Magnetic Resonance Imaging Scan
Like CT scans, MRI scans show detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays.
MRI images are very useful in showing cancer that has spread outside of the bladder into nearby tissues or lymph nodes. A special MRI of the kidneys, ureters, and bladder, known as an MRI urogram, can be used instead of an IVP to look at the upper part of the urinary system.
Medical History And Physical Exam
Your doctor will want to get your medical history to learn more about your symptoms. The doctor might also ask about possible risk factors and your family history.
A physical exam can provide information about possible signs of bladder cancer and other health problems. The doctor might do a digital rectal exam , during which a gloved, lubricated finger is put into your rectum. If you are a woman, the doctor might do a pelvic exam as well. During these exams, the doctor can sometimes feel a bladder tumor, determine its size, and feel if and how far it has spread.
If the doctor finds things that aren’t normal, you may to have lab tests done and you might be referred to a urologist for further tests and treatment.
What Are The Treatment Options For Bladder Cancer
There are four types of treatment for patients with bladder cancer. These include:
- Surgery
Sometimes, combinations of these treatments will be used.
Surgical options
Surgery is a common treatment option for bladder cancer. The type of surgery chosen will depend on the stage of the cancer.
- Transurethral resection of the bladder is used most often for early stage disease . It is done under general or spinal anesthesia. In this procedure, a special telescope called a resectoscope is inserted through the urethra into the bladder. The tumor is then trimmed away with the resectoscope, using a wire loop, and the raw surface of the bladder is then fulgurated .
- Partial cystectomy is the removal of a section of the bladder. At times, it is used for a single tumor that invades the bladder wall in only one region of the bladder. This type of surgery retains most of the bladder. Chemotherapy or radiation therapy is often used in combination. Only a minority of patients will qualify for this bladder-sparing procedure.
- Radical cystectomy is complete removal of the bladder. It is used for more extensive cancers and those that have spread beyond the bladder .
This surgery is often done using a robot, which removes the bladder and any other surrounding organs. In men, this is the prostate and seminal vesicles. In women, the ovaries, uterus and a portion of the vagina may be removed along with the bladder.
Chemotherapy
- Methotrexate
Intravesical therapy
Radiation therapy
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Biopsies To Look For Cancer Spread
If imaging tests suggest the cancer might have spread outside of the bladder, a biopsy might be needed to be sure.
In some cases, biopsy samples of suspicious areas are taken during surgery to remove the bladder cancer.
Another way to get a biopsy sample is to use a long, thin, hollow needle to take a small piece of tissue from the abnormal area. This is known as a needle biopsy, and by using it the doctor can take samples without surgery. Sometimes a CT scan or ultrasound is used to help guide the biopsy needle into the changed area.
Tests That Might Be Used To Look For Bladder Cancer
Tests for bladder cancer look for different substances and/or cancer cells in the urine.
Urinalysis: One way to test for bladder cancer is to check for blood in the urine . This can be done during a urinalysis, which is a simple test to check for blood and other substances in a sample of urine. This test is sometimes done as part of a general health check-up.
Blood in the urine is usually caused by benign problems, like infections, but it also can be the first sign of bladder cancer. Large amounts of blood in urine can be seen if the urine turns pink or red, but a urinalysis can find even small amounts.
Urinalysis can help find some bladder cancers early, but it has not been shown to be useful as a routine screening test.
Urine cytology: In this test, a microscope is used to look for cancer cells in urine. Urine cytology does find some cancers, but it’s not reliable enough to make a good screening test.
Urine tests for tumor markers: Newer tests look for certain substances in urine that might be a sign of bladder cancer. These include:
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In His Own Words: Living With Bladder Cancer
Norman is 70 years old and lives in Spooner, Wisconsin, where he owns and operates a bookstore with his wife. He learned he had bladder cancer a year ago. After a visit last week to his doctor he learned his bladder is now nice and clean.
What was your first sign that something was wrong? What symptoms did you experience?
In October 2001, I began to pass blood clots in my urine. I also felt a slight sense of urgency to urinate, which subsequently became worse as time went on. Because my wife had been planning to have elective knee surgery after Thanksgiving, I decided to wait until December to tell her about my symptoms. Of course, she encouraged me to see my doctor right away.
What was the diagnosis experience like?
After seeing my primary doctor, I was referred to an urologist, who used a cystoscope to inspect my bladder. A cystoscope is a very small instrument with a long, flexible, and slender tube with a small light at the end, which is inserted through the urethra. At that time, the urologist said it was a tumor–probably cancer. Later, the urologist took a biopsy at the time of surgery and said it appeared to be a superficial, aggressive form of cancer.
What was your initial and then longer-term reaction to the diagnosis?
