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Bladder Cancer

A bladder tumor is when abnormal cells grow on or through the bladder wall. These tumors can be benign (noncancerous) or malignant (cancerous).

Typically, early bladder cancer has few symptoms. The most common symptom is hematuria (blood in your urine that may be only visible by microscope). Other possible symptoms include:

  • Abdominal or pelvic pain
  • Fatigue
  • Painful urination
  • Urinary frequency oand/or urgency
  • Urine leakage (incontinence)
  • Weight loss

All these symptoms may be related to other medical diagnoses as well, so visit your doctor if you have any of these symptoms.

Most people diagnosed with bladder cancer are more than 70 years old. More than nine out of ten Americans with bladder cancer have a type called transitional cell cancer (TCC). This cancer begins in the innermost tissue layers of the bladder. The cancer cells can stretch and shrink when the bladder is full or empty. It can also be called Urothelial Carcinoma.

Available treatments at Memorial

The treatment of bladder cancer depends on the grade and stage of the cancer cells. You will have tests and may have a biopsy. Your provider will recommend the best treatment plan for you after he or she reviews your results and looks at our medical history.

Intravesicle Therapy

This treatment is given for superficial bladder cancers once a week for six weeks. A liquid that contains weakened bacteria called BCG (Bacillus Calmette-Guérin) is instilled into the bladder by a urethral catheter. This bacteria helps the body’s natural defenses kill the cancer cells in the bladder and prevents them from coming back.

Bladder chemotherapy can be administered directly into the bladder by a urethral catheter. This works directly on the tissues to kill the cancer cells.

Surgery

Surgery is an option for most people with bladder cancer. Below is a listing of surgical treatments per the National Cancer Institute with details about each of them.

Transurethral Resection (TUR)

The doctor uses a cystoscope to treat early bladder cancer (Stage 0 or Stage 1). No cut into your body is needed, but general anesthesia is usually given. The doctor inserts the cystoscope into the bladder through your urethra. The cutting tool is slipped through the cystoscope. A small wire loop at the end of the tool removes the cancer and burns away remaining cancer cells with an electric current.

TUR may need to be repeated. Also, bladder-instilled chemotherapy or biological therapy may be given after this type of surgery. For a few days after TUR, you may have some blood in your urine and difficulty or pain when passing urine. Otherwise, TUR generally causes few problems.

Open surgery

The surgeon makes an incision into your body to remove the cancer from your bladder.

Part of the bladder (called a partial cystectomy)

For some people with a single, small tumor in the bladder, the surgeon does not remove the entire bladder. The surgeon removes the tumor, the part of the bladder containing the tumor, and nearby lymph nodes. After part of the bladder is removed, you may not be able to hold as much urine in your bladder as before surgery. You may need to empty your bladder more often. This problem usually gets better with time.

All of the bladder (called a radical cystectomy)

For bladder cancer that has invaded the muscle layer (Stage 2 or some Stage 3), the most common type of surgery is radical cystectomy. The surgeon removes the entire bladder, nearby lymph nodes, and part of the urethra.

In addition, the surgeon usually removes the prostate from a man and may remove the uterus and ovaries from a woman. Other nearby tissues may also be removed. When the entire bladder is removed, the surgeon makes another way for urine to be collected from the kidneys and stored. You may wear a flat bag outside the body under your clothes, or the surgeon may use part of your intestine to create a pouch inside the body. Another option is a neo-bladder, or portion of your intestine that is reconfigured to create a new bladder that is reattached to your ureters and urethra in an attempt to restore a more normal urinary function. 

Robot-assisted Laparoscopic Cystectomy

This procedure spares vital nerves and muscle tissue. An alternative way for urine to be collected from the kidneys is created. Learn about robot-assisted laparoscopic cystectomy.

Radiation Therapy

Radiation Therapy can sometimes be used with intravenous chemotherapy in patients with invasive cancer. It uses high-energy beams to shrink or kill the cancer cells. Internal or external radiation or a combination may be used to treat the cancer cells. Learn more about radiation therapy at the Regional Cancer Center at Memorial.

Chemotherapy

Chemotherapy is where one or more drugs kill the cancer cells, either through injection into the urethra and bladder (intravesical) or by absorption into the blood by taking a pill or having it delivered into a vein (intravenous). Intravenous is usually used to prepare for surgery, or when the cancer has spread beyond the bladder.