Diagnosis and Treatment Options for Bladder Cancer
By Joyce Paul
Bladder cancer affects a lot of us. I personally know at least a couple of people who have had the misfortune of developing this malady. When caught early, it is supposed to be highly treatable, but sadly, many people don’t discover that they have the disease until well after it has progressed to the point that available therapies can no longer help much. Sometimes, the oversight happens because of obliviousness to the symptoms or the changes occurring in one’s body; other times, it’s because even doctors themselves misdiagnose the cancer, initially believing that it’s some sort of infection or something else. A lot of us are very much aware of the symptoms and treatment options for other types of cancer like breast cancer, thanks in no small measure to the fact that it benefits from a highly developed advocacy network that holds marathon events for fundraising and encourages high-profile celebrities to join in promoting people’s awareness of it. Bladder cancer doesn’t get that much attention, and that’s why I’m doing my part in helping people become more knowledgeable about it. I’ve written this rather academic article about the disease, where I share some important details that could just help save lives. I hope that you’re able to share this with your family and friends, too. What is bladder cancer? Bladder cancer is the fifth most common cancer in the United States and the ninth most common cancer worldwide. While commonly seen as an ailment afflicting men, bladder cancer can be also found in women, with women having a worse prognosis than men. Hence, it’s important that more people are made aware of the disease. A good start is by learning more about the diagnosis and treatment options currently available. Diagnosis With an 88% percent survival rate if bladder cancer is diagnosed by Stage I, compared to 15% percent when detected by Stage IV, the early detection of this cancer is crucial. However, screening is not advised by major medical organizations when there are no symptoms present. These symptoms include hematuria (bleeding in the urine), urinary frequency (urinating every hour or two), and dysuria (pain while urinating). Since bladder cancer’s symptoms are very similar to other ailments such as urinary tract infections (UTI), a battery of studies are often prescribed once one manifests symptoms. These include the following:
- Urinalysis with microscopy, a required urine test that detects high-grade tumors yet may miss low-grade tumors
- Urinary cytology, a urine test that looks for abnormal cells
- Urinary tract imaging with intravenous contrast for patients with hematuria, often performed prior to cystoscopy
- Cytoscopy, which is a must when the patient’s symptoms include hematuria and no other causative factors are identified
- Transurethral resection of the bladder tumor (TURBT), which is basically an “incision-less” examination and surgical removal of the tumor itself
A recent study has also found that those who frequently exhibit UTI symptoms, and do not improve over the course of time or treatment, have a high chance of having bladder cancer. Hence, it is recommended that a detailed medical history and physical exam be performed once symptoms are exhibited. Treatment Like other kinds of cancer, treatment options for bladder cancer is based on the severity of the disease. For patients whose tumors are classified as non-muscle invasive (Stage I), or those whose tumors have not broken into the muscle layer of the bladder, the National Cancer Institute (NCI) recommends TURBT. Based on several factors (depth of tumor invasion, tumor grade, likelihood of recurrence, etc.), the treatments below are implemented after TURBT:
- Immediate intravesical instillation chemotherapy
- Immunotherapy, which triggers and boosts the immune system’s own defenses to fight cancer. Bladder cancer makes use of Bacillus Calmette-Guérin (BCG), a vaccine that’s also used to fight tuberculosis
Meanwhile, for those whose cancer is already classified as muscle-invasive disease (Stage II to Stage IV), the NCI recommends two options after TURBT:
- Neoadjuvant multi-agent cisplatin-based chemotherapy, followed by radical cystectomy (bladder removal). This is then followed urinary diversion, or reconstructing a pathway for the flow of urine outside the body.
- Radiation therapy with chemotherapy.
With the choice of treatment based on the severity of the disease, comprehensive testing is essential. Hence, those experiencing symptoms are advised to seek professional help immediately, as early detection is key to survival. Author Bio: Joyce Paul is a marketing professional from Genemedics Health Institute. Her interests lie in health and nutrition. She writes about these topics and contributes to different health and wellness blogs in her free time. She also participates in awareness campaigns for HIV and Cancer in her community. Her advocacy is to help people know more about fighting these diseases. Loves to cook, bake and take long walks with her 4 dogs (two Belgian Malinois, a Golden Retriever and a Shih Tzu).