Topic Overview
What is bladder cancer?
Cancer is the growth of abnormal cells in the body. These extra
cells grow together and form masses, called tumors. In bladder cancer, these
growths happen in the bladder.
The bladder is the part of your
urinary tract that stores your urine until you are
ready to let it out. See a picture of the
female
urinary system 
or
male
urinary system .
Bladder cancer can usually be cured if it is found and treated
early. And most bladder cancer is found early.
What causes bladder cancer?
We don't know what causes bladder cancer. But we do know that
smokers are much more likely to get it than nonsmokers. In fact, experts
believe that smoking causes about half of bladder cancer in men and more than
one-fourth of bladder cancer in women.
What are the symptoms?
Blood in the urine is the main symptom. Other symptoms may
include having to urinate often or feeling pain when you urinate.
These symptoms can be caused by other problems, including a
urinary tract infection. Always call your doctor if
you see blood in your urine.
How is bladder cancer diagnosed?
To diagnose bladder cancer, your doctor will:
- Ask about your medical history and do a
physical exam, including a vaginal or rectal exam.
- Test your urine
to look for blood or abnormal cells.
- Do a
cystoscopy, a test that lets your doctor look into
your bladder with a thin, lighted viewing tool. Small tissue samples (biopsies) are taken and looked at under a microscope
to find out if there are cancer cells.
How is it treated?
Treatment choices for bladder cancer include surgery to remove
the cancer, anti-cancer drugs (chemotherapy), medicines that help your
immune system (biological therapy), and
radiation.
The treatment depends a lot on how much the cancer has grown.
Most bladder cancers are treated without having to remove the bladder.
Sometimes doctors do have to remove the bladder. For some people,
this means having urine flow into a bag outside of the body. But in many cases,
doctors can make a new bladder—using other body tissue—that works very much
like the old one.
Bladder cancer often comes back. The new tumors can often be
treated easily if they are caught early. So it’s very important to have regular
checkups after your treatment is done.
It’s common to feel scared, sad, or angry after finding out that
you have bladder cancer. Talking to others who have had the disease may help
you feel better. Ask your doctor about support groups in your area. You can
also find people online who will share their experiences with you.
What increases your chances of getting bladder cancer?
Anything that increases your chances of getting a disease is
called a risk factor. The main risk factor for bladder cancer is smoking.
Cigarette smokers are much more likely than other people to get bladder
cancer.
Other risk factors include:
- Being older than 40.
- Being male.
Men are 4 times more likely than women to get bladder cancer.
- Being
exposed to cancer-causing chemicals, such as those used in the wood, rubber,
and textile industries.
Frequently Asked Questions
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Health Tools
Health tools help you make wise health decisions or take action to improve your health.
Cause
The cause of
bladder cancer is not known. Changes in the genetic
material (DNA) of bladder cells may play a role.
Bladder cancer is twice as likely to develop in smokers than in
nonsmokers. Experts believe that smoking causes about half of bladder cancer in
men and more than one-fourth of bladder cancer in women.1
Exposure to chemicals and other substances at work—including dyes,
paints, leather dust, and others—may also cause bladder cancer.1, 2
Symptoms
The most common symptoms of
bladder cancer include:
- Blood or blood clots in the urine (hematuria).
Hematuria occurs in 80% to 90% of people who have bladder cancer and is the
most common symptom. Usually it is not painful.2
- Pain during urination (dysuria).
- Urinating small
amounts frequently.
- Frequent
urinary tract infections (UTIs).
Symptoms that may indicate more advanced bladder cancer
include:
- Pain in the lower back around the kidneys
(flank pain).
- Swelling in the lower legs.
- A growth in the pelvis
near the bladder (pelvic mass).
Other symptoms that may develop when bladder cancer has spread
include:
- Weight loss.
- Bone pain or pain in
the rectal, anal, or pelvic area.
-
Anemia.
The symptoms of bladder cancer may be similar to symptoms of
other
bladder conditions.
What Happens
Bladder cancer is the rapid, uncontrolled growth of
abnormal cells in the bladder. Cancer usually begins in the lining of the
bladder (superficial bladder cancer). The cancerous cells may grow through the
lining into the muscular wall of the bladder. Invasive bladder cancer may
spread to
lymph nodes, other organs in the pelvis (causing
problems with kidney and bowel function), or other organs in the body, such as
the liver and lungs.
