Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- How will I pee after surgery?
- Will I have other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- Is there a clinical trial that might be right for me?
- What about treatments like special vitamins or diets that friends tell me about? How will I know if they are safe?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
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What About Other Treatments That I Hear About
When you have cancer you might hear about other ways to treat cancer or treat your symptoms. These may not always be standard medical treatments. These treatments can be vitamins, herbs, special diets, and other things. You may be curious about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to be helpful. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether its a vitamin, a diet, or anything else.
Bladder Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Bladder
The bladder is a hollow organ in the lower part of the abdomen. It is shaped like a small balloon and has a muscular wall that allows it to get larger or smaller to store urine made by the kidneys. There are two kidneys, one on each side of the backbone, above the waist. Tiny tubules in the kidneys filter and clean the blood. They take out waste products and make urine. The urine passes from each kidney through a long tube called a ureter into the bladder. The bladder holds the urine until it passes through the urethra and leaves the body.
- Transitional cell carcinoma: Cancer that begins in cells in the innermost tissue layer of the bladder. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the transitional cells. Transitional cell carcinoma can be low-grade or high-grade:
- Low-grade transitional cell carcinoma often recurs after treatment, but rarely spreads into the muscle layer of the bladder or to other parts of the body.
- High-grade transitional cell carcinoma often recurs after treatment and often spreads into the muscle layer of the bladder, to other parts of the body, and to lymph nodes. Almost all deaths from bladder cancer are due to high-grade disease.
See the following PDQ summaries for more information:
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Urine Cytology Tests To Detect Cancer Cells
In a urine cytology test, a sample of the patients urine is analyzed under a microscope.1,2 This test can reveal the presence of cancer cells or cells that are pre-cancerous, meaning that they are more likely to become cancer cells later. However, this test is not enough to provide a definite diagnosis on its ownit is possible for cancer cells to be present in the bladder even if no cancer cells are detected in the urine sample.
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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When To See A Healthcare Provider
There are currently no guidelines or recommendations for screening people at risk of bladder cancer, including those who have significant risk factors. Clinical trials are ongoing to see if screening may detect bladder cancer early in some populations.
You should talk to your healthcare provider if:
- You notice any blood in your urine, even if you aren’t certain its blood, especially if persists, worsens, or is accompanied by other symptoms.
- You have any symptoms of abnormal urination, whether that means pain or burning, frequency, urgency, losing urine, difficulty starting or stopping your stream or just a sensation that something has changed.
- You have any other symptoms that just don’t feel right.
Risk Factors Causes And Symptoms
More than 90 percent of bladder cancers are transitional cell carcinomas, or cancers of the cells lining the bladder, ureters, and urethra. The exact causes are largely unknown, but both genetic and environmental factors are responsible. Bladder cancer is about 2.5 to 2.7 times more common in men than women, and whites are twice as likely to be affected as Blacks. The most significant risk factor associated with bladder cancer is smoking carcinogens are absorbed through the lungs into the bloodstream, where they are filtered out by the kidneys and enter the urinary tract. An environmental risk is presented by a class of organic chemicals called arylamines. People who work in the leather, rubber, printing, and textiles industries or with large quantities of paint are often exposed to these chemicals and should exercise caution in their use.
As with many cancers, advanced age is a risk factor, and most bladder cancers are diagnosed after the age of 60. Chronic bladder inflammation, such as that caused by recurrent bladder infections, is a risk factor, as are rare, inherited birth defects related to the development of the bladder.
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Next Steps After Urine Lab Tests
Depending on the results of the patients physical examination and urine laboratory tests, healthcare providers may need to carry out further testing to help make a diagnosis.1,2 The tests can also be used in patients who have already been diagnosed with bladder cancer to help gather more information about the cancer and develop the patients treatment plan.
Does Bladder Cancer Show Up In Urine Test
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.
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When Should I Reach Out To My Doctor About Frequent Urination
Because the conditions behind frequent urination can range wildly from casual to severe, you should speak to your doctor about anything outside of your typical urination patterns. In some cases, frequent urination may be just an annoying symptom that will end when you cut back on the caffeineor have the baby. However, if you are unsure why youre urinating so frequently, it is best to set up an appointment and talk about it. This is a symptom that can often be treated and isnt something that you need to just deal with.
There are a few signs to keep an eye out for and call your doctor immediately if you have them with frequent urination. These include:
- If you have a fever.
- If you are vomiting.
What Are The Risks Of Bladder Cancer
No single factor is directly connected to bladder cancer, but factors that can increase the risk include:
- Age: Bladder cancer typically affects people age 55 and older.
- Smoking: Carcinogens from tobacco smoke come in contact with the lining of the bladder. Smokers are three times as likely as non-smokers to get bladder cancer.
- Family history: There is evidence that bladder cancer may have a genetic component.
- Industrial chemicals: Chemicals known as aromatic amines are often used in the dye industry. Workers who have daily exposure to them, such as painters, machinists and hairdressers, may be at a higher risk for bladder cancer.
