Bladder cancer

Diagnosis

In order to diagnose bladder cancer, the following procedures can be done:

• Cystoscopy. A narrow tube with lens (cystoscope) is inserted  into the urethra to view the structures of the urethra and the bladder and detect any abnormality
• Bladder tissue biopsy. Small portion of the bladder is collected and examined or sometimes called Transurethral Resection of Bladder Tumor (TURBT). TURBT is also used to treat bladder cancer
• Urine cytology. The urine is analyzed under a microscope to check for cancer cells
• Diagnostic imaging procedures. Such as Computed Tomography (CT) urogram or Retrograde pyelogram

How to determine the extent of cancer

The doctor will confirm that you have a bladder cancer first. Then, there are additional procedures which may be recommended by the doctor in order to determine the extent of cancer which could detect that it may have spread through the lymph nodes or other parts of the body.

The following tests, may be recommended:

• Chest X-ray
• CT Scan
• Magnetic Resonance Imaging (MRI)
• Positron Emission Tomography (PET) Scan
• Bone Scan

The result will indicate the stage of bladder cancer from 0 to IV (Roman numerals). The lowest stage (0) means that the cancer is limited to the inner layers of the bladder and the bladder’s muscular wall is not affected. On the other hand, the highest stage (IV) means that the cancer has spread to the lymph nodes or other parts of the body.

Bladder cancer grade

You can classify a bladder cancer further through their appearance under a microscope, also known as the grading, such as:

• Low-grade bladder cancer. The appearance of the cells of this type of cancer is very similar to the normal cells or also called well-differentiated. The tumor is slow-growing and does not reach the bladder’s muscular wall.
• High-grade bladder cancer. The appearance if the cells look irregular and different from the normal cells or also called poorly-differentiated. It grows more rapidly and is more likely to invade the bladder’s muscular wall or other parts of the body.

Treatment

The type, grade and stage of cancer are some of the factors which can affect how to choose which treatment to apply aside from your general health and personal choice of treatment.

Bladder cancer treatment may include:

Surgery 

• Cystectomy– removes all or part of the bladder
• Transurethral Resection of Bladder Tumor (TURBT) Diagnose bladder cancer and removes cancer cell in inner layers of the bladder
• Neobladder reconstruction Creates a urinary diversion to reroute urine flow from the normal pathway.
• Ileal conduit Removes part of the intestine to create a new pathway of the urine
• Continent urinary reservoir A part of the intestine is used as a pouch (reservoir) holding the urine inside your body as a urinary diversion

Chemotherapy 

• Intravesical chemotherapy or bladder chemotherapy. Chemotherapy focusing on the lining of the bladder, primary treatment for superficial bladder cancer
• Systemic chemotherapy. Combined with surgery to remove the bladder and has the highest chance of cure.

Radiation therapy

Radiation therapy also an option combined with chemotherapy, when surgery cannot be done to fight cancer cells.

Immunotherapy

This treatment stimulates the body’s immune system to destroy cancer cells in the bladder or all over the body.

Targeted therapy

Targeted therapy used in the treatment of advanced cancer when other treatments fail. The specialist usually recommends a combination of treatment options.