Bladder Cancer

Your bladder stores and eliminates urine. Bladder tumors can develop on the bladder wall or the urethra. Treatment for bladder tumors vary and depend on the grade (low or high) and how deep the tumor has invaded the bladder wall.

Tumors are classified based on their growth patterns. Papillary tumors are wart-like lesions attached to a stalk. Non-papillary tumors are solid lesions with a broad base. Non-papillary tumors are less common (10%) but tend to be more invasive.

Nearly 85,000 American adults receive a diagnosis of bladder cancer every year. Bladder cancer rarely occurs before age 40. Rates are higher for people who live in the northern half of the United States.

Sometimes there are no symptoms, but if you have bladder cancer you may notice one or more of these. It’s important to understand that the presence of these symptoms doesn’t necessarily mean you have cancer, but you should be seen by a doctor to rule it out.

• Blood in the urine
• Urinating more frequently and with urgency
• Bladder pain
• Difficulty passing your urine

Researchers have found that key contributors of bladder cancer include:

• Smoking
• Family history of bladder cancer
• Some diabetes medications
• Working with or near certain chemicals
• Chronic bladder infection
• Previous chemotherapy or radiation

Men are three times more likely than women to develop the disease, and white men have a higher risk than people of color. Ninety percent of those diagnosed are older than 55.

Research also has shown that exposure to certain chemicals, typically at industrial job sites, can

During your visit to Spokane Urology, your doctor will ask you questions regarding your medical history and will perform a physical exam including the pelvis and rectum.

Other tests that may be performed during or after your visit:

• Urinalysis: A test that looks for blood in the urine or infection.
• Labs: Urine culture and cytology may be requested. Cytology examines cells in the urine for evidence of cancer. FISH (fluorescence in situ hybridization) testing uses voided urine to detect DNA material that suggests bladder cancer might be present. Blood work may be needed to assess kidney function.
• Imaging: A CT scan or MRI scan may be needed depending on your history and kidney function. These tests evaluate the urinary tract and look for any spread of disease.
• Cystoscopy: This test is performed in the office in which your physician inserts a small scope into the urethra to examine the urethra, prostate (for men) and bladder.

The rate of bladder cancer cases and deaths have declined an estimated 1% a year since 2015, mainly due to a decline in smoking. Survival rates should continue to climb thanks to research studies that test new treatments, including drug therapies.

One significant advancement in treatment involves a group of drugs that guide your immune system to kill the cancer cells. These drugs, called immune checkpoint inhibitors, essentially teach your body to fight the disease itself.

Among minimally invasive treatments for patients in the earliest stages of the disease:

• Transurethral resection of the bladder (TURB): This procedure removes the small tumors from your bladder lining using a surgical instrument inserted through the urethra.
• Alternate drug treatments: This procedure includes injecting immunotherapy medication or chemotherapy directly into your bladder using a catheter.

For patients in stages II and III, we offer these treatments:

• Partial Cystectomy: This surgery cuts out the parts of the bladder invaded by tumors. Radiation and chemotherapy may follow.
• Total bladder removal (radical cystectomy): The entire bladder and surrounding lymph nodes are removed. In men, this procedure often includes removal of the prostate and seminal vesicles. In women, the uterus and part of the vagina may be removed. Following the removal, the surgeon creates a urinary conduit and urostomy or an artificial bladder using parts of the intestine.
• Chemotherapy: Patients receive a single drug or combination of drugs designed to shrink the tumor before surgery, and to prevent the tumor from growing back.
• Chemotherapy & radiation: This treatment includes a combination of chemotherapy and radiation for patients who choose not to have surgery or who cannot have surgery.
• Immunotherapy: Here, a medication helps the patient’s own immune system to attack and kill the tumor cells. It is given through a Foley catheter directly into the bladder.
• Radiation: This treatment uses high-energy radiation to destroy cancer cells and can be performed on its own or in conjunction with other treatments

If you’ve entered stage IV:

• Chemotherapy: If the cancer is too advanced to treat with surgery, the doctor will consider chemotherapy treatments. There are several drug options available based on the patient’s condition.