Bladder cancer is classified by
stage
and grade. The stage is determined by the
cancer
growth in the bladder wall and how far it has spread to nearby tissues
and other organs, such as the lungs, the liver, or the bones. The grade of
bladder cancer is determined by how the cancer cells look in comparison with
normal bladder cells.
Your health professional determines the stage and grade of your
bladder cancer by gathering information from a variety of tests, including
blood tests, urine tests,
biopsies,
bone scans,
X-rays, and
CT scans. The stage and grade of your cancer are
important factors in selecting the treatment option that is right for you.
Bladder cancer is usually curable if it is diagnosed while the
cancer is still contained in the bladder, and up to 80% of bladder cancers are
diagnosed at this early stage.3Survival rates decrease as the stage of cancer becomes
more advanced, as the cancer cells become more abnormal (grade), and when the
cancer involves lymph nodes or other body organs.1
What Increases Your Risk
The major risk factors for
bladder cancer include:
- Smoking.
- Cigarette smokers are twice as likely to
develop bladder cancer as nonsmokers.1
- Pipe and cigar smokers have a slightly increased
risk compared to nonsmokers, but the risk is significantly less than it is for
cigarette smokers.4
- Being older than 40. Your risk goes up as you get
older, and most people who get bladder cancer are in their 60s.1
- Being male. Men are 4 times more likely than
women to develop bladder cancer.1
- Race. In the U.S., white people (Caucasians)
develop bladder cancer twice as often as African-Americans or Hispanics.
Asians, Native Americans, and Alaska Natives have the lowest rates of bladder
cancer.5
- Exposure to cancer-causing
materials (carcinogens) may cause up to 20% of bladder cancer cases in the
United States. It may take years (as many as 30 to 50) for cancer to appear.
This risk may also depend on how much of the material a person is repeatedly
exposed to over time.6 Chemical exposure can be a risk
for many types of workers from truck drivers to textile workers to
hair-stylists. It has been linked to chemicals called aromatic amines that are
found in many products, including dyes, paints, solvents, inks, and the dust
from leather.7
- A history of treatment with
cyclophosphamide or arsenic.
- A diet that is high in nitrates or
rich in meat and fatty foods.
- Chronic bladder infections (cystitis), especially in people who have
catheters in place all the time.
- A history of bladder cancer or a kidney transplant.
- A
family history of bladder cancer.
- A history of radiation therapy or
chemotherapy for treatment of
endometrial or
ovarian cancer.
- Schistosomiasis, which is an infection with the parasite
Schistosoma haematobium. This condition is sometimes
found in developing countries and rarely occurs in North America.
When To Call a Doctor
If you have been diagnosed with
bladder cancer, be sure to follow your health
professional's instructions about calling when you have problems, new symptoms,
or symptoms that get worse.
Call your health professional if you:
- Have blood in your urine.
- Feel pain
when you urinate.
- Are urinating small amounts
frequently.
- Have
back or flank pain.
Watchful Waiting
If you are concerned about your symptoms or you are concerned
about your risk for bladder cancer, make an appointment with your health
professional. Watchful waiting is not appropriate if you have symptoms that do
not go away.
Who To See
Health professionals who can evaluate your symptoms and your risk
for bladder cancer include:
Health professionals who can manage your cancer treatment
include:
To prepare for your appointment, see the topic Making the Most of Your Appointment
Exams and Tests
To determine whether
bladder cancer may be the cause of your urinary
symptoms, your health professional will evaluate your:
- Physical symptoms. A physical exam may include
a
rectal exam, a
prostate exam for men, or a
pelvic exam for women.
- Medical history,
including your smoking history and your possible exposure to cancer-causing
chemicals.
- Family history of cancer.
- A
urine test and
urine culture, to determine the presence of blood,
infection, and other abnormal cells.
