Diagnosis Of Bladder Cancer
Along with the tests done if a bladder infection is suspected, a medical professional diagnosing bladder cancer will likely order or perform several more tests.
They may order a set of X-rays called an intravenous pyelogram, which lets them check the kidneys, ureters, and bladder for cancers.
Its also possible the medical professional would order a biopsy of the bladder during the cystoscopy exam. This biopsy removes a sample of the inner lining of the bladder in the area they think might be cancerous. The surgeon may even remove the entire tumor.
A specialist doctor called a pathologist then looks at the cells in the biopsy sample for signs of cancer.
Cancerous Tumours Of The Bladder
A cancerous tumour of the bladder can grow into nearby tissue and destroy it. It can also spread to other parts of the body. Cancerous tumours are also called malignant tumours.
Bladder cancer is often divided into 3 groups based on how much it has grown into the bladder wall.
- Non-invasive bladder cancer is only in the inner lining of the bladder .
- Nonmuscle-invasive bladder cancer has only grown into the connective tissue layer .
- Muscle-invasive bladder cancer has grown into the muscles deep within the bladder wall and sometimes into the fat that surrounds the bladder.
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Treatment Options For Invasive Cancer
When the bladder is removed, the urinary tract must be reconstructed to allow passage of the urine. This is called a urinary diversion. In a male the nerves responsible for the urge for erections run alongside the prostate, and a nerve-sparing operation can be done in order to preserve erectile function. When it is necessary to remove these nerves, a nerve graft can be performed to bridge the gap between the cut ends of the nerves. The nerve graft is harvested from the sural nerve, which is on the outside of the ankle and is commonly used for nerve graft procedures in other parts of the body.
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Evaluation For Metastatic Disease
Complete blood count, blood chemistry tests , liver function tests, chest radiography, and CT or magnetic resonance imaging of the abdomen and pelvis should be included in the metastatic workup for invasive bladder cancer.12 A bone scan may be performed if the alkaline phosphatase level is elevated or if symptoms suggesting bone metastasis are present.
Urinalysis Testing For Blood In Urine
Urinalysis can be used to test a patients urine sample for the presence of blood in the urine.1-3 The medical term for the symptom of blood in the urine is hematuria. Many patients diagnosed with bladder cancer have the symptom of blood in the urine that is easily visible, but in some patients the amount of blood is so small that it is not visible to the naked eye. Urinalysis can detect very small amounts of blood in the urine, which can sometimes help to diagnose bladder cancer at an earlier stage, if bladder cancer is present. Urinalysis can also be used to check the levels of other substances, such as sugar, protein, and white blood cells, in a patients urine.
Prognosis In Squamous Cell Carcinoma
Tumor stage, lymph node involvement, and tumor grade have been shown to be of independent prognostic value in SCC. However, pathologic stage is the most important prognostic factor. In one relatively large series of 154 cases, the overall 5-year survival rate was 56% for pT1 and 68% for pT2 tumors. However, the 5-year survival rate for pT3 and pT4 tumors was only 19%.
Several studies have demonstrated grading to be a significant morphologic parameter in SCC. In one series, 5-year survival rates for grade 1, 2, and 3 SCC was 62%, 52%, and 35%, respectively. In the same study of patients undergoing cystectomy, the investigators suggested that a higher number of newly formed blood vessels predicts unfavorable disease outcome.
In SCC, the survival rate appears to be better with radical surgery than with radiation therapy and/or chemotherapy. In locally advanced tumors, however, neoadjuvant radiation improves the outcome. Sex and age have not been prognostically significant in SCC.
Naproxen Decreases Viability And Inhibits Anchorage
Next, we determined whether naproxen could affect viability and anchorage-independent growth of UM-UC-5 and UM-UC-14 bladder cancer cells. Naproxen was found to significantly decrease viability of both UM-UC-5 and UM-UC-14 cells. We also measured anchorage-independent cell growth using a soft agar assay and naproxen inhibited growth of UM-UC-5 and UM-UC-14 cell in soft agar.
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Evaluation Of Upper Urinary Tract
Additional workup for all patients with bladder cancer includes evaluation of the upper urinary tract with intravenous urography , renal ultrasonography, computed tomography urography, or magnetic resonance urography.21,22 Renal ultrasonography alone is insufficient to complete the evaluation of hematuria in a patient with bladder cancer because it cannot delineate details of the urinary collecting system. Traditional IVU has been largely replaced by CT urography because of increased detail and data combined in the CT .
