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Incidence
Risk Factors for Bladder Cancer
Bladder Cancer Screening
Bladder Biopsy
Grading and Staging of Bladder Cancer
Treatment Options for Early Stage Bladder Cancer
Treatment Options for Advanced Stage Bladder Cancer
At Comprehensive Urology Medical Group, our physicians are highly specialized in treating urologic cancers with the most advanced techniques. Using a team approach we strive for excellence. We aim to provide excellent cancer control, while optimizing patient satisfaction and quality of life. We work with each patient in order to specifically tailor their treatment to their own clinical situation. One of the common diseases that we treat is bladder cancer.
The bladder is located the lower abdomen and its function is to store and expel urine. Urine passes from the two kidneys into the bladder via two tubes called the ureters. The bladder has an elastic muscular wall that allows it to contract and expand as urine is stored or emptied. Urine then leaves the bladder through another tube called the urethra. About 90 percent of bladder cancers form from the cells that line the urinary tract and are called transitional cell carcinomas.
Cancer that is confined to the lining of the bladder is called superficial bladder cancer. Cancer that invades into the muscular wall of the bladder or beyond is called invasive bladder cancer. Ten percent of transitional cell cancers arise in other parts of the urinary system such as the ureters, the urethra, and the part of the kidneys that collect the urine (renal pelvis).
The symptoms that represent bladder cancer are nonspecific and sometimes can represent other urologic disorders. For this reason, our physicians perform specific screening studies to aid in the diagnosis. They perform a step by step approach to ensure the precise diagnosis is made for each patient.
Incidence of Bladder Cancer
Over 60,000 people are diagnosed with bladder cancer each year in the United States. Over the past two decades the number of cases diagnosed in the country have increased by 50%. Bladder cancer is found 3 times more often in men that in women, but women have a 30% higher chance of dying from the disease. It is found about twice as often in Caucasians than in African Americans, although African Americans and women tend to be diagnosed with a more aggressive form of the disease.
Bladder cancer is found more often in middle age (age 60-70) but can be found at any age. Younger people when diagnosed tend to have more favorable (early stage) disease.
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Risk Factors for Bladder Cancer
There are many associated factors, called carcinogens, which increase the risk of bladder cancer.
Smoking and tobacco use carry the greatest risk, contributing to over half of the cases.
Smokers carry four times the risk of developing bladder cancer compared to nonsmokers. Smoking cessation does decrease this risk somewhat with time.
Other risk factors and carcinogens include:
Older AgeChronic bladder infectionsBladder stonesPatients who have long term indwelling bladder cathetersCertain parasitic diseases, such as Schistosomiasis, often found in EgyptPrevious pelvic radiation therapy for other diseases (i.e. prostate, cervical, rectal or ovarian cancer)The chemotherapy cyclophosphamide (used to treat many cancers)Certain chemicals in the workplace (i.e. aniline dyes, combustion gases & acrolein)
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Bladder Cancer Screening
Bladder cancer usually presents with blood in the urine (hematuria). It is either seen by the naked eye (gross hematuria) or by visualization under the microscope (microscopic hematuria) at the doctor’s office. Other symptoms sometimes associated with bladder cancer include frequent, painful urination and urgency of urination.
Many urologic diseases may also cause blood in the urine such as urinary tract infections, enlarged prostate (BPH), and kidney stones. For this reason, some screening tests are performed to aid in the diagnosis. These include 1) imaging studies, 2) cystoscopy, and 3) urinary evaluation.
Imaging studies such as CT scan and intravenous pyelogram are used to help evaluate the urinary tract (kidneys, ureters and bladder) for abnormalities. These imaging studies involve injecting a dye that travels through the body and into the urinary tract to help give a highly defined view of the system.
Cystoscopy is another exam used to evaluate for abnormalities within the bladder itself. It is a simple procedure in which a camera with a thin flexible tube is placed into the bladder through the urethra to directly visualize the lining of bladder.
The urine is also tested for the presence of bladder cancer indicators or for cancer cells themselves. These tests are called NMP-22 and cytology. When used together with imaging studies and cystoscopy these tools can help detect even the hardest to find cancers in the urinary system.
Please click here to read Frequently Asked Questions...
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Bladder Biopsy
If a tumor is found within the bladder during screening, the next step will be bladder biopsy. This is usually a simple outpatient procedure utilizing endoscopic techniques (no skin incisions) to scrape the tumor from the bladder wall (called transurethral resection). When the tumor is superficial (confined within the lining of the bladder) and not aggressive (low grade) often this is all that is required to remove the cancer. However, when the tumor is more aggressive (into bladder muscle or high grade), more aggressive treatment may be necessary.
Please click here to read Frequently Asked Questions...
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Grading and Staging of Bladder Cancer
Once bladder cancer is found, a pathologist visualizes the cells under a microscope to determine its aggressiveness (low or high grade). The cancer is also staged based on where it has spread. Tumors that are confined within the bladder lining are considered Stage Ta or T1. Tumors that invade the muscle wall are Stage T2, and those that invade beyond the bladder are termed Stage T3 and T4.
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