Initial diagnostic tests will include a
cystoscopy, a test that allows your doctor to look at
your bladder with a thin lighted scope (cytoscope). Small tissue samples (biopsies) of any abnormal areas are taken and looked
at under a microscope to determine whether cancer cells are present and what
the cells look like (grade). Information from the biopsy, cytoscopy, and
sometimes other tests is used to determine the size and extent of the cancer
(stage). Cancer stage and grade tell the size and shape
of cancer cells and whether they have spread to other body areas. Knowing the
stage and grade helps you and your doctor make treatment decisions.
Other diagnostic tests that may be done include:
If bladder cancer is diagnosed, more tests may be needed to
determine whether the cancer has spread (metastasized).
- A
CT scan or
MRI may be done to determine whether the cancer has
spread to lymph nodes, the lungs, the liver, or other abdominal organs.
- A
chest X-ray may be done to determine whether the
cancer has spread to the lungs.
- A
barium enema or
colonoscopy may be done to determine whether the
cancer involves the intestines.
- A
bone scan may be done to determine whether the cancer
has spread to the bones.
Early detection of returning cancer
After you have been treated for bladder cancer, it is important
to have regular examinations and
cystoscopies to detect any recurrence early so that
additional treatment can begin immediately. Researchers are studying ways to
identify low-grade cancer cells without the need for a cystoscopy. Some tests
for specific proteins in cancer cells (tumor markers), such as BTA and NMP22,
have been approved by the U.S. Food and Drug Administration (FDA) to use to
detect recurrent cancer.8 More research is being done
on these screening methods because they are not as accurate as a cystoscopy at
this time.9
Treatment Overview
The choice of treatment and the long-term outcome (prognosis) for
people who have
bladder cancer depends on the
stage
and grade of cancer. Your health professional also considers your age,
overall health, and quality of life when developing your treatment plan.
Bladder cancer is usually curable if it is diagnosed while the
cancer is still contained in the bladder, and up to 80% of bladder cancers are
diagnosed at this early stage.3
Treatment choices for bladder cancer may
include:
-
Surgery to remove the cancer. Surgery,
either alone or in combination with radiation therapy, chemotherapy, or
biological therapy, is used more than 90% of the time to treat bladder
cancer.1
-
Chemotherapy to
destroy cancer cells using medications. Chemotherapy may be given before or
after surgery.
-
Radiation therapy to destroy cancer cells using
high-dose X-rays or other high-energy rays. Radiation therapy may also be given
before or after surgery and may be given at the same time as
chemotherapy.
-
Biological therapy to boost your body's
immune system to fight cancer cells. This therapy is
commonly used to prevent the return (recurrence) of bladder cancer.
Initial treatment
Surgery is used to treat most stages of bladder cancer.
- Small bladder tumors that remain near the
surface (superficial) may be burned with a low-voltage electrified probe
(electrocautery) during a
cytoscopy.
-
Transurethral resection (TUR) is used to remove large
superficial bladder tumors or tumors that penetrate more deeply into the tissue
but have not spread outside the bladder.
- Surgical removal of the
bladder (cystectomy) is usually done for the most advanced
stages of cancer that is confined to the bladder. Cystectomy may also be done
for high-grade bladder cancers or when there are multiple
tumors in the bladder. Surgery may not be recommended for an older adult who
has a long-term medical condition.
Chemotherapy uses medications to destroy cancer cells.
For superficial bladder cancer, the medications may be delivered directly into
the bladder using a catheter (intravesically). For cancer that has deeply
invaded the bladder or spread to
lymph nodes or other organs, chemotherapy may be given
orally or
intravenously (IV).
Side
effects may differ, depending on the medications used and your age and
overall health. Recent studies show that chemotherapy given before cystectomy
(neoadjuvant) may increase the effectiveness of
treatment for many people.10, 11
More studies are being done.
Radiation therapy, which uses high-dose X-rays or
other high-energy rays to destroy cancer cells, is one of the standard
treatments for certain types of bladder cancer. Radiation therapy also is used
as
palliative care to relieve symptoms and preserve
kidney function. Home treatment can help manage some of the
side
effects of radiation therapy.
Biological therapy uses medications to boost or
restore your body's
immune system. Biological therapy is most often used
for superficial bladder cancer. It may be used after a transurethral resection
(TUR) to prevent cancer recurrence.
