Urology Clinic / Urologic Oncology / Bladder Cancer

Bladder Cancer

Different forms of cancer can grow along the inside of the bladder. Bladder cancer can be superficial, meaning it stays only on the surface of the inside of the bladder, or invasive, meaning it grows deeper into the bladder or outside the bladder.

Bladder cancer is nearly three times more common in men than in women, and twice as common in Caucasians as in African Americans.

Vanderbilt is a leader in bladder cancer care through the use of advanced surgical techniques, cutting-edge technology and world-class research.

Bladder Cancer: Causes, Symptoms and Diagnosis

Causes

Cigarette smoking is the top risk factor for bladder cancer, doubling your risk. People who work in the textile, dye, rubber or leather industries are at higher risk of bladder cancer because of exposure to a class of chemicals called aromatic amines. People without any risk factors and at any age can develop bladder cancer.

Symptoms

The most common symptom of bladder cancer is blood in the urine, which can be painless, invisible, and can come and go. Other symptoms include having to urinate more often, increased urgency to urinate or painful urination. If you have one of these symptoms, its important to get medical attention.

Diagnosis

Bladder cancer is most often diagnosed by looking at cells in the urine under a microscope. Its confirmed by inspecting the bladder with a cystoscope, a thin tube with a lens and a light that can be threaded into the bladder. This is a quick procedure that can be performed in the clinic. If cancer is suspected, a doctor will take biopsies (samples of tissue) from the bladder. Once cancer is confirmed, a CT scan, chest x-ray,and blood work may also be done to see if the cancer has spread to other parts of the body.

About 75% of all bladder tumors are diagnosed while they are superficial, meaning still in the lining of the bladder. The five-year survival rate for this type of bladder cancer is over 90%. Although superficial bladder cancer tends to come back, most of the tumors that return are also superficial. Up to 20% of superficial tumors may become invasive and grow into the muscle layer of the bladder. These tumors are more likely to spread to other parts of the body and require more invasive treatment.

Bladder Cancer: Treatment

Treatment for bladder cancer depends on the stage of the disease at the time of diagnosis. At Vanderbilt, a team of experienced surgeons, medical oncologists and pathologists works together to create a custom care plan for each patient.

In superficial bladder cancer, the main treatment is usually minimally invasive surgery using cystoscopes and laser or electrical energy. In patients whose cancer may come back or spread, medication may be placed inside the bladder during treatment.

Surgery to remove the bladder is the most common treatment for invasive bladder cancer, although radiation and/or chemotherapy can be used as well to treat cancer that has spread outside the bladder.

Vanderbilt is one of the leading centers in the world for bladder removal surgery. Radical cystectomy (removal of the bladder) is performed frequently here, and our experience with this helps reduce complications, hospital stay and recovery time. We also are a world leader in neobladder technique, which creates a new bladder substitute and allows patients to urinate normally.

For patients who need surgery to remove the entire bladder, its almost always necessary to remove nearby lymph nodes and organs (prostate and seminal vesicles in men; uterus, fallopian tubes and ovaries in women) to help prevent cancer from coming back or spreading. After this surgery, surgeons must create a new way for the body to store and empty urine. One approach, called an ileal conduit, requires a patient to wear a bag on the outside of the body to collect urine. During this procedure, a conduit for the urine is created using a segment of the small intestine. It transfers urine directly from the kidneys and ureters through the skin and into the collection bag.

Surgeons at Vanderbilt, however, have been among the countrys pioneers in a more advanced technique that doesnt require an external bag. In forming a neobladder, Vanderbilt surgeons use a length of intestine to simulate a bladder thats hooked to the urethra. This way, the patient can void urine normally. At Vanderbilt, our surgeons have performed hundreds of neobladder procedures.

Vanderbilt surgeons were the first and continue to be the only surgeons in Tennessee performing radical cystectomy (entire bladder removal) with the DaVinci robot to decrease pain after the operation and speed up recovery. We treat more patients with this approach than any other medical center in the Southeast.

When bladder cancer metastasizes (spreads), it usually goes to the lung, liver or bones. The most common treatment is chemotherapy. Vanderbilt oncologists (cancer doctors) use various chemotherapy drugs including paclitaxel (Taxol), gemcitabine (Gemzar), ifosfamide (Ifex), cisplatinum and carboplatinum with encouraging results.