Health Break | Published July 31, 2006 | Written by Tara Baney, RN, MS, AOCN

Signs, Symptoms and Treatments For Bladder Cancer

The American Cancer Society estimates that 61,420 people will be diagnosed with bladder cancer and 13,060 will die from the disease in 2006.

Bladder cancer occurs more commonly in people over the age of 55 (90 percent of all cases) and half are found in those above the age of 73. It occurs more commonly in males than in females. Blood in the urine is often the first sign of bladder cancer.

Most people associate smoking with lung cancer but there is also a strong link to bladder cancer and a history of smoking. Smokers are twice as likely to get bladder cancer as nonsmokers.

Some of the carcinogens (cancer-causing chemicals) in tobacco smoke are absorbed from the lungs into the bloodstream. From the blood, they are filtered by the kidneys and concentrated in the urine. These chemicals in the urine damage the lining of the bladder, which increases the chance of cancer developing.

Exposure to chemicals, such as those used in the rubber, leather, textiles, paint product and printing industries have also been linked to the development of bladder cancer.

When describing bladder cancer, often it is described as either superficial or invasive. These classifications describe whether or not the tumor is only in the lining of the bladder or if it has penetrated in the muscle layer of the bladder wall. The depth of invasion will determine the type of treatment.

Most people with bladder cancer will undergo a surgery procedure called a transurethral resection of a bladder tumor (TURBT). A small tube with a camera and light at the end (cystoscope) is inserted into the urethra (tube the urine passes out of the body) and into the bladder. The urologist is able to look at the tumor, and remove it for diagnosis, treatment and staging purposes.

If the tumor has not penetrated into the muscle and is only within the lining, there may be no further treatment other than cystoscopies on a regular basis to look for recurrence of the tumor.

If the tumor is one that is more likely to reoccur, Bacillus Calmette-Guerin (BCG), which is a weakened strain of the tuberculosis bacteria, may be instilled into the bladder once a week for six weeks. This causes an inflammation in the bladder, which causes any residual cancer cells to slough off. It also causes peoples immune systems to help destroy the cancer.

If a person is found to have invasive bladder cancer, removal of the bladder is usually the treatment of choice. If surgery is not an option, radiation along with chemotherapy may be an option.

Years ago people who had their bladder removed only had the option of wearing a pouch on their abdomen that would collect their urine. Over the last 10 to 15 years, surgical techniques have been developed to reconstruct a new bladder or pouch out of intestine. After these procedures, people will either be able to urinate as they did with their own bladders or they may have small openings in their abdomens (stoma) in which they will insert catheters several times a day to drain the urine out of an internal pouch in the abdomen that holds the urine. Whichever surgery people undergo, they can continue to live full and active lives despite the changes in their urinary systems.

If you would like more information regarding bladder cancer, contact the American Cancer Society at 800.ACS.2345, or visit the ACS Web site; the National Cancer Institute; or Tara Baney, Oncology Clinical Nurse Specialist at Mount Nittany Medical Center, who can be reached by phone at 814.231.7005.

Tara Baney is the oncology clinical nurse specialist for the Penn State Cancer Institute at Mount Nittany Medical Center.