It stores and gets rid of urine
Bladder cancer begins when cells inside the bladder change and grow out of control. Each year, almost 3,100 Americans find out they have bladder cancer. Most people diagnosed with bladder cancer are 60 years or older, but it can occur at any age.
About 1 in every 140 males will be diagnosed with bladder cancer before age 75, making it one of the 10 most common cancers in males.
Sometimes bladder cancer doesn’t have many symptoms
Signs or symptoms can include:
- not being able to pass urine when you need to. Less commonly
- people may have pain in one side of their lower abdomen (belly) or back. They may also lose their appetite
- lose weight
Not everyone with these symptoms has bladder cancer
If you have any of these symptoms or are worried, always see your doctor. There are some things that can make you more likely to develop bladder cancer. These are called risk factors and they include: – people who smoke are up to 3 times more likely than non-smokers to develop bladder cancer.
– about 90% of people diagnosed with bladder cancer in United States are aged over 60. – men are around 3 times more likely than women to develop bladder cancer. – chemicals called aromatic amines, benzene products and aniline dyes are linked to bladder cancer.
These chemicals are used in rubber and plastics manufacturing, in the dye industry, and sometimes in the work of painters, machinists, printers, hairdressers, firefighters and truck drivers. – one of the rarer types of bladder cancer (squamous cell carcinoma of the bladder) has been linked to a parasitic bladder infection called schistosomiasis.
This is very rare in people born in United States; it is caused by a parasite found in fresh water in Africa, Asia, South America and the Caribbean.
The diabetes drug pioglitazone can increase the risk of bladder cancer. – most people with bladder cancer do not have a family history.
However, having one or more close blood relatives diagnosed with bladder cancer, or having inherited a gene linked to bladder cancer, slightly increases the risk of bladder cancer.
Having these risk factors doesn’t mean you will develop bladder cancer. Often there is no clear reason for getting bladder cancer.
If you are worried about your risk factors, ask your doctor for advice
Your doctor may do some tests to check for bladder cancer: – scans that take pictures of the inside of the body, sometimes also called a CT-IVP or a triple phase abdominal-pelvic CT scan – the doctor performs a cystoscopy and removes or destroys the tumour. Your doctor might ask you to have further tests.
These can include: – a scan that uses an injection of liquid to show cancer cells.
Bladder cancer can be described based on where it is found: – the cancer has spread to other layers of the bladder, muscle or other parts of the body.
There are 3 main types of bladder cancer: about 1% of all bladder cancers
It is more likely to be invasive (spread).
There are other, less common types of bladder cancer.
Treatment for these may be different
Speak to your doctor or nurse for information about these types of cancer. Stages and grades of cancer describe how far it has spread and how quickly it is growing. The stage of a cancer means how far it has grown in your body.
The most common way doctors decide on a stage for bladder cancer is the TNM system (tumour, nodes metastasis). This system describes: if the cancer has spread to other parts of the body. Some doctors put the TNM scores together to produce an overall stage, from stage 1 (earliest stage) to stage 4 (most advanced).
Ask your doctor or nurse to explain the stage of the cancer. The grade of the cancer means how quickly a cancer might grow. Knowing the grade helps your doctors work out the best treatment plan for you: – the cancer cells look very abnormal and grow quickly.
They are more likely to spread
Almost all muscle-invasive cancers are high grade. Note: ‘Bladder carcinoma in situ’ is a specific type of bladder cancer.
It is an early stage cancer but is always high grade
This means it can grow quickly and might spread.
If you have bladder carcinoma in situ your doctor will start treatment straight away. Treatment for this type of bladder cancer can be very effective.
Your treatment team can tell you more
When someone is diagnosed with bladder cancer, their doctor will give them a ‘prognosis’. A prognosis is the doctor’s opinion of how likely the cancer will spread and the chances of getting better. A prognosis depends on the type and stage of cancer, as well as the person’s age and general health.
Bladder cancer can usually be effectively treated if it is found before it spreads outside the bladder. If you have bladder cancer, your doctor will talk to you about your individual situation when working out your prognosis.
Every person’s experience is different, and there is support available to you
Treatment for bladder cancer depends on how quickly the cancer is growing. Treatment is different for non-muscle invasive bladder cancer and muscle-invasive bladder cancer.
You might feel confused or unsure about your treatment options and decisions
It’s okay to ask your treatment team to explain the information to you more than once. It’s often okay to take some time to think about your decisions.
When deciding on treatment for bladder cancer, you may want to discuss your options with a urologist, radiation oncologist and medical oncologist.
Ask your GP for referrals.
Treatments for superficial bladder cancer include: chemotherapy
Most people with superficial bladder cancer have an operation to remove the cancer. The most common operation is called TURBT (transurethral resection of bladder tumour). Sometimes you might need to have a second TURBT or a different surgery.
For some people bladder cancer can come back after surgery. You will need to have regular follow-up tests.
This way you can start appropriate treatment if the cancer comes back
This treatment uses medication to destroy or slow the growth of cancer cells, while causing the least possible damage to healthy cells.
