Bladder Cancer

Bladder cancer is a relatively rare form of cancer that starts in the lining of your bladder. Your bladder is a small hollow organ that holds urine. Healthcare providers have many ways to treat bladder cancer, including surgery to remove bladder cancer.

Causes #

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.

Symptoms #

• Visible blood in your pee (hematuria): Healthcare providers can also spot microscopic amounts of blood in pee when they do an urinalysis.

• Pain when you pee (dysuria): 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 you’re peeing many times during a 24-hour period.

• Having trouble peeing: The flow of your pee may start and stop 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 doesn’t go away after treatment with antibiotics.

Diagnosis #

Urinalysis #

Providers use a variety of tests to analyze your pee. In this case, they may do urinalysis to rule out infection.

Cytology #

Providers examine cells under a microscope for signs of cancer.

Cystoscopy #

• This is the primary test to identify and diagnose bladder cancer.

• For this test, providers use a pencil-sized lighted tube called a cystoscope to view the inside of your bladder and urethra.

• They may use a fluorescent dye and a special blue light that makes it easier to see cancer in your bladder.

• Providers may also take tissue samples while doing cystoscopies.

Magnetic resonance imaging (MRI) test #

This imaging test uses a magnet, radio waves and a computer to take detailed images of your bladder.

Computed tomography (CT) scan #

Providers may do this test to see if cancer has spread outside of your bladder.

Chest X-ray #

This test lets providers check for signs bladder cancer has spread to your lungs.

Bone scan #

Like a chest X-ray, bone scans check for signs bladder cancer has spread to your bones.

Treatment #

Chemotherapy #

These are cancer-killing drugs. Providers may use intravesical therapy to deliver chemotherapy drugs directly to your bladder via a tube inserted into your urethra. Intravesical therapy targets cancer without damaging healthy tissue.

Immunotherapy #

Immunotherapy is a treatment that uses your immune system to attack cancer cells. There are different types of immunotherapy:

Bacillus Calmette-Guerin (BCG) #

This is a vaccine that helps boost your immune system.

PD-1 and PD-L1 inhibitor therapy #

• PD-1 and PD-L1 are proteins found on certain cells.

• PD-1 is on the surface of T-cells that help regulate your body’s immune responses.

• PD-L1 is a protein found on the surface of some cancer cells.

• When these two proteins connect, the connection keeps T-cells from killing cancer cells.

• In inhibitor therapy, the two proteins can’t connect, leaving the way clear for T-cells to kill cancer cells.

Radiation therapy #

• Radiation therapy may be an alternative to surgery.

• Healthcare providers may combine radiation therapy with TURBT and chemotherapy.

• This treatment is an alternative to bladder removal surgery.

• Healthcare providers consider factors such as tumor growth and tumor characteristics before recommending this treatment

Targeted therapy #

Targeted therapy focuses on the genetic changes that turn healthy cells into cancer cells. For example, drugs called FGFR gene inhibitors target cells with gene changes that help cancer cells grow.

Surgery #

• Surgery is a common bladder cancer treatment. Providers chose surgical options based on the cancer stage.

• For example, many times, TURBT, the procedure used to diagnose bladder cancer, can treat bladder cancer that hasn’t spread.

• Healthcare providers either remove the tumor or use high-energy electricity to burn it away with a process known as fulguration.