Transurethral Resection Of A Bladder Tumour
If abnormalities are found in your bladder during a cystoscopy, you should be offered an operation known as TURBT. This is so any abnormal areas of tissue can be removed and tested for cancer .
TURBT is carried out under general anaesthetic.
Sometimes, a sample of the muscle wall of your bladder is also taken to check whether the cancer has spread, but this may be a separate operation within 6 weeks of the first biopsy.
You should also be offered a dose of chemotherapy after the operation. This may help to prevent the bladder cancer returning if the removed cells are found to be cancerous.
See treating bladder cancer for more information about the TURBT procedure
What Is Muscle Invasive Bladder Cancer
Muscle invasive bladder cancer is a cancer that spreads into the detrusor muscle of the bladder. The detrusor muscle is the thick muscle deep in the bladder wall. This cancer is more likely to spread to other parts of the body.
In the U.S., bladder cancer is the third most common cancer in men. Each year, there are more than 83,000 new cases diagnosed in men and women. About 25% of bladder cancers are MIBC. Bladder cancer is more common as a person grows older. It is found most often in the age group of 75-84. Caucasians are more likely to get bladder cancer than any other ethnicity. But there are more African-Americans who do not survive the disease.
What is Cancer?
Cancer is when your body cells grow out of control. When this happens, the body cannot work the way it should. Most cancers form a lump called a tumor or a growth. Some cancers grow and spread fast. Others grow more slowly. Not all lumps are cancers. Cancerous lumps are sometimes called malignant tumors.
What is Bladder Cancer?
When cells of the bladder grow abnormally, they can become bladder cancer. A person with bladder cancer will have one or more tumors in his/her bladder.
How Does Bladder Cancer Develop and Spread?
The bladder wall has many layers, made up of different types of cells. Most bladder cancers start in the urothelium or transitional epithelium. This is the inside lining of the bladder. Transitional cell carcinoma is cancer that forms in the cells of the urothelium.
Treatment For Bladder Cancer
Treatment for bladder cancer depends on how quickly the cancer is growing. Treatment is different for non-muscle invasive bladder cancer and muscle-invasive bladder cancer.
You might feel confused or unsure about your treatment options and decisions. Its okay to ask your treatment team to explain the information to you more than once. Its often okay to take some time to think about your decisions.
When deciding on treatment for bladder cancer, you may want to discuss your options with a urologist, radiation oncologist and medical oncologist. Ask your GP for referrals.
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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.
Bladder cancer can be described based on where it is found:
- non-muscle invasive the cancer has not spread to other layers of the bladder or muscle
- muscle-invasive the cancer has spread to other layers of the bladder, muscle or other parts of the body.
There are 3 main types of bladder cancer:
- urothelial carcinoma 80 to 90% of bladder cancers sometimes called transitional cell carcinoma
- squamous cell carcinoma 1 to 2% of all bladder cancers. It is more likely to be invasive
- adenocarcinoma 1 to 2% of all bladder cancers. It is more likely to be invasive .
There are other, less common types of bladder cancer. Treatment for these may be different. Speak to your doctor or nurse for information about these types of cancer.
Muscle Invasive Urothelial Carcinoma
Muscle invasive urothelial carcinoma tumors have spread into or through the muscle layer of the bladder wall.
- T2 tumors have spread into the muscle layer of the bladder wall.
- T3 tumors have spread through the muscle layer and into the fatty tissue surrounding the bladder.
- T4 tumors have spread to nearby pelvic organs, the pelvic wall, or the abdominal wall.
As well as assigning a T category, the commonly used TNM clinical staging system also assigns urothelial carcinoma to an N category and an M category . For further information regarding bladder cancer classification, see Bladder Cancer Stages.
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Permission To Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as NCIs PDQ cancer information summary about breast cancer prevention states the risks in the following way: .
The best way to cite this PDQ summary is:
PDQ® Adult Treatment Editorial Board. PDQ Bladder Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated < MM/DD/YYYY> . Available at: . Accessed < MM/DD/YYYY> .
Images in this summary are used with permission of the author, artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.
Surgery For Bladder Cancer
Surgery is done for most bladder cancers. The type you have depends on the stage of the cancer.
Removing the tumor from the inside bladder is the most common surgery for early bladder cancer. This can be done during a cystoscopy. A a cystoscope with a looped wire on the end is used to remove the tumor.