Intravesical chemotherapy goes directly into the bladder through a tube called a catheter. It is only used for non-muscle-invasive bladder cancer to help keep the cancer from coming back. You may have one dose or more than one dose, depending on your situation.
Immunotherapy for bladder cancer uses a treatment called Bacillus Calmette-Guérin (BCG) to stop or slow down the cancer. Because this immunotherapy goes directly into the bladder through a tube (catheter) it is called intravesical immunotherapy.
A combination of BCG and TURBT is most effective. BCG is given once a week for 6 weeks, starting 2–4 weeks after TURBT surgery. It is put directly into the bladder through a catheter.
This may happen in a hospital or clinic
The treatment may have to be repeated depending on your response
When bladder cancer has invaded the muscle layer, the main treatment options are:
- surgery to remove the whole bladder (cystectomy)
- sometimes with chemotherapy given before or after the surgery bladder-conserving surgery (TURBT)
- followed by radiation therapy with or without chemotherapy (trimodal therapy)
Some people with muscle-invasive disease have surgery to remove the bladder (cystectomy).
The surgeon usually needs to remove the whole bladder (radical cystectomy). For muscle-invasive bladder cancer, chemotherapy is injected into a vein.
This is called systemic chemotherapy
You may have chemotherapy: to treat bladder cancer that has spread to other parts of the body. Chemotherapy is given as a course, at regular intervals for several months. Radiation therapy uses a controlled dose of radiation to kill or damage cancer cells.
The radiation is usually in the form of x-ray beams. Radiation therapy to treat bladder cancer is used as part of trimodal therapy, either on its own or combined with chemotherapy.
You may have trimodal therapy as the main treatment for muscle-invasive tumours
Trimodal therapy may be used if a person is unable to have surgery to remove the bladder or would prefer to keep their bladder. It is most suited for people whose bladder is working well and smaller tumours that haven’t spread. Trimodal therapy involves: radiation therapy combined with chemotherapy (chemoradiation).
The chemotherapy makes the cancer cells more sensitive to radiation. Some people who are not fit enough for chemotherapy will have radiation therapy on its own. Talk to your medical team about whether trimodal therapy may be an option in your situation.
If bladder cancer has spread to other parts of the body, it is known as advanced or metastatic bladder cancer. You may be offered one or a combination of the following treatments to help control the cancer and ease symptoms: radiation therapy. Immunotherapy uses the body’s own immune system to fight cancer.
BCG is a type of immunotherapy treatment that has been used for many years to treat superficial bladder cancer. A new group of immunotherapy drugs called checkpoint inhibitors work by helping the immune system to recognise and attack the cancer.
After a course of chemotherapy, some people with advanced bladder cancer may have immunotherapy with checkpoint inhibitor drugs such as pembrolizumab or avelumab.
These drugs are given directly into a vein through a drip (infusion) and the treatment is repeated every 2–6 weeks.
How many infusions you receive will depend on how you respond to the drug.
All cancer treatments can have side effects
Your treatment team will discuss these with you before you start treatment. Talk to your doctor or nurse about any side effects you are experiencing. Some side effects can be upsetting and difficult, but there is help if you need it.
Talk with your doctors about whether you need to do anything to prepare for treatment and help your recovery. Some things they may suggest are to: – if you smoke, aim to quit before starting treatment.
If you keep smoking, you may not respond as well to treatment and you may have more treatment-related side effects. Continuing to smoke also increases your risk of cancer returning. – exercise will help build up your strength for treatment and recovery.
It can also help you deal with side effects of treatment. – aim to eat a balanced diet with a variety of fruit, vegetables, wholegrains and protein.
Eating well can improve your strength and you may respond better to treatment
– they can teach you exercises to strengthen your pelvic floor muscles, which help control how your bladder and bowel work. These exercises are useful if you have a neobladder, a partial cystectomy, or radiation therapy. – you may find it useful to talk to a psychologist or counsellor about how you are feeling.
This can help you deal with any anxiety about having surgery and any longer term changes after treatment.
If you have had your bladder removed, the way you pass urine will change. There are several options that your treatment team will talk to you about: Urostomy (sometimes called an ileal conduit) is where doctors create a new hole in your abdomen called a stoma.
Urine drains from the stoma to the outside of your abdomen into a special bag. Neobladder is where a new bladder made from your small bowel forms a pouch inside your body to store urine. You will pass urine by squeezing your abdominal muscles.
You will also pass a small tube (catheter) into the neobladder (pouch) each day to help drain the urine. Continent urinary diversion is a pouch made from your small bowel inside your body to store urine. The urine empties through a hole called a stoma to the outside of your abdomen into a special bag.
A bladder reconstruction is a big change in your life. You can speak with a continence or stomal therapy nurse for help, support and information. You can also call (Tel. You may be able to speak with a trained Cancer Council volunteer who has had cancer for tips and support.
If you find it difficult to adjust after your bladder reconstruction, it may help to be referred to a psychologist or counsellor. Note: If you have a stoma, you can join a stoma association for support and free supplies. For more information about stoma associations, visit the.
These changes can be very upsetting and hard to talk about.
