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Bladder Cancer

The wall of the bladder is lined with cells called transitional cells and squamous cells. More than 90 percent of bladder cancers begin in the transitional cells. This type of bladder cancer is called transitional cell carcinoma. About 8 percent of bladder cancer patients have squamous cell carcinomas.

Cancer only in cells in the lining of the bladder is called superficial bladder cancer. This type of bladder cancer often comes back after treatment, but it does not tend to progress. If the tumor recurs, the disease often recurs as another superficial cancer in the bladder. Cancer that begins as a superficial tumor may grow through the lining and into the muscular wall of the bladder. This is known as invasive cancer. Invasive cancer may extend through the bladder wall. It may grow into a nearby organ such as the uterus or vagina in women or the prostate gland in men. It also may spread to other parts of the body.

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When bladder cancer spreads outside the bladder, cancer cells are often found in nearby lymph nodes. If the cancer has reached these nodes, cancer cells may have spread to other lymph nodes or other organs, such as the lungs, liver or bones.

When cancer spreads or metastasizes from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if bladder cancer spreads to the lungs, the cancer cells in the lungs are actually bladder cancer cells. The disease is metastatic bladder cancer, not lung cancer. It is treated as bladder cancer, not as lung cancer. Doctors sometimes call the new tumor "distant" disease.

Fortunately, the majority of bladder cancers do not grow rapidly and can be treated without major surgery. Thus, most patients with bladder cancer are not at risk of developing a cancer that will spread and become life threatening. Early detection is vital; it allows the prompt treatment that gives patients the best chance for a favorable outlook.

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Common symptoms of bladder cancer include:

  • Blood in the urine, making the urine slightly rusty to deep red
  • Pain during urination
  • Frequent urination, or feeling the need to urinate without result

These symptoms are not sure signs of bladder cancer. Infections, benign tumors, bladder stones or other problems also can cause these symptoms.

If a patient has symptoms that suggest bladder cancer, the doctor may check general signs of health and may order lab tests. The person may have one or more of the following procedures:

  • Physical exam — The doctor feels the abdomen and pelvis for tumors. The physical exam may include a rectal or vaginal exam.
  • Urine tests — The laboratory checks the urine for blood, cancer cells and other signs of disease.
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People with bladder cancer have many treatment options, including surgery, radiation therapy, chemotherapy or biological therapy. Some patients may receive a combination of therapies.

Surgery

Surgery is a common treatment for bladder cancer. The type of surgery depends largely on the stage and grade of the tumor. Your doctor can explain each type of surgery and discuss which is most suitable for you.

  • Transurethral resection — The doctor may treat early or superficial bladder cancer with transurethral resection (TUR). During TUR, the doctor inserts a cystoscope into the bladder through the urethra. The doctor then uses a tool with a small wire loop on the end to remove the cancer and burn away any remaining cancer cells with an electric current, called fulguration. You may need to be in the hospital and may need anesthesia. After TUR, patients may also have chemotherapy or biological therapy. (See below.)
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Reviewed by health care specialists at UCSF Medical Center.