Understanding Bladder Cancer - Diagnosis and Treatment

How Is Bladder Cancer Diagnosed?

To diagnose bladder cancer, your doctor completes a thorough medical history and examination, and then he or she will probably send you to a urologist, a surgeon who has special training in managing diseases of the bladder.

The first test he or she will probably 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 and take a urine sample for cytology and perform a brush biopsy, This combination increases the probability of an accurate diagnosis over 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 ( biopsy). The doctor should also perform an 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 X-rays, CT, bone scans,  ultrasound, and MRI of the bladder, kidneys, and other organs provide information about tumor size, location, and the degree or amount of spread to other parts of the body.

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.

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.

Recurrent Bladder Cancer. This means that the cancer has come back after treatment.

If diagnosed early, superficial malignancies 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 beam. Combined with chemotherapy or radiation therapy, TUR may also be successful against more invasive bladder cancer. Using this approach, the abdomen isn't cut. The side effects are usually mild and short-lived and include bleeding and mild pain. You'll be able to go home within a day of the procedure.