Bladder Cancer

What Is Bladder Cancer?

Bladder cancer occurs when there are abnormal, cancerous cells growing in the bladder, a triangle-shaped, hollow organ located in the lower abdomen which stores urine.

According to the American Cancer Society, about 74,690 new cases of bladder will be diagnosed in 2014. Men are about three times more likely to get bladder cancer during their lifetime than women, and Caucasians are more likely to get bladder cancer than African-Americans, Hispanics or Asians.

We have extensive experience in treating early-stage to rare bladder cancers, and offer advanced treatment options in a supportive environment.

Bladder Cancer

Types of Bladder Cancer

There are several types of bladder cancer, including:

  • Transitional cell (urothelial) carcinoma: Transitional cell carcinoma begins in the cells lining the inside of the bladder. Transitional cells also line the other parts of the urinary tract, including the kidneys, ureters, and urethra. Transitional cell carcinoma is the most common kind of bladder cancer, occurring in about 90% of cases.
  • Squamous cell carcinoma: Squamous cell carcinoma begins in squamous cells—thin, flat cells found in the tissue that form the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. About 4% of bladder cancers are squamous cell carcinomas.
  • Adenocarcinoma: Adenocarcinoma is cancer that begins in the cells of glandular structures lining certain organs in the body. Adenocarcinomas account for only about 2% of bladder cancers.

Urethral cancer is a rare cancer that occurs in the cells that line the urethra, the tube through which urine exits the body from the bladder; in women, the urethra measures 1 ½ inches long and in men, the urethra (passing through the prostate gland and the length of the penis) is about 8 inches long. This disease affects women more often than men.

  • Squamous cell carcinoma is the most common type of urethral cancer. It forms in cells in the part of the urethra near the bladder in women, and in the lining of the urethra in the penis in men.

Anterior urethral cancer is when the cancer is closest to the outside of the body, and posterior urethral cancer is when the cancer is closest to the bladder.

Cystoscopy

Cystoscopy

Also called cystourethroscopy, a cystocscopy is an examination in which a scope (a flexible tube and viewing device) is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones. Samples of the tissue (called a biopsy) may be removed through the cystoscope for examination under a microscope in the laboratory.

IVP

Intraveneous Pyelogram (IVP)

Intraveneous pyelogram (IVP) is a series of X-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein. The images are used to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow. It may also be used to evaluate other diseases or check for spread of bladder cancer to other areas of the urinary tract.

Ultrasound

What Is an Ultrasound?

Ultrasonography, which is sometimes called sonography, uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. The sound waves bounce off body parts and send back an image, like sonar on a submarine. A computer then looks at the signals sent back by the sound waves and creates an image of the body using those signals.

Ultrasounds are used to view internal organs as they function, and to assess blood blow through various vessels. Ultrasound procedures are often used to examine many parts of the body such as the abdomen, breasts, female pelvis, prostate, scrotum, thyroid and parathyroid, and the vascular system. During pregnancy, ultrasounds are performed to evaluate the development of the fetus.

CT Scan

MRI

PET Scan

What Is Positron Emission Tomography (PET) Scan?

Positron emission tomography, also called PET imaging or a PET scan, is a type of nuclear medicine imaging. A PET scan measures important body functions, such as blood flow, oxygen use, and sugar (glucose) metabolism, to help doctors evaluate how well organs and tissues are functioning.

PET is a powerful diagnostic test that is having a major impact on the diagnosis and treatment of disease. A PET scan (positron emission tomography scan) monitors the biochemical functioning of cells by detecting how they process certain compounds, such as glucose (sugar). PET can detect extremely small cancerous tumors, subtle changes of the brain and heart, and give doctors important early information about heart disease and many neurological disorders, like Alzheimer’s.

Most common medical tests, like CT and MRI scans, only show details about the structure of your body. PET scans give doctors images of function throughout the entire body, uncovering abnormalities that might otherwise go undetected. This allows doctors to treat these diseases earlier and more accurately. A PET scan puts time on your side. The earlier the diagnosis, the better the chance for treatment.

For example, a PET scan is the most accurate, non-invasive way to tell whether or not a tumor is benign or malignant, sparing patients expensive, often painful diagnostic surgeries and suggesting treatment options earlier in the course of the disease. Although cancer spreads silently in the body, PET can inspect all organs of the body for cancer in a single examination.

Today, most PET scans are performed on instruments that are combined PET and CT scanners. The combined PET/CT scans provide images that pinpoint the location of abnormal metabolic activity within the body. The combined scans have been shown to provide more accurate diagnoses than the two scans performed separately.

About nuclear medicine

Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose or treat a variety of diseases, including many types of cancers, heart disease, and certain other abnormalities within the body. Depending on the type of nuclear medicine exam you are undergoing, the radiotracer is either injected into a vein, swallowed or inhaled as a gas and eventually accumulates in the organ or area of your body being examined, where it gives off energy in the form of gamma rays. This energy is detected by a device called a gamma camera, a PET scanner and/or probe.

Bladder Cancer Staging

Once you’ve received a bladder cancer diagnosis, your doctor will determine the grade and stage of the cancer:

  • Grade: Differentiates the cells from normal tissue and estimates the rate of cancer growth.
  • Stage: Indicates the extent the cancer has spread and if other body parts or organs are affected.

Additional tests may be needed to determine if bladder cancer is limited to the bladder or if it has spread.
The American Joint Committee on Cancer (AJCC) provides guidelines for staging of bladder cancer. The stages range from Stage 0 to Stage 4 and have detailed criteria for tumor size, invasiveness, presence in lymph nodes, and whether or not the cancer has metastasized (spread) to other organs. A general description of each stage of bladder cancer follows:

  • Stage 0 bladder cancer: Cancer cells are found only on the inner lining of the bladder. This is also called superficial cancer or carcinoma in situ.
  • Stage 1 bladder cancer: Cancer cells are found deep in the lining of the bladder, but have not invaded the bladder muscle.
  • Stage 2 bladder cancer: Cancer cells are present in the muscle of the bladder.
  • Stage 3 bladder cancer: Cancer cells have spread through the bladder muscle into the tissues around the bladder, such as the prostate in men or the uterus in women.
  • Stage 4 bladder cancer: Cancer has progressed further into the abdominal cavity, and may have spread to lymph nodes and other organs in the body.
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