Bladder Cancer

In 2007, there were 67,000 new cases of bladder cancer, 50,000 for males and 17,000 for females. Overall, 1 in 28 people will get bladder cancer in their lifetime. The most common cause of bladder cancer is smoking, accounting for up to 80% of cases.

The most common presentation is blood in the urine, usually without pain. Frequency and urgency of urination are other common symptoms. The diagnosis is made by sending urine to the lab to assess for cancer cells and looking in the bladder with a small lighted telescope to document the tumor.

Treatment and initial diagnostic staging are accomplished by a similar procedure performed through a scope to trim the cancerous tissue from the bladder wall.

Treatment at that point is determined by the cell type (grade) and depth of tumor invasion into the bladder wall (stage). The most common kind of bladder cancer is transitional cell carcinoma (TCC) accounting for 90% of cases.

Treatment options include observation, instilling medicine in the bladder to prevent recurrence (i.e., BCG), partial removal of the bladder or total removal of the bladder.

The bladder can be removed through open surgery or robotically. A new bladder is then constructed out of intestine and empties through the urethra similar to normal voiding (neobladder), or through a small opening (stoma) in the abdominal wall (ileal conduit or loop). Nerve sparing can be performed to maintain erections when appropriate. Occasionally chemotherapy is required before or after surgery.