What is cancer of the bladder?

The bladder is part of your urinary tract, which includes:

• Kidneys, which make urine
• Ureters, which are the tubes that carry urine from the kidneys to the bladder
• Bladder, which stores urine
• Urethra, which is the tube that drains urine from the bladder

Cancer of the bladder (bladder cancer) is an abnormal growth of cells that form tumors in the lining of the bladder. A bladder tumor may be either noninvasive (superficial) or invasive. A noninvasive tumor is usually a small growth that has not yet grown into the bladder wall. An invasive tumor spreads into the bladder wall. If the cancer spreads to other parts of the body, it is still bladder cancer, and is called metastatic bladder cancer.

There are different types and stages of bladder cancer based on what kind of cancer cells are found, where the tumor started, and where it has spread. Knowing your type and stage of bladder cancer you have helps your healthcare provider decide on the best treatment plan for you. It is important to diagnose and treat bladder cancer as soon as possible. The main goals of treatment are to kill the tumor cells, prevent a local cancer from spreading, and prevent metastatic cancer from spreading more than it already has.

In most cases, bladder tumors happen after the cells lining the urinary tract have been exposed to cancer-causing chemicals in the urine for many years. Chemicals in the urine can come from smoking cigarettes, working with chemicals, or taking certain medicines.

What can I expect in the hospital?

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

• You will be checked often by the hospital staff.
• Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
• Your fluid output may be monitored closely by keeping track of the amount of urine and bowel movements you produce. You may have a small tube (catheter) placed into your bladder through the urethra to drain and measure urine from the bladder.

Testing

Testing may include:

• Blood tests to check for infections and blood loss
• Urine tests to check for bacteria and blood in your urine
• Urine tests to check for cells, proteins or other chemicals that may be a sign of cancer in the bladder
• Tests to look for abnormalities in your bladder, which may include:
  • Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the bladder and other parts of the urinary tract
  • Cystourethroscopy: A test in which a long, flexible tube and tiny camera is put through the urethra up into your bladder to look for cancer or other problems. A biopsy may be taken to help make a diagnosis. A biopsy is the removal of a small sample of tissue for testing.
  • Intravenous pyelography (IVP): An X-ray taken after an injection of a special dye into a vein to help your provider see tumors, the location of stones, or blockages as the dye moves through your kidneys and urinary tract
  • Laparoscopy: A surgical procedure in which a small cut is made near your bellybutton (navel) and your healthcare provider inserts a lighted tube with a camera through the cut and into your abdomen to look at the organs and pelvic cavity. A biopsy may be taken to help make a diagnosis.
  • Magnetic resonance imaging (MRI): A powerful magnetic field and radio wave are used to take pictures from different angles to show thin cross sections of the bladder and other parts of the urinary tract
  • Ultrasound scan: Sound waves and their echoes are passed through your body from a small device (called a transducer) that is held against your skin to create pictures of the inside of the bladder and other parts of the urinary tract
• Tests to check if the cancer has spread to other parts of your body, including:
  • Blood tests to check for certain hormones, proteins, or chemicals that may be high if you have cancer, or to check for cancer cells in the blood
  • Bone X-rays: Pictures of your bones to check for cancer
  • Bone scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows any areas of bone where the radioactive material is being absorbed.
  • Chest X-ray: Pictures of the inside of your chest to check for cancer
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows areas where the radioactive material is being absorbed.

Treatment

The treatment for bladder cancer depends on the location of the tumor, your symptoms, how well you respond to treatment, your overall health, and any complications you may have. Bladder cancer can often be cured, depending on whether it is noninvasive or invasive, how large it was when you were diagnosed, and whether the cancer has spread. You may need to make lifestyle changes to stay as healthy as possible, manage other treatments you may need, or adjust to a urostomy if you have one.

• You will have a needle (IV) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
• Your provider may treat your bladder cancer by putting chemicals or other medicines, such as chemotherapy, into your bladder. This is called intravesical therapy.
• You may have a procedure, called fulguration, to destroy the tumor by burning it with a high-frequency electrical current passed through a scope that is inserted into your bladder (cystoscope).
• You may need surgery to treat bladder cancer. Surgery may include:
  • Transurethral Resection of the Bladder Tumor (TURBT): Surgery to remove the bladder tumor through a cystoscope
  • Cystectomy: Surgery to remove all or part of your bladder and your urethra. If the entire bladder is removed, your provider will create a new way for urine to pass out of your body. This can include:
    • Urostomy: Your surgeon will remove a healthy piece of intestine and attach the end of the ureters to it. A cut will be made in the skin of your belly for this piece of intestine to drain urine (called a stoma). Urine is collected in a bag outside the body.
    • Continent urinary diversion: Your surgeon may use a piece of healthy intestine to create a pouch to collect urine from the ureters inside the body. The pouch may be connected to the urethra or to the outside of the body. You will need to use a catheter to empty the urine from the pouch.
  • Laparoscopy: A surgical procedure in which a small cut is made near your bellybutton (navel) and your healthcare provider inserts a lighted tube with a camera through the cut and into your abdomen to remove the bladder tumor, part of the bladder, or the whole bladder
  • Lymph node dissection: Surgery to remove lymph nodes in the area near the bladder to check if the cancer has already spread. It also allows the pathologist to determine the stage of the cancer accurately. This will allow your healthcare providers to determine if you need more treatment after you recover from surgery.
• Other treatments may include:
  • Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells.
  • Radiation therapy, which uses high-energy X-rays to kill cancer cells.
• Your provider may also prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat or prevent anemia, which means you don’t have enough red blood cells to carry oxygen to your body. Anemia may be caused by your cancer, your treatment, or other problems.
  • Reduce swelling
  • Treat or prevent side effects, such as nausea or constipation, from other treatments
  • Help your immune system fight cancer

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Bloating or pain in your belly
  • Depression
  • Blood in your urine
  • Deep bone pain
  • Nausea or vomiting
  • Redness, swelling, pain, warmth, or drainage from your surgical wound
  • Fever, chills, or muscle aches.
  • Urgent need to urinate often
• Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital with bladder cancer is 4 to 6 days.