Understanding Bladder Cancer -- Diagnosis and Treatment
How Is Bladder Cancer Diagnosed?
To diagnose bladder cancer, your doctor completes a thorough medical history and examination, often following with a referral to a urologist, a doctor who specializes in managing diseases of the bladder.
The first test the urologist may perform is an intravenous pyelogram (IVP), followed by a cystoscopy. During a cystoscopy, the bladder can be viewed through a fiber-optic lighted tube known as a cystoscope. The urologist will pass the cystoscope through the urethra into the bladder. A urine sample for cytology will be obtained and a brush biopsy will be performed. This combination approach increases the probability of an accurate diagnosis as compared to a urine cytology specimen alone. If the doctor sees anything unusual, like a tumor, a tiny tissue sample is taken through the tube and examined in the laboratory.The doctor should also perform a bimanual examination to determine if there is a mass that can be felt and whether the bladder is mobile or fixed. Should a tumor be malignant, the treatment will depend on how far, if at all, the cancer has spread.
Blood and urine studies (to look for cancer cells and infection) and imaging studies with a chest X-ray, a CT scan of the abdomen and pelvis and possibly a bone scan, provides information about tumor size, location, and the degree to which the cancer has spread to other parts of the body.
will be taken to stage the bladder cancer, or determine the extent of the disease.
What Are the Treatments for Bladder Cancer?
Treatment for bladder cancer depends on the stage of the cancer, a measure of how widespread the cancer might be. Here are the stages:
TX: The primary tumor cannot be assessed.
T0: There is no evidence of primary tumor.
Stage Oa. This is a non-invasive papillary cancer.
Stage 0, or carcinoma in situ. This is early bladder cancer that just affects the inner lining of the bladder and is designated as non-invasive.
Stage I. Here, the cancer has spread deeper into the lining of the bladder, but doesn't affect the muscle wall of the bladder.
Stage II. The cancer affects the inside part of the muscles of the bladder and is designated as invasive.
Stage III. The bladder cancer has spread through the muscle wall of the bladder and may be affecting the tissue that surrounds the bladder or the reproductive organs.
Stage IV. The cancer has spread outside the bladder to any of the following: prostatic stroma, seminal vesicles, uterus, vagina, pelvic wall, abdominal wall, lymph nodes, or other organs.
Recurrent bladder cancer. This means that the cancer has come back after treatment.
If diagnosed early, superficial tumors can usually be treated successfully by transurethral resection (TUR). In this procedure, the surgeon inserts a small tube into the bladder through the urethra and removes the tumor surgically or burns it out with heat or a laser. Using this approach, the abdomen isn't cut. The side effects usually include bleeding and mild pain. You'll be able to go home within a day of the procedure.
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