Positron Emission Tomography Scan
A positron emission tomography scan can help to show where the cancer is and whether it has spread to other parts of the body.
Before the scan, youll be given an injection of a very small amount of a radioactive medication, known as a tracer. The amount of radiation is very small and no more than you would receive from a normal X-ray.
The most common tracer used is a radioactive form of glucose . Youll then rest for about an hour to allow the tracer to travel to areas in your body where glucose is used for energy.
The scan itself can take up to an hour and produces an image of the tracer in your body. The tracer shows up cancers because they use glucose in a different way to normal tissue.
Causes Of Bladder Cancer
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 more than 1 in 3 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.
Ial Or Radical Cystectomy
Some people with stage 2 or stage 3 bladder cancer will need to undergo surgery to remove part of the bladder or surgery to remove the entire bladder . If you need to have a radical cystectomy, the surgeon will often create another way for urine to be stored and removed from the body. Some people who have a radical or partial cystectomy may also have chemotherapy treatment.
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What Causes Bladder Cancer
Healthcare providers and researchers dont know exactly why certain bladder cells mutate and become cancerous cells. Theyve identified many different risk factors that may increase your chance of developing bladder cancer, including:
- Cigarette smoke: Smoking cigarettes more than doubles your risk of developing bladder cancer. Smoking pipes and cigars and being exposed to second-hand smoke may also increase your risk.
- Radiation exposure: Radiation therapy to treat cancer may increase your risk of developing bladder cancer.
- Chemotherapy: Certain chemotherapy drugs may increase your risk.
- Exposure to certain chemicals: Studies show that people who work with certain chemicals used in dyes, rubber, leather, paint, some textiles and hairdressing supplies may have an increased risk.
- Frequent bladder infections: People who have frequent bladder infections, bladder stones or other urinary tract infections may be at an increased risk of squamous cell carcinoma.
- Chronic catheter use: People who have a chronic need for a catheter in their bladder may be at risk for squamous cell carcinoma.
Stage I Bladder Cancer
Stage I bladder cancers are cancerous tumors that have spread from the inner layer of the bladder into the connective tissue layer just under it.
These tumors havent yet reached the muscular layers of the bladder, so theyre often called non-muscle-invasive bladder cancer. Some cases of non-muscle-invasive bladder cancer progress to muscle-invasive bladder cancer, which is more serious.
According to SEER, a third of bladder cancers are diagnosed when theyre local, when they havent spread beyond the organ they developed in, stage I and II.
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How Long Does Stomach Cancer Take To Develop
Stomach cancer typically starts in the stomach lining and grows slowly over several years without causing noticeable symptoms.
Stomach cancer can be difficult to diagnose in the early stages, since if symptoms do appear, they are often mistaken for symptoms of other gastrointestinal problems. As a result, stomach cancer can go undiagnosed for years before the symptoms grow serious enough to call for testing.
Women And Bladder Cancer: Sharing Stories To Advance Research
BCAN was invited to share the experiences of women diagnosed with bladder cancer at the Bladder Cancer in Women: Identifying Research Needs to Improve Diagnosis and Treatment program sponsored by Johns Hopkins Greenberg Bladder Cancer Institute and the American Urological Association Translational Research Collaboration. Each of these womens stories are memorable and unique. Sadly, their stories are repeated around the country because women are not the typical bladder cancer patient. Read the the transcript of their presentation.
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Prognosis And Survival For Bladder Cancer
If you have bladder cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for bladder cancer.
Signs And Symptoms Of Bladder Cancer
Sometimes bladder cancer doesnt have many symptoms. Signs or symptoms can include:
- blood in your urine
- pain or burning when passing urine
- not being able to pass urine when you need to.
Not everyone with these symptoms has bladder cancer. If you have any of these symptoms or are worried, always see your doctor.
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Surgery To Look Inside The Tummy
If other tests have not confirmed a diagnosis, you may have a small operation to look inside the tummy at the pancreas. This is called a laparoscopy.
The surgeon puts a thin tube called a laparoscopy through a small cut they make in your tummy. You have this done under a general anaesthetic.
