Symptoms Of Bladder Cancer
Blood in your urine is the most common symptom of bladder cancer.
The medical name for this is haematuria and it’s usually painless. You may notice streaks of blood in your urine or the blood may turn your urine brown. The blood isn’t always noticeable and it may come and go.
Less common symptoms of bladder cancer include:
- a need to urinate on a more frequent basis
- sudden urges to urinate
- a burning sensation when passing urine
If bladder cancer reaches an advanced stage and begins to spread, symptoms can include:
- swelling of the legs
Other Types Of Bladder Cancer
Approximately 2% of bladder cancers are adenocarcinomas. Nonurothelial primary bladder tumors are extremely rare and may include small cell carcinoma, carcinosarcoma, primary lymphoma, and sarcoma . Small cell carcinoma of the urinary bladder accounts for only 0.3-0.7% of all bladder tumors. High-grade urothelial carcinomas can also show divergent histologic differentiation, such as squamous, glandular, neuroendocrine, and sarcomatous features.
What Is Unique About Our Approach To Treating These Cancers
Yale Medicines approach to treating urologic cancers is patient-driven, says Dr. Leapman. Not all cancers are the same, and the urologic oncologists at Yale are focused on using all available resources to understand the multiple forces that impact how an individual should be treated.
Our approach is team-driven, he says, allowing experts from multiple disciplines to collaborate and offer world-class, personalized care.
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Causes Of Malignant Neoplasm Cancer
The abnormal growth of cells in the human body can be linked to various causal factors. One or more of these factors may be at play, and the exact cause can be determined only after elaborate medical tests are performed on the patient. The main factors that can lead to a cancerous growth of cells in the human body are as follows:
Gene Mutations Mutation or changes in the DNA sequence of one or more cells in the human body may lead to cancer. The cells may be located at any part of the body. When the DNA sequencing is changed, the cells start behaving differently than what they are supposed to do. Though it is not necessary that a mutation will definitely trigger cancerous growth, yet if the changes in the sequence instruct the cells to rapidly multiply without the ability to stop, it may lead to malignant neoplasia. All new cells thus produced will be mutated ones and they, too, can grow uncontrollably, thus leading to a quick growth of the tumor.
Smoking Smoking tobacco in any form can lead to cancer. Tobacco contains various complex chemical compounds amongst which atleast 70 chemicals are known to be carcinogenic, i.e., induced cancerous growth in the body. When dried tobacco is burned, the smoke is inhaled by the smoker and those around them, thus allowing the harmful chemicals to enter the body. These carcinogens, then, may affect the genome of the person and trigger neoplasia.
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.
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What Is A Urinary Tract Tumor
A urinary tract tumor is a type of cancer that develops from the disorganized uncontrolled growth of cells that make up the urinary system. A tumor of the urinary tract could involve the kidneys, ureters , urinary bladder, prostate gland , and urethra .
Bladder tumors are by far the most common type of urinary tract tumor. Of these, transitional cell carcinoma is the most common. This type of tumor originates from the cells that line the bladder. Bladder tumors need to be distinguished from benign conditions such as inflammatory masses or polyps and noncancerous diseases that cause thickening of the bladder wall.
Primary kidney tumors are relatively rare in both cats and dogs and are almost always malignant. About 50% of these tumors arise from the cells that line the kidney tubules . These are called renal carcinomas. While renal carcinoma is the most common kidney cancer in dogs, renal lymphoma is the most common kidney cancer in cats.
Primary tumors of the urethra or ureter are also rare in cats and dogs. These types of tumors develop from the cells that line the ureter and urethra.
Tumors can also develop in the prostate gland in male dogs.
What Are The Symptoms Of Urologic Cancers
Most of the time, symptoms dont occur until the cancer has become more advanced. Then, they depend on the type of cancer. Blood in the urine is a symptom of bladder, kidney and prostate cancerat later stages, pelvic and back pain can also develop. Patients with prostate cancer may also have other changes in urination and sexual function. Those with testicular or penile cancer may notice a visible lesion on the skin, along with other skin changes or swelling. Any cancer patient can experience weight loss and fatigue.
More often, these cancers are detected during a routine physical exam of the abdomen or genitals.
