Approximately 75,000 people die every year from bladder cancer in the United States. Although bladder cancer can occur at any time, it most commonly occurs after age 70. It is in the top five cancers for men and in the top 10 cancers for women. The good news is that if detected early, it can be treated quite effectively. The bad news is that although treated, it can recur.
What is bladder cancer?
The bladder is a storage organ for urine before it passes out of the body. The tube that leads from the bladder out of the body is called the urethra. The bladder is very similar to a balloon in that it can expand and decrease in size as it fills and empties.
The wall of the bladder has several layers. Most commonly, bladder cancer will occur on the very inner layer of the bladder. As bladder cancer grows and progresses, it can affect the middle and outer layers, including the muscle layer of the bladder.
In worst case scenarios, parts of the cancer can break through the muscle layers and spread throughout the body. This is known as metastatic cancer. The best thing to do is catch bladder cancer in its earliest stages, when it solely affects the inner lining of the bladder, before becoming invasive and affecting the muscle, or metastasizing.
What causes bladder cancer?
Causes of bladder cancer are poorly understood, but we do understand there are certain risk factors, including: smoking, exposure to radiation near the bladder, exposure to caustic chemicals used in the manufacturing industries, as well as certain anti-cancer medications that can also increase the risk for developing bladder cancer. Repeated bladder infections with parasites are rare in the United States but common throughout the world, and can also be a risk factor for developing bladder cancer.
How is bladder cancer diagnosed?
Possible signs and symptoms of bladder cancer can include blood in the urine and changes in bladder habits that include: increased frequency of urination, or inability to pass urine despite having the urge to do so, pelvic pain, back pain, or pain with urination. Most commonly, blood in the urine (that causes the urine to appear bright red or orange) is the initial warning sign.
Remember, there are many causes for blood in the urine, and bladder cancer is just one. Anytime there is blood in the urine, no matter what the cause, it should always be evaluated by a physician.
Tests to diagnosis bladder cancer include special urine tests to evaluate for cancer cells, imaging studies (CT scans), and the gold standard test, a procedure called a cystoscopy. This is where the physician uses a small, flexible tube with a camera. The tube is inserted through the urethra and visualizes the inside of the bladder.
Additionally with a cystoscopy, if an area or spot looks suspicious, the cystoscope also has the ability to take a small sample of tissue for additional evaluation by a pathologist (biopsy).
How is bladder cancer treated?
Once the diagnosis of bladder cancer is established, treatment options are designed based on the type of bladder cancer, how aggressive the bladder cancer is, and how far it has progressed. Evaluation includes determining if the cancer is just on the inner layer of the bladder, involves the middle or outer layers including the muscle of the bladder, or if it has broken through and metastasized to other parts of the body.
The exact treatment for bladder cancer will be determined by the physician, oncologist, and sometimes, urologic surgeon. Sometimes the entire bladder needs to be removed. If this is the case, there are many options for such a patient to collect and dispel urine. The treatments for bladder cancer include immunotherapy, chemotherapy, radiation therapy, surgery and/or any combination of these.
As was mentioned earlier, the upside for bladder cancer is that it’s easily treated if caught early. The downside is that it has a tendency to recur, even with successful initial treatment.
After being successfully treated for bladder cancer, it is very important to see your doctor on a regular and lifelong basis for appropriate monitoring and the very best long-term outcome.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.