How Is Metastatic Bladder Cancer Treated
The way that metastatic bladder cancer is treated depends primarily on where the cancer has spread and the type of cells that make up the primary tumor. Its important to remember that when bladder cancer spreads, the secondary tumors are still considered to be bladder cancer not lung cancer, liver cancer or any other type of malignancy. Potential treatment options may include chemotherapy, radiation therapy and clinical trials.
At Moffitt Cancer Center, weve treated many patients with metastatic bladder cancer, creating tailored treatment plans for every single one. To help ease the burdens of treatment, we also offer comprehensive supportive care services for patients and their caregivers.
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 doesn’t go away can be difficult and very stressful.
Life after bladder cancer means returning to some familiar things and also making some new choices.
Bladder Cancer: The Symptoms You Shouldnt Ignore
One patient shares his experience being diagnosed with a disease he knew nothing about.
A recent survey showed that almost two-thirds of adults are unaware of the signs of bladder cancer, with 10% having never even heard of the disease.1 Yet bladder cancer is one of the top 10 most common cancers in the world.2
One of the groups of people most at risk of bladder cancer are older men5 and this proved true for Dave from Torquay, UK.
Dave was diagnosed with bladder cancer in 2008 when he was aged 61. At the time of diagnosis, he knew nothing about the disease or its signs and symptoms. Based on his experiences he is keen to raise awareness about bladder cancer, by sharing his story.
It was Christmas Eve and we had finished dinner, explains Dave. After dinner, I went to the toilet and I noticed my urine was blood red. It was a real shock. Immediately, I told my wife as soon as I discovered blood in my urine – we both didnt know what to do. Although Dave didnt know it at the time, this was a symptom of bladder cancer. In fact, the most common.3,5 Other symptoms include abdominal pain, lower back pain and bladder irritation. 3,5
Dave was quick to act once he spotted the change in his urine. He explains, As soon as my doctors surgery opened after Christmas, I booked an appointment and was referred straight away. Within a couple of days I went to see a urologist.
Visit the campaign website: www.wecarecampaign.org
Read Also: What Were Your Symptoms Of Bladder Cancer
Changes In Bladder Habits Or Symptoms Of Irritation
Bladder cancer can sometimes cause changes in urination, such as:
- Having to urinate more often than usual
- Pain or burning during urination
- Feeling as if you need to go right away, even when your bladder isn’t full
- Having trouble urinating or having a weak urine stream
- Having to get up to urinate many times during the night
These symptoms are more likely to be caused by a urinary tract infection , bladder stones, an overactive bladder, or an enlarged prostate . Still, its important to have them checked by a doctor so that the cause can be found and treated, if needed.
Warning Signs & Symptoms Of Bladder Cancer
Bladder cancer is one of the most common types of cancer in males. It is actually the most recurrent diagnosis of urologic cancer, and it is widespread in countries of North and South America, Asia, and Europe.
The bladder is a structure from the urinary tract that collects the urine that initially comes from the kidneys and is transported into the bladder by the ureters. When the storage capacity of the bladder is met, we feel the urge to pass urine.
Bladder cancer develops when the linings of the bladder start to grow without any control. It mostly affects males, and when such growth is aggressive, it may spread quickly to other organs and cause metastasis. Therefore, it is vital to be able to identify bladder cancer from the start to be able to look for professional help if needed.
For that purpose, heres a list of the 10 most important warning signs and symptoms of bladder cancer.
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Early Symptoms Of Bladder Cancer
The following are some of the early-stage bladder cancer symptoms you might experience:
1. Blood in the Urine
Blood in urine, often referred to as hematuria, is the most common symptom or sign of bladder cancer. With this symptom:
- You might have enough blood to change your urine color to pink, orange or, less often, dark red.
- Your urine color is sometimes normal, but a urine test , which the doctor performs during a general medical checkup or if you have other symptoms, can still detect small traces of blood.
- You may have blood one day and not the next, with your urine staying clear for weeks or maybe even months at a time.
Generally, the earlier stages of bladder cancer when the cancer is small and confined to your bladder only cause bleeding with either no pain or little pain.
It’s important to note that blood in your urine doesn’t necessarily indicate bladder cancer. The cause of blood may be due to another factor. In fact, many healthy individuals may have some unseen blood in their urine at some stage . And, for most individuals, the cause isn’t cancer.
In many situations, the cause is due to other things like benign tumors, medications or foods, infection, bladder or kidney stones or another benign kidney disease. Still, you should have your doctor check it out.
If you’re concerned about cancer, ask them about Cxbladder, a non-invasive genomic urine test that quickly and accurately detects or rules out bladder cancer.
What Are The Stages Of Bladder Cancer
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.
Also Check: Can Stress Cause Overactive Bladder
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.
