Bladder Cancer

What is Bladder Cancer?

Bladder cancer affects approximately 70,000 adults each year in the United States, making it one of the most common forms of cancer. It is also a greater worry for men than for women, although it can happen at any age. Initially, testicular cancer is the main concern for adolescents and young adults and becomes rarer as men grow older. However, as this concern declines, there is an increased risk of prostate cancer. Unfortunately, bladder cancer is often overlooked as something to worry about with both testicular and prostate cancers being highly publicized, but it shouldn't be. This year alone, over fifty thousand men (53,000) in the US will be diagnosed with bladder disease, and over 10,000 men will die from it.

Bladder cancer is three times more common in men than women and it is the fourth most common internal malignancy in American men, making it one of the 10 deadliest cancers. Ethnicity plays a role as well with African Americans having only half the risk of developing the disease when compared to Caucasian men. The disease is fairly uncommon before the age of 60, making age another major risk factor for developing bladder cancer, becoming more prevalent the older we get.

The bladder is a hollow, muscular organ that is located in your lower abdomen whose main function is to store urine. The beginning stages of bladder cancer usually begins within the cells that line the inside of your bladder called the urothelial cells. This type of cancer is most commonly found in the bladder; however, other parts of the urinary tract drainage system can also develop this same type of cancer.

Luckily, bladder cancer is highly treatable and 7 out of 10 diagnoses are found at an early stage. However, once it has developed, no matter what the stage, there is a higher likelihood of recurrence making follow up tests for years after treatment a must. These annual tests will make sure that the cancer has not recurred or advanced to a higher stage.

Symptoms and Causes of Bladder Cancer

Symptoms include:

  • Blood in the urine (hematuria is the medical term that physicians use to describe the presence of blood in a patient's pee or urine ) - the urine will appear cola colored or bright red
  • Painful urination
  • Frequent urination
  • Pelvic Pain
  • Back Pain

Causes include:

  • Increasing Age – Bladder Cancer can occur at any age, but the risk greatly increases after you reach sixty (60) years of age.
  • Smoking – Smoking cigarettes, cigars and pipes can increase your risk for bladder cancer as harmful chemicals can accumulate in the urine.
  • Being a White Male – Caucasians are at greater risk than other ethnicities and men are more likely to develop bladder cancer than women.
  • Previous Cancer Treatment or Family History – Those with previous cancer diagnosis with radiation treatment aimed at the pelvis have an increased risk of developing bladder cancer. Also, although it is rare for bladder cancer to run in families, if your first-degree relatives (parent, sibling or child) has a history of bladder cancer, you may have an increased risk.
  • Chemical Exposure – Being exposed to certain chemicals can increase the risk of developing bladder cancer as the kidneys filter the harmful chemicals from your bloodstream and move them to your bladder. The main culprits are chemicals that are used in the manufacturing of dyes, textiles, paints, leather and rubber products.

How is Bladder Cancer Diagnosed?

Bladder Cancer does require a medical diagnosis. If you've developed symptoms such as blood in the urine, call and make an appointment with your doctor to get it checked out. The first step will be to rule out other causes of the blood in the appearing in the patient's urine and also locating the bladder tumor itself if all other causes are ruled out. First, a urine culture will be taken to rule out bladder or kidney infections. After that, a digital rectal exam will be performed to check for prostate cancer or benign prostatic hyperplasia.

Most often the diagnosis of bladder cancer relies on a test called a cystoscopy. During this test, a local anesthetic is administered and a thin, flexible fiber-optic tube, called the cystoscope, is inserted through the urethra into the bladder. The urologist is able to see the bladder, take pictures as well as insert instruments through the cystoscope to obtain biopsies of the bladder wall.

What is the Treatment for Bladder Cancer?

The treatment of bladder cancer depends upon the stage of the disease and the aggressiveness of the cancer cells.

  • Transurethral Resection of the Bladder Tumor (TURBT) - This is performed in the early stages (Ta, Tis, T1) before the cancer has invaded the bladder muscle. Much like the diagnosis procedure, the urologist will use a cystoscope to work inside of the bladder and remove all visible tumors. The urologist may still start a chemotherapy drug regime, such as Mytomycin, after the procedure is complete.
  • Bacillus Calmette-Guerin (BCG) bacteria - Carcinomas in the Tis "flat tumors" stage that suggest a high likelihood of recurrence require more aggressive forms of treatment usually involving immunotherapy. The BCG bacteria are injected into the bladder and boost the body's own tumor-fighting cells. Mytomycin C is a chemotherapy drug that is instilled in the bladder and an alternative to the BCG bacteria. With either case, chemotherapy has to be delayed for a few weeks, unlike TURBT, as the surgical sites in the bladder need to heal.
  • Radical Cystectomy - This is done when when the cancer does not respond to local therapy and for invasive tumors that have penetrated the bladder wall (stages T2 and T3). It is the surgical removal of entire bladder and nearby lymph nodes. In men, the prostate and seminal vesicles are also removed.

Only your doctor can determine the best course of action to treat your bladder cancer. If you are experiencing any of the above symptoms, or have a family history or other risk factors please call Philadelphia Urology at 215-563-1199 to schedule an appointment or simply contact us online today!

About Philadelphia Urology

At Philadelphia Urology Associates, Dr. Bruce Sloane is a nationally renowned specialist in Men's Health issues and Age Management Medicine. Throughout Philadelphia and the surrounding areas, patients seek his expertise to treat bladder cancer and other urological issues such as premature ejaculation and erectile dysfunction. Using state-of-the-art equipment and having extensive specialized education and training, Dr. Sloane will find the treatments and solutions that will work for you.

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