9 Things Doctors Want You to Know About Bladder Cancer

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Jennifer Nelson on April 9, 2021
  • Woman with doctor
    Spreading the Word About Bladder Cancer
    Bladder cancer doesn’t get the same publicity as some other more high-profile cancers, but it’s no less serious. Three doctors who diagnose and treat bladder cancer share what they want patients (and everyone else) to know about this disease.
  • Man smoking
    1. “Smoking is the number one risk factor for bladder cancer.”
    Many people know smoking is linked to lung cancer, but they may not be aware it’s also the leading risk factor for bladder cancer. Although stopping smoking decreases your chances of bladder cancer (as well as other cancers), the risk persists for up to 20 years after you stop. “We measure smoking in pack years. Number of packs you smoke and how many years you smoked, says Alex Shteynshlyuger, MD, director of urology at New York Urology Specialists. “The greater the number, the greater the risk.” But not everyone who gets bladder cancer is a smoker. About 30% of bladder cancer patients never smoked.
  • Male friends
    2. “There are a few other risks for bladder cancer.”
    “In different parts of the United States, the risk is different and that has to do with environmental factors,” says Dr. Shteynshlyuger. Some areas of the U.S. have a higher risk due to heavy radon, a radioactive gas found in the ground. Certain chemicals may also predispose you, such as those in dye factories. People who have had radiation therapy are at a higher risk. And finally, men and adults over age 45 are at greater risk for bladder cancer.
  • Stomach exam
    3. “Don’t ignore the early symptoms of bladder cancer.”
    Signs of bladder cancer include any changes in urinary habits, like blood in the urine, frequent urination, or urinary urgency. Some people also have pelvic pain. “Bladder cancer is one of the cancers that is often misdiagnosed or has a late diagnosis,” says Dr. Shteynshlyuger. One reason is its symptoms mimic other medical problems such as urinary tract infections (UTI), kidney and bladder stones, and an overactive bladder. “Anyone with blood in their urine should be evaluated by a urologist,” says Dr. Shteynshlyuger.
  • doctor-looking-at-liver-scan
    4. “We diagnose bladder cancer a variety of ways.”
    A urologist can find and diagnose bladder cancer by taking a good medical history and running tests like a urinalysis to check for blood in the urine. Doctors may also perform a cystoscopy, which uses a small camera to look inside the bladder. If anything’s abnormal, doctors will perform a biopsy to check for cancer in the bladder. If you receive a bladder cancer diagnosis, you may require additional scans. “Because the presence of bladder cancer is a sign that cancers may be present in other areas of the body—and particularly in the urinary system—the physician may want to do imaging tests, such as CT scan, MRI, ultrasound and X-ray,” says James Fagelson MD, FACS at Urology Associates in Denver.
  • Doctor and patient
    5. “Treatment is determined by the type of bladder cancer.”
    Bladder cancer is graded into types. Low-grade bladder cancer has a good outlook for treatment success. High-grade cancer has a higher likelihood of invading the bladder wall, making it more difficult to treat. Doctors also stage bladder cancer from 0 to IV. Stage 0 means the cancer hasn’t invaded the bladder wall. In stage IV, cancer has spread to lymph nodes or other parts of the body. The good news: About 85% of diagnosed bladder cancers are low-grade. “Essentially nobody with low-grade, superficial bladder cancer dies from it,” says Matt Johnson, MD, at Aurora Health Care in Milwaukee. “That’s why it’s very important to diagnose the disease early and treat it promptly.”
  • Surgery
    6. “There are many treatments for low-grade bladder cancer.”
    The treatment for low-grade bladder cancer is typically the surgical removal of the tumor. Doctors perform this surgery as an outpatient procedure, using a small camera through the urethra. Chemotherapy before or after surgery or immunotherapy can also help the body attack the cancer. Patients may also receive radiation with or without surgery. “The good news is most bladder cancers are low risk, which means removing them surgically can cure the disease, says Dr. Shteynshlyuger. “However, there is a very high chance of the tumor coming back either in the same spot or a different spot in the bladder or kidneys.” Following treatment, it’s important that patients are monitored every three months initially, then six months, then once a year after having had bladder cancer.
  • Surgeon talking to team of doctors
    7. “Treating high-grade bladder cancer is a little more challenging.”
    The other 15% of men and women who have high-grade bladder cancer require more aggressive therapy. This includes cystectomy, removing all or part of the bladder. A partial cystectomy removes the part of the bladder where the cancer has penetrated the muscle. A radical cystectomy removes the entire bladder and surrounding lymph nodes. “Radical cystectomy for men includes removal of the prostate, and radical cystectomy for women often includes removal of the ovaries, the uterus, the fallopian tubes and a section of the vagina,” says Dr. Fagelson. Surgery can be done conventionally through an abdominal incision or sometimes laparoscopically using special instruments through a small incision.
  • Medicine pointing at bladder
    8. “Doctors can reconstruct the bladder.”
    Reconstructive surgery is required after the removal of the bladder. There are several types of bladder reconstruction, including receiving a completely new bladder called a neobladder, created from a section of the bowel. Patients can have mostly normal urination afterward. “We can do it with the da Vinci Robot, which is a robotic approach and very advanced laparoscopic technique to remove the bladder and to create a solution for urinary diversion,” says Dr. Johnson.
  • Despondent man
    9. “Unfortunately, bladder cancer can recur.”
    Although it can often be treated, bladder cancer does have a high recurrence rate. Part of treatment, even for low-grade bladder cancer, includes frequent follow-ups with your urologist or oncologist. “Bladder cancer is one of the most expensive diseases to treat,” says Dr. Shteynshlyuger. “Part of it is because while these cancers are well treated, they keep coming back. So patients need a lot of surveillance, follow-ups and interventions.” The good news is advances in surgical treatment over the last 10 years have led to better success rates and easier recoveries for many patients.
9 Things Doctors Want You to Know About Bladder Cancer
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Last Review Date: 2021 Apr 9
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