What is Blad­der Cancer?

Can­cer is a dis­ease char­ac­ter­ized by cells that divide and grow with­out reg­u­la­tion. Can­cer cells form a tumor that can inter­fere with organ func­tion, invade and dam­age nearby tis­sues, and spread to other parts of the body. Blad­der can­cer is can­cer that begins in the blad­der, which is an organ that stores your body’s liq­uid waste (urine.) Blad­der can­cer is the fourth most com­mon type of can­cer in men and the eighth most com­mon type in women today.

The causes of blad­der can­cer are not known, but it is clearly not a con­ta­gious dis­ease. Some peo­ple are at higher risk for devel­op­ing blad­der can­cer. It is found pri­mar­ily in peo­ple over the age of 40. Men are twice as likely to develop blad­der can­cer as women. Cig­a­rette smok­ers are more like to develop blad­der can­cer, as are peo­ple whose occu­pa­tions reg­u­larly expose them to cancer-causing agents—occupations such as hair­dressers, painters, metal work­ers, truck dri­vers, and work­ers in the chem­i­cal industry.

Cer­tain par­a­sitic infec­tions, a pre­vi­ous bout of blad­der can­cer, and hav­ing a fam­ily mem­ber diag­nosed with blad­der can­cer also indi­cate an increased risk for devel­op­ing the disease.

Symp­toms of Blad­der Cancer

The pri­mary symp­toms of blad­der can­cer are:

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Blood in the urine
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Painful uri­na­tion
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Feel­ing the need to uri­nate fre­quently
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Feel­ing the need to uri­nate with the inabil­ity to do so

Note that these symp­toms don’t always indi­cate blad­der can­cer. A doctor’s exam is nec­es­sary to iden­tify what’s caus­ing the symptoms.

Treat­ment Options

The type of treat­ment for blad­der can­cer depends on sev­eral fac­tors: the type of blad­der can­cer, how far the dis­ease has pro­gressed (the can­cer “stage,”) and how much the can­cer cells still look like nor­mal cells (the tumor “grade.”) Blad­der can­cer can be treated using surgery, radi­a­tion ther­apy, chemother­apy, or bio­log­i­cal ther­apy. Some­times peo­ple receive a com­bi­na­tion of these treatments.

Surgery

Blad­der surgery is a fre­quent blad­der can­cer treat­ment. The sim­plest surgery is called a transurethral resec­tion, in which a doc­tor inserts a tool through the ure­thra into the blad­der and uses it to remove can­cer cells. This is used only for early stages of can­cer. It’s often used in com­bi­na­tion with chemother­apy or bio­log­i­cal therapy.

Rad­i­cal cys­tec­tomy is a type of blad­der surgery where the doc­tor removes the entire blad­der, along with nearby lymph nodes, a por­tion of the ure­thra, and other organs that may con­tain can­cer cells. This surgery is used when a large por­tion of the blad­der is affected by can­cer. In blad­der surgery for women, this means that the uterus, ovaries, and part of the vagina may be removed. In blad­der surgery for men, the prostate, sem­i­nal vesi­cles, and a por­tion of the vas def­er­ens are removed.

Seg­men­tal cys­tec­tomy is sim­i­lar to rad­i­cal cys­tec­tomy, but only a por­tion of the blad­der is removed. This type of blad­der surgery allows the sur­geon to remove only the affected por­tion of the bladder.

Radi­a­tion Therapy

Radi­a­tion ther­apy, like surgery, only affects the body in the tar­geted area of the blad­der. It uses high-energy rays to kill can­cer cells. Radi­a­tion can be applied exter­nally, using an exter­nal machine, or inter­nally, using radioac­tive mate­r­ial placed directly in or near the tumor.

Chemother­apy

Chemother­apy is a treat­ment for can­cer using anti­cancer drugs. In some instances, chemother­apy for blad­der can­cer can be admin­is­tered locally. The doc­tor inserts drugs directly into the blad­der via a tube through the ure­thra.
Other chemother­apy treat­ments are sys­temic treat­ment, mean­ing that they affect cells and tis­sues through­out the body and not just in the can­cer­ous area. Because chemother­apy harms nor­mal cells that divide rapidly as well as can­cer cells, it can cause a num­ber of side effects, includ­ing hair loss, increased sus­cep­ti­bil­ity to infec­tion, nau­sea, vom­it­ing, diar­rhea, and mouth and lip sores.

Bio­log­i­cal Therapy

Bio­log­i­cal ther­apy is some­times used in com­bi­na­tion with transurethral resec­tion surgery. In one type of bio­log­i­cal ther­apy, the patient receives a solu­tion of bac­te­ria that stim­u­late the body’s immune sys­tem to attack can­cer cells. All bio­log­i­cal ther­a­pies acti­vate the body’s nat­ural immune reac­tion to help destroy can­cer cells.

Liv­ing with a Urostomy

If your entire blad­der has to be removed, the sur­geon per­forms urostomy surgery to detour liq­uid waste from the blad­der area and pro­vide an alter­nate way for it to leave the body. Urine exits the body through a sur­gi­cally cre­ated open­ing in the abdom­i­nal wall called a stoma.

After urostomy surgery, you need to watch for the fol­low­ing pos­si­ble complications:

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Block­age of the stoma
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Exces­sive bleed­ing of the stoma
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Stoma injury
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Severe skin irri­ta­tion around the stoma
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Infec­tion is a com­mon side effect of urostomy surgery. Antibi­otics are used to treat urostomy infec­tion.
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Uri­nary crys­tals: These occur when the urine is too alka­line. They can cause stomal irri­ta­tion and/or bleeding.

Uri­nary crys­tals can be pre­vented by keep­ing the stoma clean and main­tain­ing acidic urine. If uri­nary crys­tals form, you can apply a com­press damp­ened with equal parts white vine­gar and water for a few min­utes when chang­ing the pouch.

Post-surgery recov­ery time will vary from patient to patient—and the recov­ery process is not just phys­i­cal. Urostomy patients will need to learn to care for their new stoma and learn to deal with the prac­ti­cal issues sur­round­ing the pouch­ing sys­tem. At the same time, it’s nor­mal for a urostomy patient to feel grief or anger at their body changes. Many sup­port resources are avail­able after urostomy surgery to help peo­ple deal with phys­i­cal, emo­tional, and social stresses. Remem­ber: you’re not alone. Here are a few orga­ni­za­tions avail­able to help:

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The United Ostomy Asso­ci­a­tions of Amer­ica, Inc. (www.uoaa.org) pro­vides infor­ma­tion, sup­port and advo­cacy for peo­ple who require ostomy surgery. They also host dis­cus­sion boards where osto­m­ates can find oth­ers for advice, encour­age­ment, and cama­raderie.
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The Inter­na­tional Ostomy Asso­ci­a­tion (www.ostomyinternational.org) pro­vides infor­ma­tion about dif­fer­ent ostomy asso­ci­a­tions world­wide.
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Wound, Ostomy and Con­ti­nence Nurses Soci­ety (www.wocn.org) can give you local refer­rals for nurses who spe­cial­ize in ostomy care.