Of course, my wife and I were very concerned, but we didnt have crying fits or anything. We relied on the doctor to advise us about the treatment options.
How is bladder cancer treated?
Did you seek any type of emotional support?
Signs And Symptoms Of Cancer
Signs and symptoms are ways the body lets you know that you have an injury, illness, or disease.
- A sign, such as fever or bleeding, can be seen or measured by someone else.
- A symptom, such as pain or fatigue, is felt or noticed by the person who has it.
Signs and symptoms of cancer depend on where the cancer is, how big it is, and how much it affects nearby organs or tissues. If a cancer has spread , signs or symptoms may appear in different parts of the body.
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What To Watch For: Symptoms That Led To Our Bladder Cancer Diagnosis
You have bladder cancer. Four words that can instantly send your life spinning into uncharted territory.
When you get that diagnosis, everything seems to hit at once. The doctor appointments. The uncertainty. And the emotions. All of the emotions. How is it that someone can feel everything and nothing all at the same time?
Looking back, were there telltale signs that something was not quite right? We asked our BladderCancer.net community what initial symptoms led to their bladder cancer diagnosis. Here is what they said.
Prognosis And Survival Rates For Bladder Cancer
When someone is diagnosed with bladder cancer, their doctor will give them a prognosis. A prognosis is the doctors opinion of how likely the cancer will spread and the chances of getting better. A prognosis depends on the type and stage of cancer, as well as the persons age and general health.
Bladder cancer can usually be effectively treated if it is found before it spreads outside the bladder.
If you have bladder cancer, your doctor will talk to you about your individual situation when working out your prognosis. Every persons experience is different, and there is support available to you.
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Would You Like To Share Your Story
Inspire other people and those newly diagnosed with the details of your bladder cancer journey.
To help you write your story heres a few pointers to get you started, you can include …
- A little bit about yourself including your age and things you like to do
- How you first discovered you had bladder cancer
- What your treatment has been
- What life changes you have made since diagnosis
- What positives can you share about your experiences
- What advice would you give to someone just diagnosed
Submit your story along with a selfie photograph to
Talk in confidence about whats worrying you in our
How Can I Prevent Bladder Cancer
If you have risk factors for bladder cancer, there are things you can do to lower your risk, including:
Quit smoking. Cigarette smokers are two to three times more likely to develop bladder cancer. Quitting smoking is one of the most important things you can do for prevention.
Ready to stop smoking? Try these resources.
Help! I Want to Quit Smoking! | American Heart AssociationHelp for Cravings and Tough Situations While You’re Quitting Tobacco
Avoid harmful chemicals. Following safety procedures when working with hazardous chemicals is an important aspect of bladder cancer prevention since substances used in dye, textile, rubber, leather, and trucking industries might cause harm to the bladder.
Some studies have indicated that consuming high amounts of arsenic in drinking water is linked to a greater risk of bladder cancer. Researchers are not exactly sure why exposure to this element is related to cancer.
Drink water and stay hydrated. Drinking a lot of water could dilute harmful substances in your urine and flush them out of your bladder. While there is no conclusive evidence demonstrating that drinking water reduces the risk of bladder, some researchers believe it may help.
Eat fruits and vegetables. Some studies have suggested that a diet high in fruits and vegetables might help protect against bladder cancer. Cruciferous vegetables like broccoli, cabbage, and cauliflower, especially have been linked to a reduction in the risk of developing cancer.
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Transurethral Resection Of Bladder Tumor
If an abnormal area is seen during a cystoscopy, it needs to be biopsied to see if it’s cancer. A biopsy is when tiny pieces of the abnormal-looking tissue are taken out and tested for cancer cells. If bladder cancer is suspected, a biopsy is needed to be sure of the diagnosis.
The procedure used to biopsy an abnormal area is a transurethral resection of bladder tumor , also known as just a transurethral resection . During this procedure, the doctor removes the tumor and some of the bladder muscle around the tumor. The removed samples are then sent to a lab to look for cancer. If cancer is found, testing can also show if it has invaded the muscle layer of the bladder wall. For more on how this procedure is done, see Bladder Cancer Surgery.
Bladder cancer can sometimes start in more than one area of the bladder . Because of this, the doctor may take samples from many different parts of the bladder, especially if cancer is strongly suspected but no tumor can be seen. Salt water washings of the inside the bladder may also be collected and tested for cancer cells.
Watching For Possible Symptoms Of Bladder Cancer
No screening tests are recommended for people at average risk, but bladder cancer can be found early because it causes blood in the urine or other urinary symptoms. Many of these symptoms often have less serious causes, but its important to have them checked right away so the cause can be found and treated, if needed. If the symptoms are from bladder cancer, finding it early offers the best chance for successful treatment.
