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Bladder Cancer

The bladder is a hollow organ in the pelvis with flexible, muscular walls. Its main function is to store urine before it leaves the body. Urine is made by the kidneys. From the kidneys, it is carried to the bladder through tubes called ureters; then it is excreted through the urethra. The bladder has four main layers. The transitional or urethelium is the innermost layer. The laminia propria is beneath the urethrlum and is comprised of a thin layer of connective tissue, blood vessels and nerves. Next is the muscularis propria, which is a thick layer of muscle. Outside of this muscle, a layer of fatty connective tissue separates the bladder from other nearby organs. Ninety-five percent of bladder cancers occur in the transitional layer. When cancers are non-invasive, they have occurred only in the transitional layer. When they have grown beyond the transitional layer, they are considered invasive.

Symptoms:

A lot of patients with bladder cancer have no obvious symptoms. Blood in the urine is the main symptom. Sometimes the blood is visible but most of the time it is not visible and only seen on the microscope and is usually painless.

Risk Factors:

The following factors increase your risk for bladder cancer: 

  • Cigarette smoking: Estimated to cause 50% of bladder cancers
  • Exposure to inductrial chemicals
  • Chronic bladder inflammation
  • Chemotherapy or radiation therapy for other cancers
  • Men are at higher risk than women
  • Family history

Evaluation & Diagnosis:

Once aware of the blood in the urine, your provider will do a thorough history and physical. Some of the tests s/he may do to evaluate whether cancer is present are:

  • Ultrasound of urinary tract
  • Urine cytology to check for cancer cells
  • Urine FISH: A test that checks for cancer DNA
  • Cystoscopy
  • CT scan and /or intravenous Pyelogram

Treatment:

Treatment depends on the stage of the disease, the type of cancer, the patient’s age and overall health. Your physician will develop a personalized treatment plan to meet your individual needs. Options include:

  • Transurethral Resection
  • Radical Cystectomy
  • Chemotherapy
  • Radiation
  • Immunotherapy