- Drinking contaminated water: This includes water that has been treated with chlorine or drinking water with a naturally high level of arsenic, which occurs in many rural communities in the United States,.
- Taking certain herb: Supplements such as Aristolochia fangchi, a Chinese herb, sometimes used for weight loss has been linked to higher rates of bladder cancer.
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Other Squamous Cell Carcinoma Risk Factors
Having bladder diverticula may increase an individuals chance of developing SCC. Rarely, bacillus Calmette-Guerin treatment for CIS has been reported to lead to development of SCC. Development of bladder cancer at a younger age has been associated with bladder exstrophy. SCC has also been described in urachal remnants.
Coffee consumption does not increase the risk of developing bladder cancer. Early studies of rodents and a minority of human studies suggested a weak connection between artificial sweeteners and bladder cancer however, most recent studies show no significant correlation.
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.
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Advanced Or Metastatic Transitional Cell Carcinomas
First-line regimens for advanced or metastatic transitional cell carcinomas consists of and ) or a combination of , , , and .
Taxanes or have been used as second-line therapy .
such as is often used as second-line therapy for metastatic urothelial carcinoma that has progressed despite treatment with GC or MVAC.
In May 2016, the FDA granted to for locally advanced or metastatic treatment after failure of cisplatin-based chemotherapy. The failed to achieve its of .
In April 2021, the FDA granted accelerated approval to for people with locally advanced or metastatic urothelial cancer who previously received a platinum-containing chemotherapy and either a programmed death receptor-1 or a programmed death-ligand 1 inhibitor.
What Will Happen After Treatment
You’ll 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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What Is Upper Tract Urothelial Carcinoma
While the majority of bladder cancers arise in the bladder, the urothelial cells that line the bladder are found in other locations in the urinary system. Sometimes these urothelial cancers can occur in the lining of the kidney or in the ureter that connects the kidney to the bladder. This is known as upper tract urothelial cancer correspond to a subset of urothelial cancers that arise in the urothelial cells in the lining of the kidney or the ureter . Learn more about UTUC on the BCAN website here.
Looking For More Of An Introduction
If you would like more of an introduction, explore this related item. Please note that this link will take you to another section on Cancer.Net.
- ASCO Answers Fact Sheet:Read a 1-page fact sheet that offers an introduction to bladder cancer. This free fact sheet is available as a PDF, so it is easy to print.
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There Are Different Types Of Treatment For Patients With Bladder Cancer
Different types of treatment are available for patients with bladder cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Localized/early Transitional Cell Carcinomas Of Bladder
Transitional cell carcinomas can be very difficult to treat. Treatment for localized stage transitional cell carcinomas is surgical resection of the tumor, but recurrence is common. Some patients are given into the bladder either as a one-off dose in the immediate post-operative period or a few weeks after the surgery as a six dose regimen.
Localized/early transitional cell carcinomas can also be treated with infusions of into the bladder. These are given weekly for either 6 weeks or 3 weeks . Side effects include a small chance of developing systemic or the patient becoming sensitized to BCG, causing severe intolerance and a possible reduction in bladder volume due to scarring.
In patients with evidence of early muscular invasion, radical curative surgery in the form of a cysto-prostatectomy usually with lymph node sampling can also be performed. In such patients, a bowel loop is often used to create either a “neo-bladder” or an “ileal conduit” which act as a place for the storage of urine before it is evacuated from the body either via the urethra or a urostomy respectively.
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Other Causes Of Blood In The Urine
Blood in the urine is common. At any one time, between 1% and 18% of the population will have asymptomatic microscopic hematuria, but only 1.3% of patients with this symptom have bladder cancer. Other causes of hematuria include:
- Certain foods
- Some medications , Rifadin , certain blood thinners, laxatives. and chemotherapy drugs
- Bladder and/or kidney infections
Permission To Use This Summary
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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> .
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What Does Your Bladder Do
Your bladder is part of your urinary system. The job of the urinary system is to filter waste products from your blood and transport the waste products or urine, out of your body. The diagram below shows the organs of the urinary system. Most of the urinary tract is lined with a special layer of cells called transitional cells. The primary machines in the human filtering system are the two kidneys located close to the backbone and protected by the ribs. The kidneys work independently. They have the significant task of filtering approximately 20% of total blood volume each minute and removing the by-products of digestion and of other body functions.
Once produced, the urine is stored in the central part of the kidney called the renal pelvis. At regular intervals, the renal pelvis contracts and propels the urine through the ureters. These narrow, thin-walled tubes extend from inside the renal pelvis to the bladder. The bladder is a thick-walled structure, consisting of a relatively thin inner layer with a thick muscle covering.
Are There Any Other Tests That May Be Recommended
Any one or more of the following may be suggested:
Urinalysis:Urine is tested for evidence of infection, blood or diabetes
Bladder Ultrasound:Sound waves are used to check the amount of urine left behind in your bladder after you urinate
Cystoscopy:A thin tube with a telescope is used to look inside your urethra and bladder for anything that may be irritating your bladder
Urodynamics:Various techniques are used to measure pressure in the bladder and the flow of urine
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