Home treatment measures may help relieve some common side effects
of cancer treatment, such as nausea, vomiting, fatigue, hair loss, stress, or
sleep problems.
If you have recently been diagnosed with bladder cancer, you may
experience a wide variety of emotions in reaction to your diagnosis. Most
people feel some denial, anger, and grief. There is no "normal" or "right" way
to react to a diagnosis of cancer. You can take steps, though, to manage your
emotional reaction after learning that you have
bladder cancer. Some people find that talking with family and friends is
comforting, while others may need to spend time alone to understand their
feelings about their disease.
If your emotions are interfering with your ability to make
decisions about your health and to move forward with your life, it is important
to talk with your health professional. Your cancer treatment center may offer
counseling services. You may also contact your local chapter of the American
Cancer Society to help you find a support group. Talking with other people who
have had similar feelings after a diagnosis such as yours can help you accept
and deal with your disease.
What to think about during initial treatment
Your quality of life becomes a critical issue when considering
your treatment options. Be sure to discuss your personal preferences with your
urologist and
oncologist when they recommend treatment.
Some people with bladder cancer may be interested in
participating in research studies called
clinical trials. Clinical trials are designed to find
better ways to treat cancer patients and are based on the most up-to-date
information. People who do not want standard treatments or who are not cured
using standard treatments may want to participate in clinical trials. These are
ongoing in most parts of North America and in some other countries for people
with all stages of bladder cancer.
When bladder cancer is found early, before it has spread
outside the bladder, about 94% of people live at least 5 years after they are
diagnosed.1 The long-term outcome (prognosis) for men
older than 65, African-Americans, and those who smoke is worse than for other
people with bladder cancer.2
Treatment for advanced-stage bladder cancer is intended to
control symptoms and increase comfort (palliative
care), not cure the disease.
For more information about specific bladder cancer treatments,
see the topics:
Ongoing treatment
After initial treatment for
bladder cancer, it is important to receive follow-up
care. Your
emotional reactions may continue throughout the course
of your treatment, depending on your prognosis, the treatment methods used, and
your quality-of-life decisions.
Your
urologist or
oncologist will schedule regular checkups based on the
stage
and grade of your tumor. These checkups usually include:12
- A
cystoscopy and
urine test every 3 to 6 months during the first and
second years after your initial treatment.
- A cystoscopy and urine
test every 6 months during the third and fourth years after your initial
treatment.
- Yearly examinations after the fourth year.
People with high-grade tumors of any stage may also have an
intravenous pyelogram (IVP) or computed tomography (CT
urogram) done every year.2
Treatment if the condition gets worse
Bladder cancer can come back (recur) in the bladder or
spread (metastasize) to other parts of the body. Recurrent bladder cancer may
be treated with surgery or
chemotherapy to slow cancer growth and relieve
symptoms.
Participation in a
clinical trial may be recommended if you have been
diagnosed with recurrent bladder cancer.
Complementary therapies
In addition to conventional medical treatment, some people may
want to try complementary therapies, such as:
Complementary therapies are not a substitute for the standard
treatment recommended for bladder cancer. Before you try any of these
therapies, discuss their possible benefits and side effects with your health
professional. Let him or her know if you are already using any such therapies.
For more information, see the topic
Complementary Medicine.
What To Think About
Most treatments for bladder cancer cause side effects. Side
effects may differ, depending on the type of treatment used and your age and
overall health. Your health professional can talk to you about your treatment
choices and the side effects associated with each treatment.
- Side effects of
chemotherapy may include loss of appetite, nausea,
vomiting, diarrhea, mouth sores, or hair loss. There is also an increased
chance of getting a serious infection during chemotherapy
treatment.
- Side effects of
surgery depend on how extensive your surgery was to
treat the stage of your cancer. Men may have erection problems after surgery if
the bladder is removed (cystectomy).
Home treatment measures may help you manage the side
effects.
Palliative care
If your cancer gets worse, you may want to think about
palliative care. Palliative care is a kind of care for
people who have illnesses that do not go away and often get worse over time. It
is different than care to cure your illness, called curative treatment.
Palliative care focuses on improving your quality of life—not just in your
body, but also in your mind and spirit. Some people combine palliative care
with curative care.