When the cancer is more invasive, the cancer is removed along with part of the bladder or the entire bladder.
If only part of the bladder is removed, you’ll still be able to hold and release urine as normal, though in smaller amounts. If the entire bladder is removed, you’ll need another way to store and pass urine. Your doctor can explain the options for this.
Side effects of surgery
Any type of surgery can have some risks and side effects. For instance, removing the bladder not only changes how your body passes urine, but it can also cause sexual side effects. If you have these or any other problems, let your doctors know. There are ways to help deal with many side effects.
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Cancer May Spread From Where It Began To Other Parts Of The Body
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if bladder cancer spreads to the bone, the cancer cells in the bone are actually bladder cancer cells. The disease is metastatic bladder cancer, not bone cancer.
How Is Bladder Cancer Diagnosed
The main test to diagnose bladder cancer is called a cystoscopy, which is usually performed by a specialist doctor called a urologist. The doctor will look inside your bladder with a small camera. If they see anything suspicious, they will take a biopsy, a small sample of tissue, to be examined in a laboratory.
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What To Expect From A Cystoprostatectomy
If cancer has spread to the walls of the bladder, doctors typically recommend chemotherapy before surgery to slow cancer growth. Research has shown that this can improve survival rates. So can additional chemotherapy after the cystoprostatectomy.
The operation itself is performed in the hospital under general anesthesia and can last 4-6 hours. âWe try to get patients out of the hospital in 5 to 7 days, while recovery takes 4 to 6 weeks,â Richstone says.
Patients also get counseling from a nurse to learn how to operate the new urinary diversion mechanism, he adds.
How Does Bladder Cancer Spread
Bladder cancer usually begins in the cells of the bladder lining. In some cases, it may spread into surrounding bladder muscle. If the cancer penetrates this muscle, it can spread to other parts of the body, usually through the lymphatic system.
If bladder cancer spreads to other parts of the body, such as other organs, it’s known as metastatic bladder cancer.
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Palliative Or Supportive Care
If your cancer is at an advanced stage and canât be cured, your medical team should discuss how the cancer will progress and which treatments are available to ease the symptoms.
You can be referred to a palliative care team, who can provide support and practical help, including pain relief.
Page last reviewed: 01 July 2021 Next review due: 01 July 2024
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About The Bladder Renal Pelvis Ureter And Urethra
The bladder is a hollow organ in the pelvis that stores urine before it leaves the body during urination. This function makes the bladder an important part of the urinary tract. The urinary tract is also made up of the kidneys, ureters, and urethra. The renal pelvis is a funnel-like part of the kidney that collects urine and sends it into the ureter. The ureter is a tube that runs from each kidney into the bladder. The urethra is the tube that carries urine out of the body. The prostate gland is also part of the urinary tract.
The bladder, like other parts of the urinary tract, is lined with a layer of cells called the urothelium. This layer of cells is separated from the bladder wall muscles, called the muscularis propria, by a thin, fibrous band called the lamina propria.
Bladder cancer begins when healthy cells in the bladder liningmost commonly urothelial cellschange and grow out of control, forming a mass called a tumor. Urothelial cells also line the renal pelvis and ureters and urethra. Cancer that develops in the renal pelvis and ureters is also considered a type of urothelial cancer and is often called upper tract urothelial cancer. In most cases, it is treated in much the same way as bladder cancer and is described in this guide. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. Benign bladder tumors are very rare.
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Expert Review And References
- Al-Ahmadie H, Lin O, Reuter VE. Pathology and cytology of tumors of the urinary tract. Scardino PT, Lineham WM, Zelefsky MJ, Vogelzang NJ . Comprehensive Textbook of Genitourinary Oncology. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins 2011: 16:295-316.
- American Society of Clinical Oncology . Bladder Cancer. 2017 : .
- Feldman AS, Efstathiou JA, Lee RJ, Dahl DM, Michaelson MD, Zietman AL. Cancer of the bladder, ureter, and renal pelvis. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins 2015: 65:896-916.
- Martini FH, Timmons MJ, Tallitsch RB. Human Anatomy. 7th ed. San Francisco: Pearson Benjamin Cummings 2012.
- Penn Medicine . All About Bladder Cancer. University of Pennsylvania 2017 : .