For patients unable to undergo contrast injection , magnetic resonance urography may be used to evaluate the upper urinary tract. These tests are useful for disease staging and excluding other causes of hematuria. Pelvic imaging should be performed before transurethral resection to improve staging accuracy because postoperative inflammation mimics the appearance of tumor infiltration.21 Pelvic imaging also may detect synchronous upper tract urothelial cancer, which can occur in 5 percent of patients with bladder cancer.22
Treating Bladder Cancer That Progresses Or Recurs
If cancer continues to grow during treatment or comes back after treatment , treatment options will depend on where and how much the cancer has spread, what treatments have already been used, and the patient’s overall health and desire for more treatment. Its important to understand the goal of any further treatment if its to try to cure the cancer, to slow its growth, or to help relieve symptoms as well as the likely benefits and risks.
For instance, non-invasive bladder cancer often comes back in the bladder. The new cancer may be found either in the same place as the original cancer or in other parts of the bladder. These tumors are often treated the same way as the first tumor. But if the cancer keeps coming back, a cystectomy may be needed. For some non-invasive tumors that keep growing even with BCG treatment, and where a cystectomy is not an option, immunotherapy with pembrolizumab might be recommended.
Cancers that recur in distant parts of the body can be harder to remove with surgery, so other treatments, such as chemotherapy, immunotherapy, targeted therapy, or radiation therapy, might be needed. For more on dealing with a recurrence, see Understanding Recurrence.
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Treatment Of Stage I Bladder Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stage I bladder cancer may include the following:
- Transurethral resection with fulguration. This may be followed by one of the following:
- Intravesicalchemotherapy given right after surgery.
- Intravesical chemotherapy given right after surgery and then regular treatments with intravesical BCG or intravesical chemotherapy.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Signs Of Bladder Cancer: What Women Should Know
Bladder cancer may not be on your radar even if youre vigilant about getting routine GYN care. After all, its far more common among men than women, and the majority of cases affect patients over age 65. However, dont let those stats keep you from learning to spot the warning signs.
While bladder cancer isnt one of the most common cancers in women, about 18,000 women are diagnosed with bladder cancer every year in the United States . The Bladder Cancer Advocacy Network reports that women are more likely to be diagnosed with bladder cancer at an advanced stage because they may not be on the lookout for early signs.
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Large Or Visible Hematuria
Large or visible hematuria is also called gross hematuria. They may appear pink, red, or brown in the toilet. When visible, the color varies depending on:
- Amount of blood in the urine
- Length of time blood has been in the urine
- Urine level of acidity
When blood is visible in the urine, you should contact your doctor.2
When urinating, I bled like crazy.
Toilet full of blood.
What Is Bladder Cancer
Bladder cancer starts when cells that make up the urinary bladder start to grow out of control. As more cancer cells develop, they can form a tumor and, with time, spread to other parts of the body.
The bladder is a hollow organ in the lower pelvis. It has flexible, muscular walls that can stretch to hold urine and squeeze to send it out of the body. The bladder’s main job is to store urine. Urine is liquid waste made by the 2 kidneys and then carried to the bladder through 2 tubes called ureters. When you urinate, the muscles in the bladder contract, and urine is forced out of the bladder through a tube called the urethra.
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Treating Stage Iv Bladder Cancer
These cancers have reached the pelvic or abdominal wall , may have spread to nearby lymph nodes , and/or have spread to distant parts of the body . Stage IV cancers are very hard to get rid of completely.
Chemotherapy is usually the first treatment if the cancer has not spread to distant parts of the body . The tumor is then rechecked. If it appears to be gone, chemo with or without radiation or cystectomy are options. If there are still signs of cancer in the bladder, chemo with or without radiation, changing to another kind of chemo, trying an immunotherapy drug, or cystectomy may be recommended.
Chemo is typically the first treatment when bladder cancer has spread to distant parts of the body . After this treatment the cancer is rechecked. If it looks like it’s gone, a boost of radiation to the bladder may be given or cystectomy might be done. If there are still signs of cancer, options might include chemo, radiation, both at the same time, or immunotherapy.
In most cases surgery cant remove all of the cancer, so treatment is usually aimed at slowing the cancers growth and spread to help people live longer and feel better. If surgery is a treatment option, it’s important to understand the goal of the operation whether it’s to try to cure the cancer, to help a person live longer, or to help prevent or relieve symptoms from the cancer.
Because treatment is unlikely to cure these cancers, many experts recommend taking part in a clinical trial.
What Is Upper Tract Urothelial Carcinoma
While the majority of bladder cancers arise in the bladder, the urothelial cells that line the bladder are found in other locations in the urinary system. Sometimes these urothelial cancers can occur in the lining of the kidney or in the ureter that connects the kidney to the bladder. This is known as upper tract urothelial cancer correspond to a subset of urothelial cancers that arise in the urothelial cells in the lining of the kidney or the ureter . Learn more about UTUC on the BCAN website here.
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What Should I Do If I See Red
Blood in the urine is the most common symptom ofbladder cancer. Dont ignore this warning sign. Not even once.