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Ask Your Doctor For A Referral To A Urologist
For women diagnosed with a UTI, Dr. Donat has this advice: Make sure your doctor sends a urine culture for testing, she says. If you did have a culture, make sure it came back positive to confirm that you actually have an infection. If the culture was negative or your bladder symptoms continue despite treatment, dont be afraid to ask your doctor for a referral to a urologist to get a formal evaluation.
Tests can sometimes distinguish the bleeding associated with bladder cancer from postmenopausal uterine bleeding, but the results are not always clear-cut. Your gynecologist can send a catheterized urine sample for testing to determine the source of the blood and to evaluate for gynecologic causes of the bleeding, Dr. Donat explains. If your gynecologic exam fails to identify the source of the bleeding or is inconclusive, or if your irritative bladder symptoms persist, you should also seek out the expertise of a urologist.
Hematuria may originate in the bladder or the kidneys, says Dr. Donat, so a urologist needs to check both. This is best done with a special CT scan of the urinary tract called a CT urogram and by looking in the bladder with a lighted telescope called a cystoscope. This procedure, called a cystoscopy, is usually done in an office in just a few minutes and does not require anesthesia, says Dr. Donat. A urine test called a cytology may also be sent to check for cancer cells in the urine.
If You’re Concerned About Bladder Cancer Ask Your Doctor About Cxbladder
Cxbladder is a non-invasive genomic urine test that quickly and accurately detects or rules out bladder cancer. The test combines clinical risk factor markers with genetic information, measuring five biomarker genes to detect the presence or absence of bladder cancer.
When should you use Cxbladder?
- When you’ve seen blood in your urine
- If tests reveal you have blood in your urine
- When you’re being monitored for recurrent bladder cancer
Cxbladder provides peace of mind and can make a meaningful difference to your care
- Cxbladder gives you certainty, resolving diagnostic ambiguity and improving overall detection accuracy.
- Most patients experiencing hematuria or who are being monitored for bladder cancer recurrence do not have cancer. Cxbladder enables the accurate rule out of patients who do not have bladder cancer, reducing the need for further invasive tests.
With performance proven in 12 peer-reviewed studies, Cxbladder is trusted by over 1,800 urologists in over 40,000 patients. The test is covered by Medicare and comes with the option of in-home sampling.
Cxbladder provides reliable results that will help your doctor make informed diagnosis and management decisions with you.
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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.
What Are The Risk Factors For Bladder Cancer
Some factors increase the risk of bladder cancer:
- Cigarette smoking is the biggest risk factor it more than doubles the risk. Pipe and cigar smoking and exposure to second-hand smoking may also increase one’s risk.
- Prior radiation exposure is the next most common risk factor .
- Certain chemotherapy drugs also increase the risk of bladder cancer.
- Environmental exposures increase the risk of bladder cancer. People who work with chemicals, such as aromatic amines are at risk. Extensive exposure to rubber, leather, some textiles, paint, and hairdressing supplies, typically related to occupational exposure, also appears to increase the risk.
- Infection with a parasite known as Schistosoma haematobium, which is more common in developing countries and the Middle East.
- People who have frequent infections of the bladder, bladder stones, or other diseases of the urinary tract, or who have chronic need for a catheter in the bladder, may be at higher risk of squamous cell carcinoma.
- Patients with a previous bladder cancer are at increased risk to form new or recurrent bladder tumors.
Other risk factors include diets high in fried meats and animal fats, and older age. In addition, men have a three-fold higher risk than women.
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How Do I Know If I Have Bladder Cancer
Many people with bladder cancer do not exhibit symptoms. A bladder cancer diagnosis is often made when red blood cells are detected in a urine test . Urologists are generally the doctors who diagnose and treat bladder cancer. Their specialty is the urinary tract, which includes the bladder, kidneys, ureters, and urethra.
Common Symptoms of Bladder Cancer
Blood in the urine
In many cases, blood in the urine is an early sign of bladder cancer. The blood may change the color of the urine to pink, orange, or dark red. The color of the urine could even be normal, and small amounts of blood may be discovered during the urine test . Blood may be there one day and gone the next. The urine could remain clear for months. However, if the patient has bladder cancer, the blood will eventually reappear.
The early stages of bladder cancer often cause bleeding but with very little pain or discomfort. Its important to note that blood in the urine does not always indicate that you have bladder cancer. More often than not, its caused by benign tumors, an infection, bladder stones, or another non-cancerous ailment. Its still critical to be seen by a doctor if you have blood in the urine.
Bladder habit changes
While bladder symptoms are more often the result of conditions unrelated to cancer, bladder cancer may cause changes to bladder habits, including:
Needing to urinate with little or no results Having to urinate more than usual Painful urination