Bladder Cancer


What Is Bladder Cancer?

The bladder is a hollow, flexible pouch in your pelvis. Its main job is to store urine before it leaves your body. Your kidneys make pee. Tubes called ureters carry the pee from your kidneys to your bladder. When you use the bathroom, the muscles in your bladder push the urine out through a tube called the urethra.

You get bladder cancer when cells inside of it grow out of control. Over time, a tumor forms. It can spread to nearby fat and tissue. In severe cases, it can spread to distant parts of your body, including your lymph nodes, bones, lungs, or liver.

Bladder cancer is rare. It accounts for just 5% of all new cancers in the U.S.

What Are the Symptoms of Bladder Cancer?

The most common -- and often, the first -- symptom is blood in your urine. It may be just a little, or it can be enough to change the color of your pee. It may turn orange, pink, or darker red.

You may see blood one day, but not the next. If you have bladder cancer, the blood eventually comes back. In some cases, you can’t see blood in your urine. Your doctor or lab tech will only see it under a microscope.

Make an appointment if you have any of these other symptoms:

  • You have to pee more often than usual
  • Your urine changes color
  • It hurts or burns when you pee
  • You feel like you have to pee -- even if your bladder’s not full
  • You can’t pee, or you pee very little

If you notice any of these things, call your doctor, but don’t panic. Having these symptoms doesn’t mean you have cancer. You could have a urinary tract infection, bladder infection, or some other less serious condition.

Once bladder cancer starts to spread, you may notice that:

  • You can’t pee, even when you feel like you have to
  • Your lower back hurts
  • You’re losing weight without trying
  • You’re not as hungry as usual
  • You have swollen feet
  • Your bones hurt
  • You often feel extremely tired or weak

Again, see your doctor if any of these things happen to you. They could also signal that you have something other than bladder cancer.

Bladder Cancer Treatments: What to Know

If you have bladder cancer, there are several available treatment options. Your doctor will help you decide which treatment is best for you and this will depend on a number of things. These include your age, how much the cancer has spread (doctors call this your cancer “stage”), and any other health conditions you have.

Surgery

Transurethral resection of bladder tumor (TURBT) is the most common surgery for bladder cancer that’s in the early stages.

Your doctor will put an instrument called a resectoscope into your bladder through your urethra. That’s the tube that urine flows through when you go to the bathroom. The resectoscope has a wire loop at the end. Your doctor will use it to remove abnormal tissues or tumors. If you still have cancer after the tumor is removed, your doctor can destroy it using a laser and another tool called a cystoscope.

Cystectomy

In this type of surgery, your doctor removes part of your bladder (a partial cystectomy) or all of it (a radical cystectomy).

If cancer has spread to the muscle layer of your bladder and is still small, your doctor may be able to perform a partial cystectomy. But most people who have cancer that has grown into the muscle of the bladder will need a more extensive surgery instead.

If the cancer is large or has spread to more than one part of your bladder, your doctor will likely remove the entire organ and the nearby lymph nodes. This is a radical cystectomy.

Intravesical therapy

This treatment is also used for early-stage cancers. Your doctor uses a catheter to inject a liquid medication right into your bladder. He’ll choose between two different types of medications -- immunotherapy or chemotherapy (“chemo”).

  • Immunotherapy. In this method, your body’s own immune system attacks the cancer cells. Your doctor will inject a germ called Bacillus Calmette-Guerin (BCG) into your bladder through a catheter. This germ is related to the one that causes tuberculosis. This draws your body’s immune cells to your bladder. There, they’re activated by the BCG and begin to fight the cancer cells. Your doctor may start this treatment a few weeks after you have a TURBT.
  • Intravesical chemotherapy (“chemo”). If your doctor and you decide on this treatment, he’ll inject cancer-fighting medications into your bladder through a catheter. The chemo works to kill the harmful cells.
  • Systemic chemo. Your doctor will give you chemo through an IV. That means the medication travels through your bloodstream to other parts of your body. It can kill cancer cells that may have spread beyond your bladder.

Radiation therapy

This treatment involves using high-energy radiation to kill cancer cells. It’s a lot like getting an X-ray -- only much stronger. It doesn’t hurt. You might need to get radiation 5 days a week for several weeks.

Your doctor may recommend it for one of the following reasons:

  • You have early-stage bladder cancer
  • You have early-stage cancer but can’t have surgery
  • As a follow-up to TURBT or partial bladder removal surgery
  • To prevent or treat symptoms of advanced bladder cancer