Screening, Diagnosis and Treatment Options
Screening and Diagnosis: Get Checked
If your doctor is concerned about your risks of bladder cancer, he or she will suggest that you be tested. If that's the case, there are a few options:
- Imaging screenings: In order to look at your bladder, your doctor will probably inject a dye into your veins and then do an x-ray. He may also use a computerized tomography (CT) scan to review your urinary tract and the area surrounding your bladder.
- Cytology: In this test, a sample of your urine is examined under a microscope and checked for cancer cells.
- Cystoscopy: For this test, you'll receive local anesthesia. Then your doctor will insert a long tube (called a cystoscope) through your urethra. The tube has a light and a fiber-optic lens, allowing your doctor to see inside your bladder and urethra.
- Biopsy: During a cystoscopy, your doctor may take a tissue sample for biopsy. Since this procedure requires an additional tool, usually a wire loop that will help burn off cancer cells, you will probably receive general anesthesia for this test. It is also called transurethral resection of bladder tumor (TURBT).
During this process, you will be referred to a medical oncologist. If any of these tests lead to a cancer diagnosis, your doctor will then determine what stage the cancer is in. For this reason, you may need further tests, such as X-rays, bone scans, and CT scans.
In general, bladder cancer is broken down into the following stages:
- Stage I: Cancer is in the bladder lining, but it is not within the bladder wall.
- Stage II: The cancer is in the bladder wall, but has not broken through it.
- Stage III: The cancer has spread through the bladder wall and to nearby organs. For women, this would be the vagina or uterus; for men, the prostate.
- Stage IV: The cancer has spread to the lymph nodes and to other areas, such as the bones, liver, and lungs.
Treatment: Get Better
Will I be okay? That may be the first question you ask if you've been diagnosed with cancer. In many cases, the answer will be "yes." But much depends upon the stage of your cancer and your overall heath. Take time to talk to your doctor about all the treatment options you have. Possible treatments include:
- Surgery: The type of surgery recommended to you will depend on how far your cancer has spread.
- Transurethral resection of the bladder tumor (TURBT) will just remove the tumor. During this procedure, your doctor will insert a metal loop through the cystoscope and into your bladder. The loop uses an electrical current to destroy the cancer cells.
- A partial cystectomy involves removing the tumor along with part of the bladder. After this surgery, you may have to urinate more often, since your bladder will be smaller.
- A radical cystectomy is necessary when the cancer has spread throughout your bladder. It involves removing the entire bladder as well as the adjacent lymph nodes. If you are a woman, this operation may also remove the ovaries, uterus, and parts of the vagina. If you are a man, the operation may also remove the prostate and seminal vesicles. This surgery will also require that the doctor creates a new way for you to eliminate urine. Options include the use of a urostomy bag (a pouch that's connected to your kidneys) or the creation of a neobladder (which is made from part of your intestine).
- Immunotherapy: This treatment involves inserting biological drugs through your urethra and into your bladder. This therapy can be used after TURBT to prevent the cancer from recurring.
- Chemotherapy: For this treatment, you will receive cancer-fighting drugs, either in pill form or through an IV. Chemotherapy may be done before surgery to shrink a tumor or after surgery to kill any cancer cells that remain. Often the treatment is done in cycles, so your body has time to recover after each time. It can also be used in conjunction with radiation. If you undergo chemotherapy, you may lose your hair and experience fatigue and nausea.
- Radiation: During radiation, high-energy x-rays are focused on cancer cells and used to destroy them. Radiation can be used in conjunction with chemotherapy, as well as before and after surgery. Many people report fatigue and nausea after radiation therapy, but these symptoms will dissipate as you recover and get stronger.
Follow-up: Keep Watch
In the months and years after you have been treated for bladder cancer, it's important that you continue to monitor your health. Bladder cancer can come back, so be sure to schedule and keep follow-up appointments with your doctor. Depending on your situation, you may need a cystoscopy every several months, just to check that the cancer has not returned. Undergoing these tests may be stressful, but they are necessary in guarding your health.
Take good care of yourself and eat a healthy diet. Talk to your doctor about immediate follow-up if you experience any of these symptoms:
- Painful urination
- Blood in your urine
- Urinary tract infections
As you recover, allow your body time to heal. Be sure to join a support group, so you can share your story with other cancer survivors. Remember that you are not alone, and never hesitate to accept the help and support that is offered to you.
For more information on bladder cancer and screenings The Cancer Center at St. Anthony’s Hospital, please call (727) 825-1253.
St. Anthony's Cancer Center
1201 5th Ave. N., Suite 130
St. Petersburg, FL 33705
Phone: (727) 825-1253
Fax: (727) 825-1332