Palliative care may help you manage symptoms or side effects
from treatment. It could also help you cope with your feelings about living
with a long-term illness, make future plans around your medical care, or help
your family better understand your illness and how to support you.
If you are interested in palliative care, talk to your doctor.
He or she may be able to manage your care or refer you to a doctor who
specializes in this type of care.
For more information, see the topic
Palliative Care.
End-of-life issues
Some people with advanced-stage disease may choose not to have
treatment focused on prolonging life because the time, costs, and side effects
of treatment may be greater than the benefits. Making the decision about
stopping medical treatment to prolong life and shifting the focus to
end-of-life care can be difficult. For more information, see the topics:
Prevention
Bladder cancer cannot be prevented, but you may be
able to reduce some of your risk factors for developing it.2
- Cigarette smokers are much more likely to develop bladder cancer
than nonsmokers. However, after 1 to 4 years of not smoking, the risk of
developing bladder cancer decreases by 40%. Do not smoke or use other tobacco
products, and avoid exposure to cigarette smoke. For more information, see the
topic
Quitting Tobacco Use.
- Avoid exposure to
industrial chemicals, such as benzene substances and arylamines. Occupational
exposure from working with dyes, rubbers, textiles, paints, leathers, and
chemicals increases the risk of developing bladder cancer.
- Avoid
exposure to arsenic. Have your drinking water tested and drink bottled water if
you think that your water is contaminated with arsenic.
- Eat a
healthy diet. Experts believe that what you eat and drink may help prevent
bladder cancer.
- Eat a
low-fat, low-cholesterol diet that includes plenty of
fruits and vegetables. For more information, see the topic
Healthy Weight.
- Avoid
dehydration. Increase your fluid intake, particularly
water. Water dilutes cancer-causing chemicals.
- Vitamin A and
vitamin C supplements may provide some protection against bladder
cancer.
Home Treatment
If you are receiving radiation therapy or chemotherapy to treat any
stage of
bladder cancer, you can use home treatment to help
manage the side effects that may be caused by these treatments. Home treatment
may be all that is needed to manage the common problems listed below. If your
health professional has given you instructions or medications to treat these
symptoms, be sure to follow them. In general, healthy habits such as eating a
balanced diet and getting enough sleep and exercise can help control your
symptoms.
-
Home treatment for nausea or vomiting
includes watching for and treating early signs of
dehydration, such as a dry mouth, sticky saliva, and
reduced urine output with dark yellow urine. Older adults can quickly become
dehydrated from vomiting. For more information on how to deal with these side
effects, see:
Controlling nausea and vomiting caused by
chemotherapy.
-
Home treatment for diarrhea includes
resting your stomach and being alert for signs of dehydration. Check with your
health professional before using any nonprescription medications for your
diarrhea. Be sure to drink enough fluids.
-
Home treatment for
constipation includes ensuring that you drink enough fluids and eat
fruits, vegetables, and fiber in your diet each day. Do not use a laxative
without consulting your health professional.
Other issues that may arise include:
- Sleep problems. If you have trouble sleeping,
some tips for
managing sleep problems may be helpful, such as having
a regular bedtime, getting some exercise during the day, and avoiding
naps.
- Fatigue. If you lack energy and become weak easily, try
measures to help your
fatigue, which include getting extra rest, eating a
balanced diet, and reducing your stress.
-
Hair loss. Hair loss may be unavoidable, but you can
decrease irritation of your scalp by using mild shampoos and avoiding damaging
hair products.
- Body image and sexuality problems. Sexual problems
can be caused by physical or psychological factors related to the cancer or its
treatment. You may experience less sexual pleasure or lose your desire to be
sexually intimate.
- Women who have their bladder removed
(radical cystectomy) will also have their
ovaries and
uterus removed. They cannot become pregnant and may
experience
menopause soon after having the cystectomy.
- Men who have their prostate glands and seminal vesicles removed
may have erection problems and will no longer produce semen.
Many people with bladder cancer face emotional issues as a result
of their disease or its treatment.
- It is stressful to find out that you have
cancer and to undergo treatment.