It does not necessarily mean you have bladder cancer. Several conditions can cause blood in your urine . But its important to be checked by your doctor as soon as possible to seek treatment for whats causing the blood in the urine and to rule out bladder cancer as the cause.
Just because there is no pain, your condition may still be serious. Although the condition may be a bladder infection or urinary tract infection , be sure to ask your physician to do some tests to confirm that it is just an infection. If there is any doubt, ask for a referral to a urologist to investigate.
Early detection of bladder cancer is critical to receiving timely and effective treatment. It may save your life!
Why Does Bladder Cancer Cause Hematuria
Blood in the urine is a hemorrhaging of the tumor. When the blood vessels of a tumor rupture, that blood ends up in the urine. Early on, cancer blood vessels are delicate. Small tears occur easily. As a tumor grows and invades nearby tissues and blood vessels, this causes bleeding. Whether in small or large amounts, the blood exits through the urine.1,3
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How Do Healthcare Providers Diagnose Bladder Cancer
Healthcare providers do a series of tests to diagnose bladder cancer, including:
- Urinalysis: Providers use a variety of tests to analyze your pee. In this case, they may do urinalysis to rule out infection.
- Cytology: Providers examine cells under a microscope for signs of cancer.
- Cystoscopy: This is the primary test to identify and diagnose bladder cancer. For this test, providers use a pencil-sized lighted tube called a cystoscope to view the inside of your bladder and urethra. They may use a fluorescent dye and a special blue light that makes it easier to see cancer in your bladder. Providers may also take tissue samples while doing cystoscopies.
If urinalysis, cytology and cystoscopy results show you have bladder cancer, healthcare providers then do tests to learn more about the cancer, including:
Healthcare providers then use what they learn about the cancer to stage the disease. Staging cancer helps providers plan treatment and develop a potential prognosis or expected outcome.
Bladder cancer can be either early stage or invasive .
The stages range from TA to IV . In the earliest stages , the cancer is confined to the lining of your bladder or in the connective tissue just below the lining, but hasnt invaded the main muscle wall of your bladder.
Stages II to IV denote invasive cancer:
A more sophisticated and preferred staging system is TNM, which stands for tumor, node involvement and metastases. In this system:
Urine Culture Testing To Check For Utis
Urine culture testing can be used to check for urinary tract infections.1 The symptoms of bladder cancers and urinary tract infections can be quite similar, so it is important for healthcare providers check for both infection and cancer if either could be the cause. To carry out this test, the urine sample is left in a dish in the laboratory for several days, which allows any bacteria that may be contained in the urine to grow.
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Recovery Of Urinary Bladder Cancer In Cats
Whether you choose to seek treatment for your cats urinary bladder cancer or not, the overall prognosis for an affected cat is poor. Cats that have received treatment are estimated to live between six months to a year, whereas untreated cats often pass at four to six months.
Your veterinarian may prescribe an anti-inflammatory drug, such as pirioxicam, to relieve bladder pain and provide a better quality of life for your cat. Ask your veterinarian about the best recovery and management options for your cat, as each urinary bladder cancer case is different.
Transurethral Resection Of A Bladder Tumour
If abnormalities are found in your bladder during a cystoscopy, you should be offered an operation known as TURBT. This is so any abnormal areas of tissue can be removed and tested for cancer .
TURBT is carried out under general anaesthetic.
Sometimes, a sample of the muscle wall of your bladder is also taken to check whether the cancer has spread, but this may be a separate operation within 6 weeks of the first biopsy.
You should also be offered a dose of chemotherapy after the operation. This may help to prevent the bladder cancer returning if the removed cells are found to be cancerous.
See treating bladder cancer for more information about the TURBT procedure
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When Should I Reach Out To My Doctor About Frequent Urination
Because the conditions behind frequent urination can range wildly from casual to severe, you should speak to your doctor about anything outside of your typical urination patterns. In some cases, frequent urination may be just an annoying symptom that will end when you cut back on the caffeineor have the baby. However, if you are unsure why youre urinating so frequently, it is best to set up an appointment and talk about it. This is a symptom that can often be treated and isnt something that you need to just deal with.
There are a few signs to keep an eye out for and call your doctor immediately if you have them with frequent urination. These include:
- If you have a fever.
- If you are vomiting.
In Vivo Treatment With Naproxen
OH-BBN was used to induce urinary bladder tumors as previously described . When a control OH-BBN-treated rat developed a palpable bladder tumor, the rat was treated with naproxen for 5 days. At the end of this time, animals were sacrificed and the bladder tumors were quickly removed and divided so that roughly half of each tumor was snap frozen in liquid nitrogen and the other half was fixed for immunohistochemistry or immunofluorescence. This pre-surgical approach to examining biomarkers has previously been used by us to examine the effects of gefitinib on these types of tumors .
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