Bladder Cancer

Each type of cancer has unique characteristics and responds differently when treated. Our highly trained staff and physicians combine their skills with the latest equipment and techniques to treat all forms of cancer. The webpages below contain detailed information about specific types of cancer, related issues and the treatment options available.

Information written by:
Larry N. Silverman, M.D. 

Bladder Cancer

BACKGROUND

Epidemiology

Approximately 55,000 new cases of bladder cancer are diagnosed each year. The peak incidence occurs in the seventh decade of life with a male/female ratio of 3:1. Bladder cancer is the fourth most prevalent malignant disease in men. The prevalence is higher in industrialized nations and urban areas.

Risk factors for the development of bladder cancer include: Occupational exposures to dye, rubber, leather, paint, organic chemicals, textile printing, electrical cable industries, cigarette smoking, phenacetin containing analgesics, chronic irritation by long term catheter drainage for bladder calculi, and chronic infections. Transitional cell carcinomas, the most common pathologic type account for 92 percent of cancers. Squamous cell carcinomas account for 6 percent, and adenocarcinomas for 2 percent.

Of newly diagnosed bladder cancers, approximately 75 - 85 percent are superficial, and 15 - 25 percent have evidence of muscle invasion.

The bladder trigone, lateral and posterior walls, and bladder neck are the most common sites of tumor development. The most common sites of distant metastasis include the lung, bone, and liver.

Signs & Symptoms

The most common symptom experienced is gross, painless, hematuria. Less commonly, patients experience bladder irritability. A small percentage have no specific symptoms or microscopic hematuria.

Diganostic Tests

A complete history and physical examination including directed pelvic and rectal examination should always be included in any workup. Additionally, laboratory work including blood cell count, liver function test, and urinalysis should be obtained. If a bladder tumor is suspected, urine cytology can also be obtained at this time. Cystoscopy and biopsy ultimately lead to diagnosis and provide staging information.

Once a pathologic diagnosis of bladder cancer has been obtained, further tests are used for staging. CT scans of the abdomen and pelvis, chest x-ray, and bone scan are used to evaluate the extensiveness of the cancer within the pelvis as well as to look for areas of distant spread.