Arsenic In Drinking Water
Drinking water containing arsenic is associated with a greater risk of bladder cancer. However, this is not a large concern in the U.S. Where you live, as well as if you drink well water, or public system water will determine your risk. Most public water systems meet standards for low arsenic content.
Understanding The Statistics: Cancer Survival
It is important to remember that all cancer survival numbers are based on averages across huge numbers of people. These numbers cannot predict what will happen in your individual case.
Survival rates will not tell you how long you will live after you have been diagnosed with bladder cancer. But, these numbers can give you an idea of how likely your treatment will be successful. Also, survival rates take into account your age at diagnosis but not whether you have other health conditions too.
Transurethral Resection Of Bladder Tumor
TURBT is a conservative approach in which localized tumors are excised through transurethral approach followed by limited rounds of adjuvant intravesical therapies to allow preservation of bladder structure and function. It has been shown to correlate with improved patient quality of life . Low-risk NMIBC is characterized by < 3 cm solitary tumor, low grade with little epithelial involvement , and lack of carcinoma in situ . These patients usually undergo TURBT plus a single dose of perioperative intravesical chemotherapy within a few hours of tumor removal followed by regular follow-up and tumor surveillance . High-risk NMIBC patients with tumors larger than > 3 cm, and greater than T1 tumor grade, presence of CIS, lymphovascular invasion and/or multiple or recurrent tumors, receive TURBT combined with intravesical therapy. Alternatively, partial or radical cystectomy is considered .
D. Cao, in, 2014
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Who Gets Bladder Cancer
Bladder cancer is four times more common in men than women. This form of cancer is also associated with older individuals. More than 90 percent of people diagnosed with bladder cancer are over the age of 55, and the average age of diagnosis is 73.
The most common risk factor associated with this form of cancer is smoking, which is seen in about 50 percent of cases.
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.
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Types Of Bladder Cancer
Once diagnosed, bladder cancer can be classified by how far it has spread.
If the cancerous cells are contained inside the lining of the bladder, doctors describe it as non-muscle-invasive bladder cancer . This is the most common type of bladder cancer.
When the cancerous cells spread beyond the lining, into the surrounding bladder muscle, it’s referred to as muscle-invasive bladder cancer . This is less common, but has a higher chance of spreading to other parts of the body.
If bladder cancer has spread to other parts of the body, it’s known as advanced or metastatic bladder cancer.
Read more about diagnosing bladder cancer.
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.
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What Is A Bladder Tumor
A tumor can form in any part of the body, and the bladder is no exception. A bladder tumor forms when cells in the bladder overgrow, an event that causes a mass or lesion to form. Often, excess bladder cell reproduction creates a mass that is somewhat like a wart in the bladder.
Bladder tumors can be benign, which means they stay in one place and do not spread to other tissues. They can also be malignant, meaning they are cancerous and capable of moving to other parts of the body. It is malignant tumors that are potentially life-threatening.
Certain types of people are more at risk of developing bladder tumors than others. For example, men are more likely to develop them than women, and they are most frequently diagnosed in those over the age of 50. In fact, only about one percent of bladder cancer is diagnosed in those who are under 40.
There are several symptoms of bladder tumors. A person with a tumor in the bladder may have blood in his urine, and when he has to urinate, he may feel an urgent need to do so. He may also have to urinate more often than in the past, and the amounts of urine he passes may be much smaller. Sometimes a person with a tumor will experience back pain or discomfort in the abdomen.
Treatment Of Recurrent Bladder Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of recurrentbladder cancer depends on previous treatmentand where the cancer has recurred. Treatment for recurrent bladder cancer mayinclude the following:
- Radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
- A clinical trial of a new treatment.
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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Treatment Of Bladder Cancer By Stage
Most of the time, treatment of bladder cancer is based on the tumors clinical stage when it’s first diagnosed. This includes how deep it’s thought to have grown into the bladder wall and whether it has spread beyond the bladder. Other factors, such as the size of the tumor, how fast the cancer cells are growing , and a persons overall health and preferences, also affect treatment options.
