Patient education: Bladder cancer (The Basics)

What is bladder cancer? — Bladder cancer happens when normal cells in the bladder change into abnormal cells and grow out of control (figure 1).

What are the symptoms of bladder cancer? — Bladder cancer symptoms can come and go. They include:

●Blood in the urine -- This makes your urine look pink or red.

●Pain on the sides of your back or above your pubic area

●Problems with urinating – These include pain when urinating, urinating often, or leaking urine.

These symptoms can also be caused by conditions that are not bladder cancer. But if you have any of these symptoms, you should be checked by a doctor or nurse.

Is there a test for bladder cancer? — Yes. Doctors can use different types of tests to look for bladder cancer. These include:

●Urine tests – These show what types of cells are in the urine.

●Imaging tests – Imaging tests create pictures of the inside of the body. They include CT and MRI scans. These tests let the doctor look at the entire urinary tract (figure 1). They can show tumors or other abnormal growths.

●Cystoscopy – With this procedure, the doctor looks directly inside of the bladder and urethra (the tube that transports urine out of the body). To do this, they use a tool called a "cystoscope." This is a thin, flexible tube with a camera on the end. The camera sends pictures to a screen. The cystoscope is gently guided through the urethra and into the bladder. The doctor might also take a sample of tissue (called a biopsy) to look at under a microscope.

How is bladder cancer treated? — Treatment depends on the cancer stage and grade. Cancer staging is a way for doctors to find out how far a cancer has spread. The cancer grade is based on how the cancer looks under a microscope. Treatment will also depend on your age and any other medical problems you have.

People with bladder cancer often have 1 or more of the following treatments:

●Surgery to remove the cancer – With surgery, the doctor will remove the tumor. In some cases, they might have to remove part or all of the bladder and other nearby organs. This depends on how big your tumor is and how far it has spread.

If your bladder is removed, the doctor will create a new way for urine to leave your body. This can be done in a few different ways (figure 2).

●Medicines – These could include:

•Medicine given directly into the bladder – This is usually for people with very early bladder cancer that has not spread into the bladder muscle.

•Chemotherapy – This is the medical term for medicines that kill cancer cells or stop them from growing. If you need to have surgery, you will usually have chemotherapy first. This can shrink the cancer and make it easier to remove. Sometimes, chemotherapy is given after surgery. If the cancer has spread beyond your bladder, it can make your symptoms better and help you live longer.

•Immunotherapy – This is the term doctors use for medicines that work with the body's infection-fighting system to stop cancer from growing. Sometimes, immunotherapy is given after surgery. If the cancer has spread beyond your bladder, it can make your symptoms better and help you live longer.

•Targeted therapy – In some cases, your doctor might use "targeted therapy." These medicines "target" cancers with certain characteristics.

●Radiation therapy – Radiation kills cancer cells. Radiation therapy might be an option for some people instead of surgery. It is often given along with chemotherapy.

What happens after treatment? — After treatment, you will have regular check-ups to see if the cancer comes back. You might need more tests, such as urine tests, cystoscopy, and imaging tests.

Tell your doctor or nurse if you have any of the symptoms listed above. Having those symptoms could mean that the cancer has come back.

What happens if the cancer comes back or spreads? — If the cancer comes back or spreads, you might have more treatment. This could include more surgery, medicines, or radiation.

What else should I do? — Follow all of your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Bladder cancer treatment involves making many choices, such as which type of surgery or medicines to have.

Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides to this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

More on this topic

Patient education: What are clinical trials? (The Basics)
Patient education: Bladder spasm (The Basics)
Patient education: Cystoscopy (The Basics)

Patient education: Blood in the urine (hematuria) in adults (Beyond the Basics)
Patient education: Bladder cancer diagnosis and staging (Beyond the Basics)
Patient education: Bladder cancer treatment; non-muscle invasive (superficial) cancer (Beyond the Basics)
Patient education: Bladder cancer treatment; muscle invasive cancer (Beyond the Basics)