Bladder Cancer

The risk of developing bladder cancer increases with age. It typically occurs more in individuals over the age of 55 and less in individuals under the age of 40. Additionally, bladder cancer is far more common in men than in women. In fact, men develop bladder cancer at about four times the rate of women.  

People who smoke or have a history of heavy smoking develop bladder cancer at more than three times the rate of those who don't smoke or use tobacco products.

People who work with certain industrial chemicals or in environments where harmful substances are present may be at greater risk. Radon and asbestos are two of the known chemical substances known to cause cancer in humans. If you’ve received prior radiation therapy or chemotherapy, you may also be at greater risk—especially if you’ve received radiation directly to the pelvic area or had sustained use of chemo.

If you have a history of developing bladder infections, bladder stones, kidney stones or have prolonged bladder irritation, you may be at greater risk of developing bladder cancer. Additionally, having cancer in any area of the urinary tract can increase your chances of developing cancer again. In fact, bladder cancer has a very high recurrence rate.

Having Cowden syndrome, Lynch syndrome or other genetic syndromes can increase your risk of developing bladder cancer at some point in your lifetime. 

One of the most common ways to check for bladder cancer is through a test known as a cystoscopy. This procedure may be used to remove tissue samples from the bladder or to remove tumors from the surface of the bladder wall.

During this test, medicines known as porphyrins are inserted into the bladder. These drugs are then absorbed by cancer cells, which causes them to glow beneath a blue light. This process allows your Mercy doctor to pinpoint cancer cells in the bladder that may have been missed during the routine white light cystoscopy.

A urinalysis is a simple test that checks for blood and other substances in the urine. Usually, when blood is found in the urine, it’s a sign of less severe problems, such as an infection. A urinalysis can detect changes to the urine untraceable to the human eye, which may catch harmful diseases, such as bladder cancer, in their early stages.

X-rays and CT scans are two examples of imaging tests your Mercy doctor may recommend to see if your bladder cancer has spread to other parts of the body. Images may be taken of your upper or lower urinary tract, which includes your kidneys, ureters and urethra. Based on the results of the test, a biopsy may be needed to confirm any findings. 

Depending on the stage of your bladder cancer, surgical cancer treatments may be the first option. Surgical treatments for bladder cancer include transurethral resection (TURBT), cystectomy and bladder reconstruction surgery.
 

Transurethral Resection of Bladder Tumor (TURBT)

Minimally invasive by nature, a TURBT is a procedure that kills cancer cells by using an electric current or laser. During a TURBT, a thin cystoscope also known as a resectoscope is put through your urethra into your bladder. The resectoscope removes any abnormal tissues or tumors. Since TURBT requires no incisions, it’s usually performed as an outpatient procedure.

Most people who have bladder cancer only need TURBT treatment. Once the cancer is removed, patients will need occasional cystoscopy exams to make sure the tumor has not returned.
 

Cystectomy

Commonly used for more advanced bladder cancers, a cystectomy is a surgical procedure that involves the removal of part or all of the bladder.

• Partial cystectomy - a partial cystectomy. removes only the infected part of your bladder.
• Radical cystectomy - a radical cystectomy removes your entire bladder. If your bladder is removed completely, your doctor will also perform a type of surgery called urinary diversion. This allows urine to leave your body through a replacement bladder or an opening made in the abdominal wall.

Treatment for Bladder Cancer in Men

Men who need to have a radical cystectomy will usually have their prostate and seminal vesicles removed. This means they’ll no longer be able to produce the fluid needed to make semen. If you’re concerned about having children after your surgery, talk to your Mercy physician about your options.

Treatment for Bladder Cancer in Women

Women who undergo a radical cystectomy may also have their ovaries and uterus removed. Given the average age of menopause onset, treatment is much less likely to impact female fertility, since bladder cancer typically occurs in people over 55. However, if you're a woman who develops bladder cancer before menopause onset and you want to have children, talk to your Mercy doctor about what treatment options are available.

Your Mercy doctor may recommend radiation therapy before surgery to shrink your tumor or after surgery to eliminate any remaining cancer cells. Radiotherapy is also recommended for patients who are not candidates for surgery. You’ll want to review the possible side effects with your Mercy doctor before deciding if radiation therapy is right for you. 

Bladder cancer treatment plans may include chemotherapy if your cancer has spread to the lymph nodes or other distant parts of your body. It also may be used in combination with surgery and radiation therapy to increase effectiveness. In some cases, flushing the bladder with chemo drugs after the surgical removal of tumor(s) may reduce the risk of cancer recurring. Chemotherapy drugs can be delivered directly into the bladder, given in pill form or administered with an IV.

Also known as biological therapy, immunotherapy is the use of certain drugs that allow a person’s immune system to recognize and fight cancer cells in the body. Currently, BCG is the most effective biologic drug used to treat bladder cancer and prevent it from returning. Bacillus Calmette-Guérin (BCG) is a type of bacteria closely related to the one that causes tuberculosis. The BCG vaccine is a live bacteria instilled into the bladder. Designed to recruit immune cells, it attacks harmful cancer cells.