When Do You Have It
Your treatment plan depends on your risk of the bladder cancer spreading or coming back after treatment. Your doctor will tell you whether you have:
- low risk non muscle invasive bladder cancer
- intermediate risk non muscle invasive bladder cancer
- high risk non muscle invasive bladder cancer
You usually have BCG into the bladder if you have:
- a high risk of non muscle invasive bladder cancer coming back or spreading into the deeper layers of your bladder
You have a course of BCG after surgery to remove the bladder tumours .
You usually have BCG into the bladder once a week for 6 weeks. This is called the induction course.
You may then have BCG into the bladder every few weeks or months for the next 1 to 3 years. This will depend on your risk of developing invasive bladder cancer. This is called maintenance BCG therapy.
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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.
Stage 0 Bladder Cancer
Stage zero bladder cancers are called noninvasive papillary carcinoma and carcinoma in situ. Theyre precancerous lesions that could develop into more serious cancers if not treated.
These growths develop on the inner lining of the bladder. Noninvasive papillary carcinoma, also called stage 0a, forms long, thin growths into the empty space inside the bladder.
Carcinoma in situ, also called stage 0is bladder cancer, forms flatter growths that tend to be of a wilder grade. It is considered a more aggressive disease and is more likely to spread into the muscular walls of the bladder.
According to the National Cancer Institutes SEER database of cancer statistics, about half of bladder cancers are diagnosed at stage 0.
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Occupational Exposure And Safe Handling
In the 1970s, antineoplastic drugs were identified as hazardous, and the has since then introduced the concept of after publishing a recommendation in 1983 regarding handling hazardous drugs. The adaptation of federal regulations came when the U.S. first released its guidelines in 1986 and then updated them in 1996, 1999, and, most recently, 2006.
The has been conducting an assessment in the workplace since then regarding these drugs. Occupational exposure to antineoplastic drugs has been linked to multiple health effects, including infertility and possible carcinogenic effects. A few cases have been reported by the NIOSH alert report, such as one in which a female pharmacist was diagnosed with papillary transitional cell carcinoma. Twelve years before the pharmacist was diagnosed with the condition, she had worked for 20 months in a hospital where she was responsible for preparing multiple antineoplastic drugs. The pharmacist didn’t have any other risk factor for cancer, and therefore, her cancer was attributed to the exposure to the antineoplastic drugs, although a cause-and-effect relationship has not been established in the literature. Another case happened when a malfunction in biosafety cabinetry is believed to have exposed nursing personnel to antineoplastic drugs. Investigations revealed evidence of genotoxic biomarkers two and nine months after that exposure.
Whats Usually The First Symptom Of Bladder Cancer
Blood in your pee is the most common bladder cancer symptom. That said, simply having blood in your pee isnt a sure sign of bladder cancer. Other conditions cause this issue, too. But you should contact a healthcare provider whenever you spot blood in your pee. Other bladder cancer symptoms include:
- Visible blood in your pee : Healthcare providers can also spot microscopic amounts of blood in pee when they do a urinalysis.
- Pain when you pee : This is a burning or stinging sensation that you may feel when you start to pee or after you pee. Men and DMAB may have pain in their penises before or after peeing.
- Needing to pee a lot: Frequent urination means youre peeing many times during a 24-hour period.
- Having trouble peeing: The flow of your pee may start and stop or the flow may not be as strong as usual.
- Persistent bladder infections: Bladder infections and bladder cancer symptoms have common symptoms. Contact your healthcare provider if you have a bladder infection that doesnt go away after treatment with antibiotics.
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What Type Of Cancer Is Found In The Lungs Prostate And Bladder
Viewed under the microscope, squamous cells look similar to the flat cells found on the surface of the skin. Adenocarcinoma accounts for just about 1% of bladder cancer cases, according to the American Cancer Society. This type of cancer begins in glandular cells that line organs including the lungs, prostate and bladder.
When You Go Home
Some hospitals allow you to go home with the medicine in your bladder if you live close by and are okay with the treatment. Your team will let you know if you can do this. You should follow the advice on what to do when you pass urine.
You need to drink lots of fluid after this treatment for 24 hours. It helps clear your system of the BCG.
You should not have sex for 24 hours after each treatment. During your course of treatment and for a week afterwards, you should wear a condom during sex.
Having bladder cancer and its treatment can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.
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