Managing stress may include expressing your feelings
to others. Learning relaxation techniques may also be helpful. Relaxation
techniques, such as meditation, and support groups may be
helpful.
- Your feelings about your body may change following
treatment for cancer. Managing body image issues may involve talking openly
about your concerns with your partner, and discussing your feelings with your
health professional. Your health professional may also be able to refer you to
organizations that can offer additional support and information.
Bladder cancer rarely causes pain, and not all forms of cancer
treatment cause pain. If
pain occurs, many treatments are available to relieve
it. If your health professional has given you instructions or medications to
treat pain, be sure to follow them. Home treatment for pain, such as a
nonsteroidal anti-inflammatory drug (NSAID) or an
alternative therapy like
biofeedback, may improve your physical and mental
well-being. Be sure to discuss any home treatment you use for pain with your
health professional.
Some people with advanced-stage disease may choose not to have
treatment because the time, costs, and side effects of treatment may be greater
than the benefits. Making the decision about stopping medical treatment to
prolong life and shifting the focus to end-of-life care can be difficult. For
more information, see the topics:
Medications
Medications may be used to control the growth of
bladder cancer cells and to relieve symptoms.
Chemotherapy uses medications to destroy cancer cells.
Biological therapy boosts or restores your body's
immune response to destroy cancer cells.
Medication Choices
Chemotherapy may be taken by mouth (orally), injected into a vein
(intravenous, or IV), or put into the bladder through a
urinary catheter (intravesically). Chemotherapy can kill cancer cells both
inside and outside the bladder area.
Medications through a vein (IV)
- M-VAC is a combination of
methotrexate, vinblastine, doxorubicin, and
cisplatin. Methotrexate slows or stops the growth of
cancer cells in the body and is frequently used in combination with other
chemotherapy medications. Cisplatin is a heavy metal that causes cell death by
interfering with the multiplication of cancer cells.
-
Gemcitabine is an antitumor medication that interferes
with how cells divide and stops the growth of the cancer cells. It is often
combined with another drug called
cisplatin for treating bladder
cancer.
-
Doxorubicin is an anthracycline antibiotic medication.
Epirubicin and valrubicin are also anthracycline antibiotics that may be
used.
-
Paclitaxel or
carboplatin are antitumor medications that slow or
stop the growth of cancer cells in the body.
Medications through a catheter into the bladder
-
Bacillus Calmette-Guerin (BCG) may
stimulate an immune response or inflammation in the bladder wall to destroy
cancer cells within the bladder. This is known as
biological therapy.
-
Mitomycin C is an
antitumor antibiotic that interferes with the multiplication of cancer cells.
When administered directly into the bladder, mitomycin may help prevent the
recurrence of bladder cancer.
What To Think About
Medications, alone or in combination, may be delivered directly
into the bladder using a
catheter (intravesically).
Adjuvant chemotherapy may be used with
transurethral resection (TUR) of the bladder.
Chemotherapy is also used when cancer cannot be controlled with surgery.
Most chemotherapy causes some
side
effects. Home treatment may be all that is needed to manage your
symptoms. If your health professional has given you instructions or medications
to treat your symptoms, be sure to follow them. In general, healthy habits such
as eating a balanced diet and getting enough sleep and exercise can help
control your symptoms.
Clinical trials of other medications, such as
interferon or chemotherapy before surgery (neoadjuvant), are ongoing. Ask your doctor about
participating in a clinical trial.
Surgery
There are two main surgeries for
bladder cancer.
- Transurethral resection (TUR) removes cancerous
cells from the bladder.
- Cystectomy removes all or part of the
bladder if cancer has spread into the bladder muscle.
Surgery
Surgery to remove cancer
-
Transurethral resection
(TUR) is a surgical procedure that is used both to diagnose bladder
cancer and to remove cancerous tissue from the bladder.
Surgery to remove bladder
-
Cystectomy is
the surgical removal of all (total or radical cystectomy) or part (partial
cystectomy) of the bladder. It is used to treat bladder cancer that has spread
into the bladder wall (stages II and III) as either a first occurrence or as
a cancer that returns (recurs) following initial treatment. A radical
cystectomy removes the whole bladder as well as the surrounding pelvic organs.
