Q&A: How is bladder cancer diagnosed and treated?

Bladder cancer is an abnormal growth of the cells typically lining the wall of the bladder. According to the American Cancer Society, more than 80,000 new cases of bladder cancer are projected to be diagnosed in the United States this year. Men are about three times more likely to be diagnosed than women, and it is the fourth most common cancer in men.

When patients have bladder cancer, they may experience changes in their urine or urination habits. The most common symptom of bladder cancer is blood in the urine. Other symptoms that may arise, but are less common, include painful or frequent urination, or the sensation of urgency to urinate.

People who smoke are at higher risk of developing bladder cancer. Age is another factor, as people diagnosed with bladder cancer are more commonly in their 60s to 70s. Less common risk factors include those who are dealing with conditions that may cause chronic inflammation, such as long-term catheter use. And although rare, environmental exposures, such as consistently working with aniline-based dyes could increase a person’s risk of developing bladder cancer.

Doctors diagnose bladder cancer based on several tests, including a urinalysis, imaging of the kidneys and tubes that drain the kidneys (ureters), urine based cellular testing and a cystoscopy, during which a tiny telescope is inserted into the urethra to inspect the bladder. If bladder cancer is present, a urologist may recommend a procedure — called a transurethral resection of bladder tumor (TURBT) — to determine the stage and grade of the cancer.

Once bladder cancer is diagnosed, treatment options vary, depending on the cancer’s grade and depth of invasion. If the cancer has not invaded the bladder muscle walls, a urologist may recommend a procedure that involves scraping the cancerous cells off of the bladder wall. Often chemo- or immunotherapies may be utilized to help decrease the risk of disease progression or recurrences.

If the cancer is found to have invaded the muscle wall, treatment may include total or partial bladder removal with intravenous chemotherapies or bladder preservation techniques. Clinical research trials also are available to provide access to the newest therapies for bladder cancer care.

Treatment decisions are extremely nuanced and patient-specific and should be made carefully with your urologic oncologist.

It is important to monitor your urine so that you may alert your doctor of any changes.

David B. Cahn is a board-certified urologic oncologist with MidLantic Urology in Media and Broomall.