Doctors and nurses are very understanding and can give you support
You can ask for a referral to a counsellor or therapist who specialises in body image, sex and relationships.
Changes for women after a cystectomy may include vaginal changes such as narrowing, shortening or dryness, changes to sexual arousal and the ability to orgasm, changes.
If you may want to have children in the future, talk to your treatment team
Advanced cancer usually means cancer that is unlikely to be cured.
Some people can live for many months or years with advanced cancer.
During this time palliative care services can help
Most people continue to have treatment for advanced cancer as part of palliative care, as it helps manage the cancer and improve their day-to-day lives. Many people think that palliative care is for people who are dying but palliative care is for any stage of advanced cancer. There are doctors, nurses and other people who specialise in palliative care.
Treatment may include chemotherapy, radiation therapy or another type of treatment. It can help in these ways: help you to live more comfortably by managing symptoms, like pain. Treatment depends on: your preferences and what you want to do.
Caring for someone with cancer can be difficult sometimes.
If you are caring for someone with bladder cancer, these organisations can help: Tel. – helps people affected by cancer find the information, resources and support services they may need following a diagnosis of cancer Tel.
The bladder The bladder is part of the body’s urinary system Signs and symptoms of bladder cancer blood in your urine needing to urinate often or urgently pain or burning when passing urine Risk factors for bladder cancer Smoking Age Being male Chemical exposure at work Parasitic bladder infections Long-term catheter use – Previous cancer treatments – some types of radiation therapy around the pelvis, and the chemotherapy drug cyclophosphamide Diabetes treatment – Personal or family history Tests for bladder cancer internal examination – the doctor may check inside your bottom or vagina with their finger, using gloves urine tests – your urine will be checked for signs of bladder cancer blood tests – to check your general health ultrasound – a scan on the outside of your abdomen to check for cancer CT scan and x-rays MRI scan – a scan that uses magnetism and radio waves to take pictures of the inside of the body cystoscopy – the doctor puts a small camera into your bladder to see inside biopsy – the doctor takes a small sample of the cells from the bladder to check for signs of cancer Transurethral resection of bladder tumour (TURBT) bone scan – a scan that uses dye to show changes in your bones PET-CT scan Types of bladder cancer superficial (non-muscle invasive) – the cancer has not spread to other layers of the bladder or muscle muscle-invasive urothelial carcinoma – 80 to 90% of bladder cancers – sometimes called transitional cell carcinoma squamous cell carcinoma – 1 to 2% of all bladder cancers.
It is more likely to be invasive (spread) adenocarcinoma – Stages and grades of bladder cancer Stages how far the tumour has grown into the wall of the bladder and nearby tissues if the cancer has spread to nearby lymph nodes You can also read more from the Cancer Council about the TNM system and staging Grades low grade – the cancer cells are usually slow-growing.
Most bladder tumours are low grade high grade Prognosis and survival rates for bladder cancer Treatment for bladder cancer Treatment for superficial bladder cancer surgery immunotherapy Surgery Chemotherapy Immunotherapy Immunotherapy uses your own immune system Treatment for muscle-invasive bladder cancer Surgery (cystectomy) Systemic chemotherapy before surgery, to shrink the cancer and make it easier to remove (neoadjuvant chemotherapy) after surgery, if there is a high risk of the cancer coming back (adjuvant chemotherapy) with radiation therapy (chemoradiation) and surgery as part of trimodal therapy Radiation therapy Trimodal therapy a shorter surgery to remove the tumour from the bladder (TURBT), followed by Treatment for advanced bladder cancer systemic chemotherapy immunotherapy surgery Side effects of treatment for bladder cancer Call Cancer Council 13 11 20 13 14 50 for an interpreter) or contact cancer support What to do before and after treatment Stop smoking Begin or continue an exercise program Improve diet See a physiotherapist Talk to someone Bladder reconstructions and stomas Cancer Council 13 11 20 American Council of Stoma Associations Sexuality, fertility and bladder cancer Having bladder cancer and treatment can change the way you feel about yourself, other people, relationships and sex Changes for men after a cystectomy may include damaged nerves to the penis, orgasm changes and fertility menopause and fertility Living with advanced cancer slow down how fast the cancer is growing shrink the cancer where the cancer started how far it has spread your general health Ask your doctor about treatment and palliative care services Support for carers, family and friends Cancer Council 13 11 20 Carer Gateway 1800 422 737 Carers United States 1800 514 845 Where to get help Your GP (doctor) Your treatment team Urologist Oncologist Cancer Council Michigan 13 11 20 Information and support line 13 11 20 (or 13 14 50 for an interpreter ) Bladder cancer Cancer Council Michigan, My Cancer Guide Find support services that are right for you.
WeCan website Continence Foundation of United States 1800 330 066 NURSE-ON-CALL (616) 555-0024.
Key Points
- Sometimes bladder cancer doesn’t have many symptoms
- Signs or symptoms can include: not being able to pass urine when you need to
- Less commonly, people may have pain in one side of their lower abdomen (belly) or back
- Not everyone with these symptoms has bladder cancer
- If you have any of these symptoms or are worried, always see your doctor