Transurethral Resection Of The Bladder Cancer Tumor
This is when the tumor is removed from the urinary tract through the urethra using an electrical force. Transurethral resection is an endoscopic or scope procedure that does not involve making an incision in the body.
Drug therapy after TUR is commonly prescribed for patients with large, multiple or high-grade tumors.
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Risk Of Bladder Cancer
Bladder cancer occurs mainly in older people. About 9 out of 10 people with this cancer are over the age of 55. The average age of people when they are diagnosed is 73.
Overall, the chance men will develop this cancer during their life is about 1 in 27. For women, the chance is about 1 in 89.
Whites are more likely to be diagnosed with bladder cancer than African Americans or Hispanic Americans.
Signs & Symptoms Of Bladder Cancer In Women
Blood in your urine is often the first and most common early symptom of bladder cancer you experience. It could be a slight amount, or it can turn your urine color to pink, orange or darker red.
You could notice blood one day and not the next day. The blood will eventually come back if you have bladder cancer. Sometimes you won’t even see blood in your urine. The only way the doctor would be able to detect it is if they give you a urine test.
Other potential early signs of bladder cancer in women to look out for are:
- Your urine changes color.
- You need to urinate more frequently than usual.
- You feel burning or pain when urinating.
- You still feel like you need to urinate, despite your bladder not being full.
- You urinate very little or can’t urinate.
If you notice any of these symptoms, don’t panic, but contact your doctor as soon as possible. These symptoms don’t necessarily mean you have cancer. You could be dealing with a bladder infection, urinary tract infection or another less severe condition.
After bladder cancer has begun spreading, you might notice:
- You can’t urinate, even if you feel like you need to.
- You’re not as hungry as you usually are.
- Your lower back hurts.
- You’re not trying, but are losing weight.
- You frequently feel very weak or tired.
- You have swollen feet
Again, contact your doctor if you notice any of these symptoms. They most likely could indicate you have something else going on other than bladder cancer.
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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.
Cancerous Tumours Of The Bladder
A cancerous tumour of the bladder can grow into nearby tissue and destroy it. It can also spread to other parts of the body. Cancerous tumours are also called malignant tumours.
Bladder cancer is often divided into 3 groups based on how much it has grown into the bladder wall.
- Non-invasive bladder cancer is only in the inner lining of the bladder .
- Non–muscle-invasive bladder cancer has only grown into the connective tissue layer .
- Muscle-invasive bladder cancer has grown into the muscles deep within the bladder wall and sometimes into the fat that surrounds the bladder.
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Is A Mass In The Bladder Always Cancer
If youve been told that you have a mass in your bladder, you need to have it evaluated by experts uniquely qualified to determine whether or not it is cancer.
While there are several types of benign masses that can grow in the bladder, these are uncommon and account for fewer than 1% of bladder masses,” says Khurshid Guru, MD, Chair of Roswell Parks Department of Urology.
Bladder Cancer Stages And Survival Rates
Cancer survival rates are also categorized according to the stage of the cancer when it was diagnosed. The stage of cancer generally refers to how far it has progressed, and whether it has spread to other parts of the body. For bladder cancer, the 5-year survival rate for people with:2,3
- Bladder cancer in situ is around 96 percent
- Localized bladder cancer is around 70 percent
- Bladder cancer that has spread to the regional lymph nodes is 35 percent
- Distant or metastasized bladder cancer is 5 percent
If you would like to learn more about bladder cancer statistics, consider speaking with someone on your health care team. They will be able to explain more about how these statistics apply to your cancer. Tell us about your experience in the comments below, or with the community.