Following surgery to remove the bladder, your surgeon will
create a new channel for urine to pass from your body.13
- An ileal conduit
(also called a noncontinent diversion) uses a segment of your intestine to
create a channel that connects your ureters to a surgically created opening
(stoma) on your abdomen. This procedure is called a urostomy. After a urostomy,
the urine passes from the ureters through the conduit and out the opening into
a plastic bag that is attached to your skin. You will empty the bag 3 or 4
times a day, and a larger bag that allows for longer storage can be worn
overnight. You will also learn how to
care
for your urostomy.
- A continent
reservoir (continent diversion) uses a segment of your intestine to
create a storage pouch that is attached inside your abdomen. There are two
types of internal continent reservoirs.
- Abdominal diversion reservoir. The
pouch inside the abdomen connects to an opening (stoma) in the skin. This is
another form of urostomy. The opening is smaller than the opening for an ileal
conduit, and because there is a pouch inside the abdomen no bag needs to be
worn outside your body. You will need to pass a catheter through the opening to
release the urine several times a day and during the
night.
- Orthotopic diversion. The pouch in this procedure is
sometimes called a bladder substitution reservoir. If your
urethra was not removed as part of the cystectomy, you
may be able to have this type of procedure. In an orthotopic diversion, the
pouch is attached to your
ureters at one end and your urethra at the other. This
allows you to pass urine through the same opening as you did before surgery.
Some people may need to use a
catheter to release the urine.
Noncontinent diversions are simpler and may have fewer
complications either right after surgery or in the coming months and years.
Continent diversion reservoirs eliminate the need for a urine storage bag to be
worn outside the body.
What To Think About
Side effects from your surgery can include problems with bowel
functioning, such as constipation or diarrhea. Your ability to have or enjoy
sexual intercourse may also be affected.
Adhesions may develop after surgery, and a
bowel obstruction may occur as a complication if
surgery was extensive.
Other Treatment
Radiation treatment for
bladder cancer uses high-energy X-rays to kill cancer
cells and shrink tumors. External beam radiation comes from a machine outside
the body. The machine aims radiation at the area where the cancer cells are
found.
Photodynamic therapy (PDT) is being studied as a treatment for
bladder cancer. PDT uses laser light and a special light-activated substance
(Photofrin) to kill cancer cells. Results of early studies with
photosensitizers show that PDT may be effective in treating recurrent
superficial bladder cancer.8, 14
Until all the drug is out of the body, the skin can get a sort of sunburn after
even short exposures to light. This can last several weeks.15
Other Treatment Choices
-
Radiation treatment uses high-dose
X-rays to kill cancer cells and shrink tumors. It may be used before or after
surgery. Radiation therapy also may be used if a person with bladder cancer
cannot have surgery. Radiation therapy also may be used as
palliative care to shrink tumors or relieve
pain.
What To Think About
Some people with bladder cancer may be interested in
participating in research studies called
clinical trials. Clinical trials are designed to find
better ways to treat cancer patients and are based on the most up-to-date
information. People who do not want standard treatments or who are not cured
using standard treatments may want to participate in clinical trials. These are
ongoing in most parts of the United States and in some other countries for
people with all stages of bladder cancer.
The combination of conventional medical treatment and
complementary medicine is an approach that is sometimes termed integrative
medicine, in which conventional and complementary therapies work together for
the best outcome.
Other Places To Get Help
Organizations
| American Cancer Society |
| Phone: | 1-800-ACS-2345 (1-800-227-2345) |
| Web Address: | www.cancer.org |
| |
The American Cancer Society conducts educational programs and
offers many services to people with cancer and to their families. Staff at the
toll-free number have information about services and activities in local areas
and can provide referrals to local ACS divisions. |
|
| National Cancer Institute (NCI) |
| NCI Publications Office |
| 6116 Executive Boulevard |
|
Suite 3036A |
| Bethesda, MD 20892-8322 |
| Phone: | 1-800-4-CANCER (1-800-422-6237) 9:00 a.m. to 4:30 p.m. EST, Monday through Friday |
| TDD: | 1-800-332-8615 |
| E-mail: | cancergovstaff@mail.nih.gov |
| Web Address: | http://www.cancer.gov (or
https://cissecure.nci.nih.gov/livehelp/welcome.asp# for live help
online) |
| |
The National Cancer Institute (NCI) is a U.S. government agency
that provides up-to-date information about the prevention, detection, and
treatment of cancer. NCI also offers supportive care to people with cancer and
to their families. NCI information is also available to doctors, nurses, and
other health professionals. NCI provides the latest information about clinical
trials. The Cancer Information Service, a service of NCI, has trained staff
members available to answer questions and send free publications.
