Bladder Cancer - Symptoms, Diagnosis, Treatment and Care

Over 10,000 people are diagnosed with bladder cancer in the UK each year and over 50,000 each year in the United States. It contributes to 90% of bladder cancers (renal pelvic, ureter, bladder and urethra) and most commonly occurs in more than 50 people and about twice as many men as women get the disease. Although bladder cancer is preventable, the use of tobacco and working with certain chemicals are associated with a higher risk of developing the disease. Drinking plenty of fluids daily can help reduce risk. Symptoms of bladder cancer include pain and frequency of urination and blood in the urine.

Diagnosis of bladder cancer is through urology and image testing, potential risk factors that can be determined by the patient's full medical history and things like smoking and exposure to dye. NMP22®BladderChek® is a non-invasive urine test that detects high levels of nuclear nickel (NMP) caused by bladder cancer, the results of these tests when used with cystoscopy have shown to be more effective than other diagnostic tests.

Various imaging tests can also be performed, this involves dye administered via a vein and then x-rays taken as a dye moving through the urinary tract. It provides information on the function of the bladder, ureter and kidney. Other imaging tests include CT scan, MRI scan, bone scan and ultrasound. If bladder cancer is suspected cystoscopy and biopsy is performed. With a thin telescope tube cystoscopy with a small camera attached it is inserted into the bladder through the urethra for detecting abnormalities. In biopsies, tissue samples are taken and examined for cancer cells.

Once it has been determined that a tumor exists, the next step is to define the tumor status. The size of the tumor, where it is located, whether it has expanded to the surrounding tissue and whether it has spread to lymph nodes or other sites in the body are all questions that need to be answered. Tumor level or penetration depth is limited to one of two categories; (1) a superficial surface tumor, affecting only the bladder layer or (2) a deep spreading tumor, which grows into a deeper layer of bladder tissue, and may involve surrounding muscles, fats and organs.

The treatment of bladder cancer depends on the stage of the disease, the type of cancer and the age of the patient and general health. Options include surgery, chemotherapy, radiation and immunotherapy. Surgery may include removal of the bladder, prostate and lymph nodes resulting in patients needing an external urinary device, but if caught early in the tumor can be removed using instruments inserted through the urethra.

Chemotherapy is a systemic treatment that uses drugs to destroy either oral or intravenous cancer cells. In patients with early stage cancers of the bladder can be inserted into the bladder through the urethra. Some side effects of chemotherapy can be severe and include headaches, stomach aches, blurred vision, fatigue, excessive bleeding, infections and weakness.

Radiation uses high-energy radiation to destroy cancer cells. External radiology is extracted from the machine outside the body and internal radiation is emitted from pellets inserted into the tumor. Whether the type can be used after surgery to destroy the remaining cancer cells. Side effects can include rectal inflammation, skin irritation, fibrosis and impotence.

Immunotherapy can be used in cases of bladder cancer. This treatment improves the immune system's ability to fight disease. The vaccine is poured through the urethra to the urinary bladder once a week for 6 weeks to stimulate the immune system and destroy cancer cells. Side effects can be bladder inflammation, prostate inflammation and flu-like symptoms.

Bladder cancer has a high relapse rate. Urinary cytology and cystoscopy are performed every 3 months for 2 years, every 6 months for the next 2 years and then every year.

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