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What Are The Types Of Bladder Cancer Tumors That May Form
Three types of bladder cancer may form, and each type of tumor can be present in one or more areas of the bladder, and more than one type can be present at the same time:
- Papillary tumors stick out from the bladder lining on a stalk. They tend to grow into the bladder cavity, away from the bladder wall, instead of deeper into the layers of the bladder wall.
- Sessile tumors lie flat against the bladder lining. Sessile tumors are much more likely than papillary tumors to grow deeper into the layers of the bladder wall.
- Carcinoma in situ is a cancerous patch of bladder lining, often referred to as a flat tumor. The patch may look almost normal or may look red and inflamed. CIS is a type of nonmuscle-invasive bladder cancer that is of higher grade and increases the risk of recurrence and progression. At diagnosis, approximately 10% of patients with bladder cancer present with CIS.
Treating Stage Ii Bladder Cancer
These cancers have invaded the muscle layer of the bladder wall , but no farther. Transurethral resection is typically the first treatment for these cancers, but it’s done to help determine the extent of the cancer rather than to try to cure it.
When the cancer has invaded the muscle, radical cystectomy is the standard treatment. Lymph nodes near the bladder are often removed as well. If cancer is in only one part of the bladder, a partial cystectomy may be done instead. But this is possible in only a small number of patients.
Radical cystectomy may be the only treatment for people who are not well enough to get chemo. But most doctors prefer to give chemo before surgery because it’s been shown to help patients live longer than surgery alone. When chemo is given first, surgery is delayed. This is not a problem if the chemo shrinks the bladder cancer, but it might be harmful if the tumor continues to grow during chemo.
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.
For people who have had surgery, but the features of the tumor show it is at high risk of coming back, the immunotherapy drug, nivolumab, might be offered. When given after surgery, nivolumab is given for up to one year.
For patients who cant have surgery because of other serious health problems, TURBT, radiation, chemotherapy, or some combination of these may be options.
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Bladder Cancer In Men Vs Women
Bladder cancer is 3 to 4 times more common in people assigned male at birth than in people assigned female at birth.
Researchers believe the increased prevalence of bladder cancer in those assigned male at birth may be due to differences in how carcinogens are metabolized before they pass through the bladder . Or it may be that male sex hormones promote tumor formation in the bladder, whereas female sex hormones inhibit this progression.
In contrast, people assigned female at birth tend to be diagnosed at later stages of the disease, do not respond as well to treatment, and have a higher cancer-specific mortality rate, so it’s especially important for those assigned female at birth to be aware of early symptoms and seek prompt evaluation.
One study looked at the prevalence of the early cancer symptoms in both sexes, concluding that:
- Visible hematuria was present in 65% of men and 68% of women.
- Dysuria was present in 32% of men and 44% of women.
- Urgency was present in 61% of men and 47% of women.
- Nocturia was present in 57% of men and 66% of women.
Painful urination is often dismissed as due to a bladder infection or friction and may be less likely to be investigated, particularly in women. One study found that 47% of female bladder cancer patients were treated for symptoms up to a year before a diagnosis was made, without receiving any further evaluation. A lower percentage of females than males saw a urologist as well.
Tests For Bladder Cancer
Your doctor may do some tests to check for bladder cancer:
- internal examination the doctor may check inside your bottom or vagina with their finger, using gloves
- urine tests your urine will be checked for signs of bladder cancer
- blood tests to check your general health
- ultrasound a scan on the outside of your abdomen to check for cancer
- cystoscopy the doctor puts a small camera into your bladder to see inside
- biopsy the doctor takes a small sample of the cells from the bladder to check for signs of cancer.
Your doctor might ask you to have further tests. These can include:
- CT scan and x-rays scans that take pictures of the inside of the body, sometimes also called a CT-IVP or a triple phase abdominal-pelvic CT scan
- MRI scan a scan that uses magnetism and radio waves to take pictures of the inside of the body
- bone scan a scan that uses dye to show changes in your bones
- FDG-PET scan a scan that uses an injection of liquid to show cancer cells.
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