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There Are Three Ways That Cancer Spreads In The Body
Cancer can spread through tissue, the lymph system, and the blood:
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
What Are The Signs Of These Types Of Tumors
The signs of urinary tract tumors depend on what area of the urinary system is affected. Tumors of the ureters, bladder, and urethra can cause hematuria , dysuria , difficulty urinating, and frequent urination. Recurrent and often unresolving secondary urinary tract infections are commonly associated with these types of tumors. If the tumor obstructs the ureter, preventing the flow of urine to the bladder, the kidney will swell with urine causing signs of abdominal pain. If the tumor obstructs the urethra, there may be lethargy, vomiting, diarrhea, straining or the inability to urinate.
The signs of urinary tract tumors depend on what area of the urinary system is affected.
Tumors of the kidneys can cause abdominal pain, blood in the urine, or non-specific signs such as lack of appetite, nausea or vomiting, weight loss, fever, lethargy, and swelling of the abdomen. Occasionally kidney tumors can cause increased urination and drinking.
Because many urinary tract tumors will spread to other areas in the body , there may be signs elsewhere . Kidney pain can sometimes be difficult to distinguish from back pain.
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Papillary Vs Flat Cancer
Bladder cancers are also divided into 2 subtypes, papillary and flat, based on how they grow .
- Papillary carcinomas grow in slender, finger-like projections from the inner surface of the bladder toward the hollow center. Papillary tumors often grow toward the center of the bladder without growing into the deeper bladder layers. These tumors are called non-invasive papillary cancers. Very low-grade , non-invasive papillary cancer is sometimes called papillary urothelial neoplasm of low-malignant potential and tends to have a very good outcome.
- Flat carcinomas do not grow toward the hollow part of the bladder at all. If a flat tumor is only in the inner layer of bladder cells, it’s known as a non-invasive flat carcinoma or a flat carcinoma in situ .
If either a papillary or flat tumor grows into deeper layers of the bladder, it’s called an invasive urothelial carcinoma.
Evaluation For Metastatic Disease
Complete blood count, blood chemistry tests , liver function tests, chest radiography, and CT or magnetic resonance imaging of the abdomen and pelvis should be included in the metastatic workup for invasive bladder cancer.12 A bone scan may be performed if the alkaline phosphatase level is elevated or if symptoms suggesting bone metastasis are present.
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History Of Prostate Cancer In The Era Of Prostate
based screening for prostate cancer led to earlier detection of prostate cancer , and thus altered the course of the disease in the absence of treatment . Identifying the incidence and prevalence of prostate cancer increased with widespread prostate-specific antigen testing, as did the length of time that men live with their disease, as compared to the pre prostate-specific antigen era. The stage migration that occurred, with application of curative intervention at an earlier stage, undoubtedly led to a reduction inprostate cancer mortality. However, the extent to which this reduction was due to prostate-specific antigen based screening is debatable. Further, because prostate cancer progresses slowly and is found most often in older men with competing risks of mortality, the extent to which these changes in natural history have resulted in benefit and harm are also debatable.
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Treatment Of Stage I Bladder Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stage I bladder cancer may include the following:
- Transurethral resection with fulguration. This may be followed by one of the following:
- Intravesicalchemotherapy given right after surgery.
- Intravesical chemotherapy given right after surgery and then regular treatments with intravesical BCG or intravesical chemotherapy.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
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Here Are The Instructions From The Icd
Uncertain diagnosis
Do not code diagnoses documented as probable, suspected, questionable, rule out, or working diagnosis or other similar terms indicating uncertainty. Rather, code the condition to the highest degree of certainty for that encounter/visit, such as symptoms, signs, abnormal test results, or other reason for the visit.
Please note: This differs from the coding practices used by short-term, acute care, long-term care and psychiatric hospitals.
Primary malignancy previously excised
When a primary malignancy has been previously excised or eradicated from its site and there is no further treatment directed to that site and there is no evidence of any existing primary malignancy, a code from category Z85, Personal history of malignant neoplasm, should be used to indicate the former site of the malignancy.
Follow ICD-10 coding rules when reporting suspected or confirmed malignancy and personal history of malignant neoplasm. Remember, the codes that are selected stay with the patient.
