Most cases of bladder cancer start from the cells lining the bladder. The exact cause of the disease isn’t always known, though several factors can increase risk:
- Cigarette smoking. Up to half of all bladder cancers in men and several in women may be caused by cigarette smoke.
- Chemical exposure at work. Dye workers, rubber workers, aluminum workers, leather workers, truck drivers, and pesticide applicators are at the highest risk.
- Radiation treatment: Women who had radiation therapy to treat cervical cancer have an increased risk of developing bladder cancer.
- Bladder infection: A long-term (chronic) bladder infection or irritation may lead to a certain type of bladder cancer.
Bladder Cancer Symptoms
Symptoms of bladder cancer can include:
- Abdominal pain
- Blood in the urine
- Bone pain or tenderness if the cancer spreads to the bone
- Painful urination
- Urinary frequency and urgency
- Urine leakage (incontinence)
- Weight loss
Other diseases and conditions can cause similar symptoms. It is important to see a doctor to rule out all other possible causes.
Bladder Cancer Diagnosis
Your physician will perform a physical examination, including a rectal and pelvic exam. Additonal tests that may be done include:
- Abdominal CT scan
- Abdominal MRI scan
- Cystoscopy (examining the inside of the bladder with a camera), with biopsy
- Intravenous pyelogram - IVP
- Pelvic CT scan
- Urine cytology
If tests confirm you have bladder cancer, additional tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future.
Bladder Cancer Treatment Options
At the Comprehensive Cancer Center, our urologic oncologists are experts in treating bladder cancer, as well as reconstructing bladders following cancer treatment. Our surgeons are pioneers in removing cancerous bladder and reconstructing new bladders using the robotic surgery tool, known as the daVinci® Surgical System and we are consistently innovating on improvements in treating bladder cancer.
In cases where the cancer hasn’t spread beyond the bladder lining, the treatment is to “scrape” the bladder to remove cancerous cells.
There are several different advanced options for bladder cancer treatment. They include:
- Neoadjuvant chemotherapy. This is chemotherapy given before surgery to shrink the tumor. Your doctors may decide this is the best treatment because once the tumor is smaller; it will be easier to perform the surgery to remove it. Conserving as much bladder tissue as possible is important for rebuilding the bladder following surgery.
- Endoscopic surgical treatment. Your doctors may elect to remove the bladder tumor using minimally invasive techniques. This will depend on the location, type and size of your tumor.
- Robot-Assisted Surgery. With robotic surgery, surgeons make small incisions in the patient’s abdomen through which a camera and robotic instruments are inserted. The surgeon sits at a console away from the patient and controls 4 instruments using finger and hand movements. The tiny centimeter-sized instruments eliminate the need for the 6- to 8-inch incision required with traditional surgery.
- Bladder removal and urinary diversion, known as a stoma. Bladder tumors can destroy the bladder. Your doctors may have to remove the bladder completely and build a diversion into your belly button, so that urine can leave your body through a bag. This is known as continent cutaneous urinary diversion.
- Bacillus Calmette-Guerin (BCG). BCG is used to treat bladder cancer. It is a form of immunotherapy and through some unknown mechanism kills the cancer cells.
Why Multidisciplinary Teams Matter, No Matter What Stage
We create teams of the different specialists who focus on urologic cancers. What this means is that at every stage of your cancer journey, you will meet with doctors who only focus on the type of cancer you have. Together, with other specialized experts, they will decide on the best treatment for you, personalizing your treatment directly to your condition and lifestyle.
It is because of our multidisciplinary approach to cancer treatment, that we have been designated by the National Cancer Institute as a Comprehensive Cancer Center, one of only 41 in the country.
Our urologic surgeons have extensive experience in using bowel to create a “new” bladder in cases where the bladder must be removed. In addition, our surgeons use nerve-sparing techniques to improve postoperative sexual function.