Bladder Cancer Diagnosis and Treatment

By Vladimir Kakitelashvili, MD, PhD

It has been estimated that approximately 49,000 new cases of bladder cancer are reported annually in the United States. There are a number of risk factors that have been associated with bladder cancer, including cigarette smoking and chronic exposure to certain industrial chemicals and dyes.

Signs and Symptoms

Most frequently, the initial symptoms of bladder cancer are blood in the urine, a burning sensation when urinating, or a feeling of having to urinate often. It is important to note that these symptoms can also be characteristic of a urinary tract infection.

The most frequently seen tumors are called superficial transitional cell tumors that occur on the lining of the bladder.

There are two types of superficial transitional cell tumors

Papillary tumors look like mushrooms with tiny stems that are attached to the lining of the bladder wall.

Carcinoma in situ (pronounced “in sigh-to”) are tumors that are flat and solid, without the telltale stem of the papillary tumor. They appear to be growing directly on the lining of the bladder wall.

After a careful evaluation, your doctor will classify your tumor and recommend the type of treatment that is appropriate for you.

How Is Bladder Cancer Diagnosed?

If there is blood in the urine, the first step is to determine whether it is caused by bladder cancer or another urinary tract condition, such as an infection. In addition to a physical examination, your doctor may want to perform a number of tests.

One of these, a urine culture, will determine whether or not the bleeding could be the result of an infection. If urine culture is negative, your doctor will look for the reasons you have blood in the urine (also known as hematuria). He will most likely order a CT scan and perform a cystoscopy.

How Is Bladder Cancer Treated?

Your doctor will make a decision about the best treatment for your condition based on the type of tumor, its location, and the stage of disease. Some of the treatments that your physician may consider are

Transurethral resection (also called TUR) is a procedure in which a thin tube (resectoscope) is inserted through the urethra and into the bladder to remove the tumor. TUR, which eliminates the need for an external incision, is sometimes followed by a special form of cancer treatment described below.

Intravesical therapy is a treatment in which an anti-cancer medication is placed directly into the bladder to eliminate your tumor(s) or prevent them from recurring or invading the deeper layers of your bladder wall.