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:
Read Also: What Doctor To See For Bladder Infection
Advanced Symptoms Of Bladder Cancer
Bladder cancer is considered advanced when the tumor has grown and penetrated the bladder lining and surrounding layers of tissue and muscle. At this stage, the cancer may have spread to other parts of the body . Symptoms of advanced bladder cancer include the following:
- Urination problems: Inability to urinate
- Pain in the lower back: Another indication the tumor has spread is pain, particularly in the area above your pubic bone or the flank area. Pain in your perineum might also occur if your bladder cancer has reached tissues nearby. Pain may only be on one side.
- Weight loss or loss of appetite: You lose weight without trying, or you’ve lost your appetite and aren’t as hungry as usual.
- Feeling weak or fatigued: You may feel lethargic and extremely tired a lot of the time.
- Bone pain: If your cancer has spread to the bone, it can cause bone pain or a bone fracture.
- Swollen feet: Bladder cancer that has spread to your lymph nodes, for instance, could cause your feet to swell.
If the bladder cancer has spread to another part of your body, you could develop symptoms specific to that particular area. For example:
Once again, these symptoms could be due to something other than bladder cancer, so be sure to have your doctor check them out.
Signs Of Bladder Cancer That Women Should Know
Even if you’re vigilant about getting routine GYN care, bladder cancer may not really be on your radar. After all, it’s far more common among men than women, and the majority of cases affect patients over age 65. But don’t let those stats keep you from learning to spot the symptoms. Many people mistakenly think bladder cancer is only a disease of older men, but there are more than 18,000 women who are diagnosed with this cancer every year in the United States.
And because women may not be on the lookout for early bladder cancer symptoms, the Bladder Cancer Advocacy Network reports that women are more likely to be diagnosed with bladder cancer at an advanced stage. Knowing the symptoms can help you get diagnosed sooner, which can improve your prognosis.
Here are a few warning signs to watch for:
BLOOD IN YOUR URINE
This is the most common early symptom of bladder cancer, and it’s an easy one for women to overlookespecially because it’s typically painless and you can go weeks or even months between occurrences. Many women ignore this symptom because they connect it with menstruation or menopause. Women who have microscopic blood in the urine without symptoms of urgency/frequency or pain, often do not have a UTI, and in fact, the blood in the urine may be due to cancer or other conditions.
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When To Make An Appointment With Your Urologist
Bladder cancer may be overlooked in women because its easy to chalk up symptoms to a stubborn UTI or normal vaginal spotting. Unfortunately, this means women are often diagnosed after the cancer has spread and become harder to treat. So if youre worried, dont just write off your symptoms. Call your doctor to determine if its a minor infection or something more serious. If it is bladder cancer, its easier to treat if you catch it early.
If you would like to talk to a urologist, you can see if we have a location near you or you can contact us to ask a question or make an appointment.
To Confirm The Diagnosis
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.
See the separate leaflet called Cystoscopy for more details.
Ultrasound scanThis is a safe and painless test which uses sound waves to create images of organs and structures inside your body. An ultrasound scan may be used to diagnose a bladder cancer.
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For Patients With A Urostomy
If you had a radical cystectomy and now have a urostomy, you might worry even about everyday activities at first. You might have to alter some of your daily routines because of changes in how you urinate. Other issues such as having sex might also cause concerns .
Its normal to have worries and concerns when adjusting to such a major change. But its important to know there are health care professionals who are specially trained to help people with their urostomies. They can teach you to take care of your urostomy and help you cope with the changes it brings. You can also ask the American Cancer Society about programs offering information and support in your area. For more information, see our Urostomy Guide.
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 ClinicalTrials.gov website.
Recommended Reading: Why Do I Get Bladder Infections So Easily
Doctor Visits And Tests
Your schedule of exams and tests will depend on the stage and grade of the cancer, what treatments youve had, and other factors. Be sure to follow your doctors advice about follow-up tests.
Most experts recommend repeat exams every 3 to 6 months for people who have no signs of cancer after treatment. These are done to see if the cancer is growing back or if there’s a new cancer in the bladder or urinary system. Your follow-up plan might include urine tests, physical exams, imaging tests , and blood tests. These doctor visits and tests will be done less often as time goes by and no new cancers are found.
- If your bladder hasnt been removed, regular cystoscopy exams will also be done every 3 months for at least the first 2 years.
- If you have a urinary diversion, you will be checked for signs of infection and changes in the health of your kidneys. Urine tests, blood tests, and x-rays might be used to do this. Your vitamin B12 will be checked at least once a year because urinary diversions made with your intestine can affect B12 absorption. Your doctor will also talk to you about how well you’re able to control your urine. Tests will be done to look for signs of cancer in other parts of your urinary tract, too.
Some doctors recommend other lab tests as well, such as the urine tumor marker tests discussed in Can Bladder Cancer Be Found Early? Many of these tests can be used to help see if the cancer has come back, but so far none of these can take the place of cystoscopy.