Bladder Cancer
Bladder Cancer
Bladder cancer is the sixth most commonly diagnosed cancer in the US but is rarely discussed among the general public. According to the American Cancer Society, more than 70,000 Americans are diagnosed with bladder cancer each year. Bladder cancer is more common among men than women. Incidence of the disease increases with age; people over the age of 70 are two to three times more likely to develop the disease than individuals between the ages of 30-54.
Cigarette smoking is a contributing factor of more than 50 percent of bladder cancer cases. Other causes and risk factors of the disease include age, chronic bladder inflammation, diet high in saturated fat, exposure to second-hand smoke, family history, exposure to carcinogens in the workplace, certain medications, and infection of Schistosoma haematobium parasite.
Symptoms
The most common symptom of bladder cancer is blood in the urine (hematuria). Other symptoms can be frequent or painful urination and in advanced cases back pain.
Treatment
Approximately 90% of bladder cancers are diagnosed when they are in an early stage which makes them treatable. When bladder cancers have become invasive, they are life threatening and need to be treated aggressively. Much like skin cancer, bladder cancer often returns. Patients do well if it is caught early so after treatment (removal of bladder tumor) patients are put on a schedule to look in the bladder and kidneys to make sure it hasn’t returned.
Transurethral Resection of Bladder Tumor (TURBT) - This is the process where the tumor is resected via the urethra. A patient is put to sleep and a camera is placed through the urethra into the bladder. The tumor is removed using electrical current. Often a medication to kill cancer cells is placed in the bladder immediately after the surgery.
BCG Therapy - BCG is abbreviation for Bacille Calmette-Guerin and is a member of the tuberculin bacteria. BCG can help stimulate a patient’s immune system to attack the cancer cells. BCG solution is instilled directly into the bladder using a catheter. In most cases, BCG is given on a weekly basis for a minimum of six weeks. If it is working well, we will occasionally place a person on a maintenance protocol.
Treatment for Advanced Bladder Cancer
Immunotherapy – in advance cases of bladder cancer we will work jointly with a medical oncologist who can administer immunotherapy. Your urologist will continue to watch the bladder for local recurrences.
Radical Cystectomy – when a patient has advanced, local disease sometimes the best treatment is to completely remove the bladder and re-create a pathway for the urine to drain. This is a large and significant surgery.
Chemotherapy and Radiation – patients who do not want to lose their bladder can also choose the combination of chemotherapy and radiation to treat advance bladder cancer. Urologist will often work in tandem with medical and radiation oncologist to care for patients with this disease.