Rarely if a laparoscopy is not suitable you may have a bigger operation called a laparotomy instead. This is when the surgeon makes a larger cut in the tummy so they can see the pancreas.
What Is The First Sign Of Bladder Cancer
Blood in the urine, referred to as hematuria, is usually the first sign of bladder cancer. This is because early bladder cancer commonly causes bleeding without associated pain or other symptoms.
- Depending on the amount of blood present, urine may appear pink, red, or brownish in color.
- Blood may not be present all the time – there may be relatively long periods of clear urine .
If you have noticed blood in your urine it is important to speak to your doctor as soon as possible.
Other early symptoms of bladder cancer that may be experienced are urinary irritation or changes in bladder habits, such as increased urination frequency and/or urgency, pain or a burning sensation during urination, or difficulty passing urine.
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Understanding Local Bladder Cancer Metastasis
When bladder cancer spreads, it first invades the bladder wall, which is made up of four distinct layers. It can take some time for cancer to penetrate all of these layers, but once it has, it can then spread into the surrounding fatty tissues and lymph nodes. Once bladder cancer has reached the lymph nodes, it can travel to distant parts of the body through the lymphatic system. Separately, it can also continue to grow into surrounding areas such as the abdominal wall .
Start And Spread Of Bladder Cancer
The wall of the bladder has many several layers. Each layer is made up of different kinds of cells .
Most bladder cancers start in the innermost lining of the bladder, which is called the urothelium or transitional epithelium. As the cancer grows into or through the other layers in the bladder wall, it has a higher stage, becomes more advanced, and can be harder to treat.
Over time, the cancer might grow outside the bladder and into nearby structures. It might spread to nearby lymph nodes, or to other parts of the body.
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What Are The Signs And Symptoms Of Stomach Cancer
Early symptoms of stomach cancer may include:
Symptoms of stomach cancer that can intensify as the disease progresses may include:
- Trouble swallowing
- Vomiting after meals
- Stomach pain, especially after meals
- Blood tests that show anemia
- Persistent stomach ulcer
Treating Bladder Cancer That Progresses Or Recurs
If cancer continues to grow during treatment or comes back after treatment , treatment options will depend on where and how much the cancer has spread, what treatments have already been used, and the patient’s overall health and desire for more treatment. Its important to understand the goal of any further treatment if its to try to cure the cancer, to slow its growth, or to help relieve symptoms as well as the likely benefits and risks.
For instance, non-invasive bladder cancer often comes back in the bladder. The new cancer may be found either in the same place as the original cancer or in other parts of the bladder. These tumors are often treated the same way as the first tumor. But if the cancer keeps coming back, a cystectomy may be needed. For some non-invasive tumors that keep growing even with BCG treatment, and where a cystectomy is not an option, immunotherapy with pembrolizumab might be recommended.
Cancers that recur in distant parts of the body can be harder to remove with surgery, so other treatments, such as chemotherapy, immunotherapy, targeted therapy, or radiation therapy, might be needed. For more on dealing with a recurrence, see Understanding Recurrence.
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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 ones 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.
Stage Iii Bladder Cancer
Stage III bladder cancers have started to spread away from the bladder itself into either local or regional organs or into lymph nodes in the pelvis. Its divided into stage IIIA and stage IIIB.
Stage IIIA bladder cancer has either:
- Spread into the fat around the bladder or into the reproductive organs, but not to the lymph nodes
- Spread from the bladder to one lymph node in the pelvis
Stage IIIB cancer has also spread. To be defined as stage IIIB, cancer needs to be found in either:
- More than one lymph node far from major arteries
- One or more lymph nodes near the major arteries
According to SEER, 7% of bladder cancer cases are diagnosed when theyve reached stage III, or regional stage.
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How Is Bladder Cancer Treated
Treatment for bladder cancer depends on
- The stage of cancer.
- If cancer has spread beyond the lining of the bladder.
- The extent of cancer spread.
Treatment options based on tumor grade
- High-grade bladder cancer: High-grade cancers that are life-threatening and spread quickly need to be treated with chemotherapy, radiation or surgery.
- Low-grade cancers: Less aggressive cancers have a low chance of becoming high grade and do not require aggressive treatments, such as radiation or bladder removal.