Spanish-speaking staff members are also available. |
|
Related Information
References
Citations
American Cancer Society (2007). Cancer
Facts and Figures 2007, pp. 1–52. Atlanta: American Cancer Society.
Available online:
http://www.cancer.org/downloads/STT/CAFF2007PWSecured.pdf.
Pashos CL, et al. (2002). Bladder cancer epidemiology,
diagnosis, and management. Cancer Practice, 10(6):
311–322.
National Cancer Institute (2006). Bladder Cancer PDQ:
Treatment—Health Professional Version. Available online:
http://www.cancer.gov/cancertopics/pdq/treatment/bladder/healthprofessional.
Small EJ, Grossfeld GD (2003). Bladder. In M Dollinger
et al., eds., Everyone's Guide to Cancer Therapy, 4th
ed., pp. 401–411. Kansas City: Andrews McMeel.
Cancer of the urinary bladder (2005). In Cancer Stat
Fact Sheets based on LAG Ries et al., eds., SEER Cancer
Statistics Review, 1975–2003. National Cancer Institute: Bethesda, MD.
Available online: http://seer.cancer.gov/statfacts/html/urinb.html.
Messing EM (2002). Urothelial tumors of the urinary tract. In PC Walsh et al., eds., Campbell's Urology, 8th ed., vol. 4, pp. 2732–2784. Philadelphia: W.B. Saunders.
Kim HL, Belldegrun A (2005). Bladder cancer section of
Urology. In FC Brunicardi et al., eds., Schwartz's Principles
of Surgery, 8th ed., pp. 1532–1535. New York: McGraw-Hill.
American Cancer Society (2006). American Cancer Society's Detailed Guide: Bladder Cancer.
Available online: http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=44.
Black PC, et al. (2006). Molecular markers of
urothelial cancer and their use in the monitoring of superficial urothelial
cancer. Journal of Clinical Oncology, 24(35):
5528–5535.
Winquist E, et al. (2004). Neoadjuvant chemotherapy
for transitional cell carcinoma of the bladder: A systemic review and
meta-analysis. Journal of Urology, 171 (2):
561–569.
Vale CL, et al. (2003). Neoadjuvant chemotherapy in
invasive bladder cancer: A systemic review and meta-analysis. Lancet, 361 (9373): 1927–1934.
National Comprehensive Cancer Network (2007). Bladder
cancer. Clinical Practice Guidelines in Oncology,
version 1. Available online:
http://www.nccn.org/professionals/physician_gls/PDF/bladder.pdf.
Shipley WU, et al. (2005). Cancer of the bladder,
ureter, and renal pelvis. In VT DeVita Jr et al., eds., Cancer:
Principles and Practice of Oncology, 7th ed., pp. 1168–1185.
Philadelphia: Lippincott Williams and Wilkins.
Jiminez VK, Marshall FF (2002). Surgery of bladder cancer. In PC Walsh et al., eds., Campbell's Urology, 8th ed., vol. 4, chap. 79, pp. 2819–2844. Philadelphia: W.B. Saunders.
American Cancer Society (2007). Making
Treatment Decisions: Lasers in Cancer Treatment. Available online:
http://www.cancer.org/docroot/ETO/content/ETO_1_2x_Lasers_In_Cancer_Treatment.asp.
Credits
| Author | Shannon Erstad, MBA/MPH |
| Editor | Kathleen M. Ariss, MS |
| Associate Editor | Denele Ivins |
| Associate Editor | Pat Truman |
| Primary Medical Reviewer | E. Gregory Thompson, MD
- Internal Medicine |
| Specialist Medical Reviewer | Philip Belitsky, MD, FRCSC
- Urology |
| Last Updated | May 25, 2007 |
