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Bladder
Cancer
Most
cancers are named for the part of the body or type of cells
in which they begin. About 90 percent of bladder cancers are
transitional cell carcinoma, cancers that begin in the cells
lining the bladder. Cancer that is confined to the lining
of the bladder is called superficial bladder cancer. After
treatment, superficial bladder cancer can "recur";
if this happens, most often it recurs as another superficial
cancer.
In
some cases, cancer that begins in the transitional cells spreads
through the lining of the bladder and invades the muscular
wall of the bladder. This is known as invasive bladder cancer.
Invasive cancer may grow through the bladder wall and spread
to nearby organs.
Bladder
cancer cells may also be found in the lymph node surrounding
the bladder. If the cancer has reached these nodes, it may
mean that cancer cells have spread to other lymph nodes and
to distant organs, such as the lungs. The cancer cells in
the new tumor are still bladder cancer cells. The new tumor
is called metastatic bladder cancer rather than lung cancer
because it has the same kind of abnormal cells that were found
in the bladder.
Symptoms
Some
common symptoms of bladder cancer include:
- Blood
in the urine (slightly rusty to deep red in color).
- Pain
during urination.
- Frequent
urination, or feeling the need to urinate without results.
When
symptoms occur, they are not sure signs of bladder cancer. They
may also be caused by infections, benign tumors, bladder stones,
or other problems. Only a doctor can make a diagnosis. (People
with symptoms like these generally see their family doctor or
a urologist, a doctor who specializes in diseases of the urinary
system.) It is important to see a doctor so that any illness
can be diagnosed and treated as early as possible.
Diagnosis
and Staging
To
find the cause of symptoms, the doctor asks about the patient's
medical history and does a physical exam. The physical will
include a rectal or vaginal exam that allows the doctor to
check for tumors that can be felt. In addition, urine samples
are sent to the laboratory for testing to check for blood
and cancer cells.
The
doctor may use an instrument to look directly into the bladder,
a procedure called cystoscopy. This procedure may be done
with local or general anesthesia. The doctor inserts a thin,
lighted tube (called a cystoscope) into the bladder through
the urethra to examine the lining of the bladder. The doctor
can remove samples of tissues through this tube. The sample
is then examined under a microscope by a pathologist. The
removal of tissue to look for cancer cells is called a biopsy.
In many cases, performing a biopsy is the only sure way to
tell whether cancer is present. If the entire cancer is removed
during the biopsy, bladder cancer can be diagnosed and treated
in a single procedure.
A
patient who needs a biopsy may want to ask the doctor some
of the following questions:
- Why
do I need to have a biopsy?
- How
long will it take? Will I be awake? Will it hurt?
- What
side effects can I expect?
- How
soon will I know the results?
- If
I do have cancer, who will talk with me about treatment?
When?
Once
bladder cancer is diagnosed, the doctor will want to learn the
grade of the cancer and the stage, or extent, of the disease.
Grade is important because it tells how closely the cancer resembles
normal tissue and suggests how fast the cancer is likely to
grow. Low-grade cancers more closely resemble normal tissue
and are likely to grow and spread more slowly than high-grade
cancers.
Staging
is a careful attempt to find out whether the cancer has spread
and, if so, what parts of the body are affected. The stage
of bladder cancer may be determined at the time of diagnosis,
or it may be necessary to perform additional tests. Such tests
may include imaging-- CT scan, MRI, sonogram, IVP, bone scan,
or chest x-ray.
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