Treatment options may vary depending on the tumor stage.
Other Cancers That Start In The Bladder
Several other types of cancer can start in the bladder, but these are all much less common than urothelial cancer.
Squamous cell carcinoma: Only about 1% to 2% of bladder cancers are squamous cell carcinomas. Under a microscope, the cells look much like the flat cells that are found on the surface of the skin. Nearly all squamous cell carcinomas are invasive.
Adenocarcinoma: Only about 1% of bladder cancers are adenocarcinomas. The cancer cells have a lot in common with gland-forming cells of colon cancers. Nearly all adenocarcinomas of the bladder are invasive.
Small cell carcinoma: Less than 1% of bladder cancers are small-cell carcinomas, which start in nerve-like cells called neuroendocrine cells. These cancers often grow quickly and typically need to be treated with chemotherapy like that used for small cell carcinoma of the lung.
Sarcoma: Sarcomas start in the muscle cells of the bladder, but they are rare.
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What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about this. For years after treatment ends, you will see your cancer doctor. Be sure to go to all of your follow-up visits. People who have had bladder cancer are at high risk of having a second bladder cancer.
If you have no signs of cancer, most experts advise seeing with your doctor every 3 to 6 months. These visits might include urine tests, blood work, and other tests. If you still have your bladder, you will need regular exams of your bladder, too. The time between doctor visits may be longer after a few years if no new cancers are seen.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as well as you can.
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Side Effects Of Treatment For Bladder Cancer
All cancer treatments can have side effects. Your treatment team will discuss these with you before you start treatment. Talk to your doctor or nurse about any side effects you are experiencing. Some side effects can be upsetting and difficult, but there is help if you need it.
or email to speak with a caring cancer nurse for support.
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Can Bladder Cancer Spread
It depends: There are different types of bladder cancer. Some behave very aggressively while others do not. Generally, high grade cancers are associated with high risk of larger tumors which may spread and even be fatal. Low grade tumors typically do not spread outside of the bladder, though both kinds can often recur.
Transitional Cell Bladder Cancer
About 9 out of 10 bladder cancers in Ireland are the transitional cell type. This is sometimes called urothelial cancer.
Transitional cell bladder cancer develops from the cells of the bladder lining. These are called transitional cells.
When the bladder is empty, these cells are all bunched together. When the bladder is full, they are stretched out into a single layer. These cells come into contact with waste products in the urine that may cause cancer, such as chemicals from cigarette smoke.
Transitional cell bladder cancers can behave in different ways. There are early cancers that have not invaded the deeper layers of the bladder and there are invasive cancers that have. They are treated differently, so it is important to know which kind you have.
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What Are The Chances Of Dying From Bladder Cancer
· The bladder can hold about half of a liter of urine and expands, but a person usually feels the urge to urinate when the bladder is 25% full. When it is empty, the bladder will contract and become smaller. Due to the bladders skill to expand and contract, its thought of as a balloon that was muscle.
Treating Stage Iii Bladder Cancer
These cancers have reached the outside of the bladder and might have grown into nearby tissues or organs and/or lymph nodes . They have not spread to distant parts of the body.
Transurethral resection is often done first to find out how far the cancer has grown into the bladder wall. Chemotherapy followed by radical cystectomy is then the standard treatment.Partial cystectomy is rarely an option for stage III cancers.
Chemotherapy before surgery can shrink the tumor, which may make surgery easier. Chemo can also kill any cancer cells that could already have spread to other areas of the body and help people live longer. It can be especially useful for T4 tumors, which have spread outside the bladder. When chemo is given first, surgery to remove the bladder is delayed. The delay is not a problem if the chemo shrinks the cancer, but it can be harmful if it continues to grow during chemo. Sometimes the chemo shrinks the tumor enough that intravesical therapy or chemo with radiation is possible instead of surgery.
Some patients get chemo after surgery to kill any cancer cells left after surgery that are too small to see. Chemo given after cystectomy may help patients stay cancer-free longer, but so far its not clear if it helps them live longer. If cancer is found in nearby lymph nodes, radiation may be needed after surgery. Another option is chemo, but only if it wasn’t given before surgery.
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