen by a physician, as these are abnormal bodily functions. Sometimes those diagnosed with bladder cancer do not experience any bleeding or pain. Thats why routine screening and physicals are very important.

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Living As A Bladder Cancer Survivor

For some people with bladder cancer , treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. This is very common if youve had cancer.

For other people, bladder cancer might never go away completely or might come back in another part of the body. Some people may get regular treatment with chemotherapy , immunotherapy, or other treatments to try to keep the cancer in check. Learning to live with cancer that doesnt go away can be difficult and very stressful.

Life after bladder cancer means returning to some familiar things and also making some new choices.

Why Does Bladder Cancer Happen

Most cases of bladder cancer appear to be caused by exposure to harmful substances, which lead to abnormal changes in the bladder’s cells over many years.

Tobacco smoke is a common cause and it’s estimated that half of all cases of bladder cancer are caused by smoking.

Contact with certain chemicals previously used in manufacturing is also known to cause bladder cancer. However, these substances have since been banned.

Read more about the causes of bladder cancer and preventing bladder cancer

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What Are The Risks Of Bladder Cancer

No single factor is directly connected to bladder cancer, but factors that can increase the risk include:

  • Age: Bladder cancer typically affects people age 55 and older.
  • Smoking: Carcinogens from tobacco smoke come in contact with the lining of the bladder. Smokers are three times as likely as non-smokers to get bladder cancer.
  • Family history: There is evidence that bladder cancer may have a genetic component.
  • Industrial chemicals: Chemicals known as aromatic amines are often used in the dye industry. Workers who have daily exposure to them, such as painters, machinists and hairdressers, may be at a higher risk for bladder cancer.
  • Drinking contaminated water: This includes water that has been treated with chlorine or drinking water with a naturally high level of arsenic, which occurs in many rural communities in the United States,.
  • Taking certain herb: Supplements such as Aristolochia fangchi, a Chinese herb, sometimes used for weight loss has been linked to higher rates of bladder cancer.

Later Symptoms Of Bladder Cancer

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Other symptoms are much less common or may occur later during bladder cancer. Some of these symptoms may be due to the spread of a bladder cancer to other regions of the body, and include:

  • Inability to urinate
  • Blood clots in the urine
  • Low back or flank pain on one side
  • An abdominal or pelvic mass
  • Enlarged lymph nodes in the groin
  • Swelling in the feet or legs
  • Bone pain or fracture with minimal trauma
  • Nausea and vomiting, jaundice , abdominal pain, and itching
  • Shortness of breath or a chronic cough

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Patients Can Enter Clinical Trials Before During Or After Starting Their Cancer Treatment

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCIs clinical trials search webpage. Clinical trials supported by other organizations can be found on the website.

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What Are The Signs Of A Bad Bladder

People with bladder cancer may experience the following symptoms or signs. Sometimes, people with bladder cancer do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer. Blood or blood clots in the urine Pain or burning sensation during urination Frequent urination

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Can Bladder Cancer Cause Pain

People with bladder cancer may experience the following symptoms or signs. Sometimes, people with bladder cancer do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer. Blood or blood clots in the urine. Pain or burning sensation during urination.

To Confirm The Diagnosis

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Urine microscopyA sample of urine can be sent to the laboratory to look for cancerous cells under the microscope. This test may detect cancer cells. However, if no cancer cells are seen it does not rule out bladder cancer. Further tests are done to confirm or rule out the diagnosis if symptoms suggest bladder cancer.

CystoscopyCystoscopy is commonly done to confirm a bladder tumour. Having a cystoscopy entails a doctor or nurse looking into your bladder with a special thin telescope called a cystoscope. The cystoscope is passed into your bladder via your water pipe . A cystoscopy which is done just to look into your bladder is normally carried out under local anaesthetic. If a procedure is done, such as removing a tumour via a cystoscope, a general anaesthetic is usually used.

During cystoscopy a doctor or nurse can:

  • See any areas on the lining of your bladder which look abnormal.
  • Take small samples of suspicious areas. A small sample of tissue is removed from a part of the body and then examined under the microscope to look for abnormal cells.
  • Remove a superficial tumour with instruments which can be passed down a side channel of the cystoscope.

