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Types
Types of bladder cancer
The following types of bladder cancer can also be categorized as being non-invasive, non-muscle-invasive or muscle-invasive, depending on how far the cancer has grown into the bladder wall.
Urothelial carcinoma
Urothelial carcinoma makes up more than 90 per cent bladder cancers. It starts in the cells that line your bladder (the urothelium). This type of cancer can be found in more than one place in the urinary tract and can spread into or beyond the walls of your bladder.
Squamous cell carcinoma
Squamous cell carcinoma is a type of cancer that can develop in the lining of the bladder. It makes up about five per cent of bladder cancers and often develops in people who have experienced chronic irritation such as infections.
Squamous cell carcinoma is usually invasive and diagnosed at a later stage.
Adenocarcinoma
Adenocarcinomas are cancers that start in the glands that line your organs. They make up about 2 per cent of bladder cancers and can spread from other parts of the body.
Small cell carcinoma
Small cell carcinoma starts in the cells of the neuroendocrine system which are found in every organ. This is a rare cancer that spreads quickly.
Soft-tissue sarcoma
Soft tissue sarcoma can very rarely start in the muscle cells of the bladder. Radiation therapy for another form of cancer is the main risk of sarcoma of the bladder.
Symptoms
Symptoms
Symptoms of bladder cancer include any of the following:
- Blood in your urine
- Pain during urination
- Frequent urination
Having these symptoms does not necessarily mean you have bladder cancer. These are common symptoms for many conditions.
Diagnosis
Diagnosis
If you have symptoms that could be a sign of bladder cancer, there are several tests that can be used to make a diagnosis.
Uroflow test
An uroflow checks if you have any problems urinating. During the test, you urinate in a special device that measures the amount of urine and the time it takes for you to empty your bladder.
Urine test
You physician may order a urine test called a urine cytology test. During the test, a urine sample is tested for abnormalities. A urine test can determine that you may have cancer, but you need further tests to confirm the diagnosis.
Cytoscopy
During a cytoscopy, a physician inserts a narrow tube called a cytoscope through the urethra. The cytoscope has a very small camera that helps the physician check inside of your bladder for abnormalities.
Biopsy
A biopsy is a procedure where a physician takes a small sample of tissue so it can be examined under a microscope in a laboratory.
A biopsy is often performed during a cytoscopy. If any abnormalities are found during the cystoscopy, the physician can take a small sample of tissue from the inside of your bladder at the same time. This will help the physician make a definite diagnosis.
Imaging tests
Physicians may also order imaging tests such as a computed tomography scan (CT scan) or magnetic resonance imaging to see how large the tumour is and whether it has spread.
Treatment
Treatment
If you have been diagnosed with bladder cancer, your uro-oncology care team will discuss your treatment options with you. We will help you weigh the benefits of each treatment option against the possible risks and side effects.
The treatment options for bladder cancer depend on the type of cancer you have and the stage of your disease.
The most common treatments for bladder cancer are surgery and chemotherapy. Radiation therapy, immunotherapy or targeted therapy are other less common treatments.
Surgery
Surgery is a common treatment for bladder cancer. If your cancer is in an early stage, you may be able to have surgery to remove only the tumour. If you have more advanced cancer, a surgeon may need to remove your whole bladder, as well as nearby tissues and lymph nodes. This is called a cystectomy.
If you need a cystectomy, the surgeon will also perform surgery to give your body a new way to pass urine from the body.
Chemotherapy
Chemotherapy uses medication to treat your cancer. There are two types of chemotherapy used to treat bladder cancer: intravesical chemotherapy and systemic chemotherapy.
Intravesical chemotherapy delivers medication directly to the bladder through a catheter.
Systemic chemotherapy uses medication that affects your whole body. It is given through either intravenous (IV) therapy or through tablets that you swallow. It is more common for bladder cancer.
We may recommend chemotherapy in combination with surgery or other treatments.