Histological And Immunohistochemical Methods
Hematoxylin and eosin-stained slides and slides stained with various combinations of the following special stains and immunohistochemical stains were retrieved and reviewed : myeloperoxidase, nonspecific esterase, chloroacetate esterase, reticulin, Congo red, cytokeratin, placental alkaline phosphatase, S100 protein, smooth muscle actin, desmin, synaptophysin, prostate-specific acid phosphatase, -fetoprotein, carcinoembryonic antigen, CDX2, ALK-1, HHV-8, TdT, cyclin D1, MIB-1, CD3, CD5, CD10, CD20, CD21, CD23, CD30, CD43, CD45, CD45ro, CD68, CD79a, CD138, kappa, and lambda light chains. In certain cases, additional immunostains were performed to clarify the tumor immunophenotype. Review of morphology and immunoprofile permitted re-classification of older cases into currently accepted diagnostic categories.
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Bladder Cancer Clinical Trials
What about Clinical Trials?
You may hear about clinical trials for your bladder cancer. Clinical trials are research studies that test if a new treatment or procedure is safe and effective.
Through clinical trials, doctors find new ways to improve treatments and the quality of life for people with disease. Trials are available for all stages of cancer. The results of a clinical trial can make a major difference to patients and their families. Please visit our clinical trials research webpage to learn more.
Evaluation Of Upper Urinary Tract
Additional workup for all patients with bladder cancer includes evaluation of the upper urinary tract with intravenous urography , renal ultrasonography, computed tomography urography, or magnetic resonance urography.21,22 Renal ultrasonography alone is insufficient to complete the evaluation of hematuria in a patient with bladder cancer because it cannot delineate details of the urinary collecting system. Traditional IVU has been largely replaced by CT urography because of increased detail and data combined in the CT .
For patients unable to undergo contrast injection , magnetic resonance urography may be used to evaluate the upper urinary tract. These tests are useful for disease staging and excluding other causes of hematuria. Pelvic imaging should be performed before transurethral resection to improve staging accuracy because postoperative inflammation mimics the appearance of tumor infiltration.21 Pelvic imaging also may detect synchronous upper tract urothelial cancer, which can occur in 5 percent of patients with bladder cancer.22
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How Can I Prevent Bladder Cancer
You may not be able to prevent bladder cancer, but it may be helpful to know the risk factors that may increase the chance youll develop bladder cancer. Bladder cancer risk factors may include:
- Smoking cigarettes: Cigarette smoking more than doubles the risk of developing bladder cancer. Smoking pipes and cigars or being exposed to second-hand smoke also increases that risk.
- Cancer treatments: Radiation therapy is the second-most common risk factor. People who have certain chemotherapy drugs may also develop an increased risk of bladder cancer.
- Exposure to certain chemicals: People who work with chemicals, such as aromatic amines , are at an increased risk. Extensive exposure to rubber, leather, some textiles, paint and hairdressing supplies, typically related to occupational exposure, also appears to increase the risk.
- Infections: People who have frequent bladder infections, bladder stones or other urinary tract diseases may have an increased risk of developing bladder cancer.
- Past bladder cancer: People with a previous bladder cancer are at increased risk to form new or recurrent bladder tumors.
Treatment Of Stage Iv Bladder Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stage IV bladder cancer that has not spread to other parts of the body may include the following:
- Urinary diversion or cystectomy as palliative therapy to relieve symptoms and improve quality of life.
Treatment of stage IV bladder cancer that has spread to other parts of the body, such as the lung, bone, or liver, may include the following:
- External radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
- Urinary diversion or cystectomy as palliative therapy to relieve symptoms and improve quality of life.
- Aclinical trial of new anticancer drugs.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
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The Following Stages Are Used For Bladder Cancer:
Stage 0
In stage 0, abnormalcells are found in tissue lining the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stages 0a and 0is, depending on the type of the tumor:
- Stage 0a is also called noninvasive papillary carcinoma, which may look like long, thin growths growing from the lining of the bladder.
- Stage 0is is also called carcinoma in situ, which is a flat tumor on the tissue lining the inside of the bladder.
Stage I
In stage I, cancer has formed and spread to the layer of connective tissue next to the inner lining of the bladder.
Stage II
In stage II, cancer has spread to the layers of muscle tissue of the bladder.
Stage III
Stage III is divided into stages IIIA and IIIB.
- cancer has spread from the bladder to the layer of fat surrounding the bladder and may have spread to the reproductive organs and cancer has not spread to lymph nodes or
- cancer has spread from the bladder to one lymph node in the pelvis that is not near the common iliac arteries .