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Early Signs Of Bladder Cancer In Women

Knowing the signs and symptoms can help you get diagnosed sooner, which may improve your prognosis. Here are five warning signs to watch for:

  • Blood in the urine . This is the most common early symptom of bladder cancer and typically the first sign of bladder cancer that is seen. Its easy for women to overlook because its typically painless and can go weeks or even months between occurrences. Many women ignore this symptom because they attribute it to menstruation or menopause. If you are unsure if there is an issue, your best bet is to consult a urologist
  • UTI-like symptoms. Bladder cancer can be mistaken for a Urinary Tract Infection because many of the symptoms overlap. Patients may experience increased frequency and urgency of urination, pain with urination, or urinary incontinence. If youve noticed any urinary problemsyou have to go all the time, or you feel like you have to go but cant, or you have a hard time emptying your bladderor if antibiotics dont seem to be helping your UTI symptoms, talk to your doctor.
  • Unexplained pain. More advanced bladder cancers are often associated with pain. Pain can occur in the flank area, abdomen, or pelvis. Patients can also develop pain in their bones if the cancer has spread to their bones. If youre having aches and pains in those areas, tell your doctorespecially if youve also noticed spotting or UTI symptoms.
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    Determining The Stage And Extent Of Your Cancer

    Once your physician confirms you have cancer of the bladder, they might recommend additional testing to determine if the cancer has spread to other areas of your body, like your lymph nodes.

    Testing might include:

    The doctor will use the information from this testing to determine the stage of your cancer. The bladder cancer stages are indicated by a 0 to IV range of Roman numerals. The lowest cancer stages indicate it’s confined to your bladder’s inner layers and hasn’t begun affecting your muscular bladder wall. Stage IV, the highest stage, indicates the cancer has begun spreading to distant organs and lymph nodes of your body.

    The cancer stages system is continually evolving and becoming more complex with the improvement of cancer diagnosis and treatment. The stage of cancer you have will also determine which treatment will serve you best.

    For more information on bladder cancer stages, please refer to the American Cancer Society website.

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    Is Bladder Cancer A Fatal Illness

    Left untreated, bladder cancer may spread to other parts of your body. Cancer thats metastasized, or spread, may affect how long youll live with bladder cancer. Like many types of cancer, early detection and treatment increase the chance of living longer with bladder cancer. According to the National Cancer Institute, 96% of people who received treatment for early-stage cancer were alive five years after diagnosis. Overall, 77% of people with bladder cancer were alive five years after diagnosis.

    Transurethral Resection Of Bladder Tumor

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    If your urologist suspects bladder cancer, they may recommend performing a transurethral resection of bladder tumor during the cystoscopy.

    A transurethral resection is when a small piece of tissue is removed from your bladder in order to be biopsied to determine if its cancerous. A transurethral resection can also be used to treat a bladder tumor.

    The most common side effects of the TURBT are bleeding, pain, and burning when urinating. These may be intermittent and can last for up to one month. In rare cases, it can cause a small tear or injury to the bladder.

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    Radiotherapy With A Radiosensitiser

    Radiotherapy is given by a machine that beams the radiation at the bladder . Sessions are usually given on a daily basis for 5 days a week over the course of 4 to 7 weeks. Each session lasts for about 10 to 15 minutes.

    A radiosensitiser should also be given alongside radiotherapy for muscle-invasive bladder cancer. This is a medicine which affects the cells of a tumour, to enhance the effect of radiotherapy. It has a much smaller effect on normal tissue.

    As well as destroying cancerous cells, radiotherapy can also damage healthy cells, which means it can cause a number of side effects. These include:

    • erectile dysfunction
    • difficulty passing urine

    Most of these side effects should pass a few weeks after your treatment finishes, although there’s a chance they’ll be permanent.

    Having radiation directed at your pelvis usually means you’ll be infertile for the rest of your life. However, most people treated for bladder cancer are too old to have children, so this isn’t usually a problem.

    After having radiotherapy for bladder cancer, you should be offered follow-up appointments every 3 months for the first 2 years, then every 6 months for the next 2 years, and every year after that. At these appointments, your bladder will be checked using a cystoscopy.

    You may also be offered CT scans of your abdomen, pelvis and chest after 6 months, 1 year and 2 years. A CT scan of your urinary tract may be offered every year for 5 years.

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