Bladder Cancer

BLADDER

Dr. Herman and Dr. Kester, top South Florida urologists, serving the Fort Lauderdale, Miami and Palm Beach areas, specialize in the Diagnosis and Treatment of Bladder Cancer. Call us immediately to schedule an appointment.

Our In-Office Diagnostic Tools include: • CYSTOSCOPY • ULTRASOUND • BLADDER BIOPSY. Our Treatments include: • SURGERY • CHEMOTHERAPY.

Female Urinary Tract	Male Urinary Tract

The bladder is a hollow organ in the lower abdomen. It stores urine, the liquid waste produced by the kidneys. Urine passes from each kidney into the bladder through a tube called a ureter.

An outer layer of muscle surrounds the inner lining of the bladder. When the bladder is full, the muscles in the bladder wall can tighten to allow urination. Urine leaves the bladder through another tube, the urethra.

The wall of the bladder is lined with cells called transitional cells. It is in these cells that bladder cancer begins.

Cancer that is only in the cells in the lining of the bladder is called superficial bladder cancer. The doctor might call it carcinoma in situ. This type of bladder cancer often comes back after treatment. This is why your doctor will recommend frequent surveillance cystoscopy If this happens, the disease most often recurs as another superficial cancer in the bladder.

Although it is uncommon, cancer that begins as a superficial tumor may grow through the lining and into the muscular wall of the bladder. This is known as invasive cancer. Invasive cancer may extend through the bladder wall. It may grow into a nearby organ such as the uterus or vagina (in women) or the prostate gland (in men).

When bladder cancer spreads outside the bladder, cancer cells are often found in nearby lymph nodes. If the cancer has reached these nodes, cancer cells may also spread to other organs, such as the lungs, liver, or bones.

When cancer spreads (metastasizes) from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if bladder cancer spreads to the lungs, the cancer cells in the lungs are actually bladder cancer cells. The disease is called metastatic bladder cancer and is treated as bladder cancer.

COMMON SYMPTOMS OF BLADDER CANCER

• Blood in the urine (making the urine slightly rusty to deep red)
• Pain during urination
• Frequent urination day or night and feeling a sense of urgency with or without incontinence

These symptoms are not sure signs of bladder cancer. Infections, benign tumors, bladder stones, or other problems can also cause these symptoms. Anyone with these symptoms should see a doctor so that the doctor can diagnose and treat the cause as early as possible.

DIAGNOSIS OF BLADDER CANCER

If a patient has symptoms that suggest bladder cancer, the doctor may check general signs of health and may order lab tests. The person may have one or more of the following procedures:

• Physical exam — The doctor feels the abdomen and pelvis for tumors. The physical exam may include a rectal and pelvic examination.
• Urine tests — The laboratory checks the urine for blood, cancer cells, and other signs of disease.
• Intravenous pyelogram — The doctor injects dye into a blood vessel. The dye collects in the urine, making the kidney, ureter and bladder show up on x-rays.
• Cystoscopy — The doctor uses a thin, lighted tube (cystoscope) to look directly into the bladder. The doctor inserts the cystoscope into the bladder through the urethra to examine the lining of the bladder. The cytoscope is usually flexible and a narcotic and antibiotic are often given so that the procedure is virtually painless. To learn more about a Cystoscopy click here.
• Biopsy - The doctor can remove samples of tissue with the cystoscope. A pathologist then examines the tissue under a microscope. The removal of tissue to look for cancer cells is called a biopsy. In many cases, a biopsy is the only sure way to tell whether cancer is present. To learn more about a Bladder Biopsy click here.

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?
• How soon will I know the results?
• Are there any risks? What are the chances of infection or bleeding after the biopsy?

PREPARING FOR TREATMENT

The doctor develops a treatment plan to fit each patient’s needs. Treatment depends on the type of bladder cancer, the stage of the disease, and the grade of the tumor. The grade of the cancer cells is a descriptive term, that explains just how closely the cancer cells resemble normal cells. The grade also suggests how fast the cancer is likely to grow. Low-grade cancers usually grow and spread more slowly than high-grade cancers.) The doctor also considers other factors, including the patient’s age and general health.

These are some questions a patient may want to ask the doctor before treatment begins:

• What kind of bladder cancer do I have?
• What is the stage of the disease? Has the cancer spread?
• What is the grade of the tumor?
• What are my treatment choices? Which do you recommend for me? Why?
• What are the expected benefits of each kind of treatment?
• What are the risks and possible side effects of each treatment?
• What is the treatment likely to cost?
• Is this treatment covered by my insurance plan?
• How will treatment affect my normal activities?

People do not need to ask all of their questions or understand all of the answers at once. They will have other chances to ask the doctor to explain things that are not clear and to ask for more information.

METHODS OF TREATMENT

People with bladder cancer have many treatment options. They may have surgery, radiation therapy, chemotherapy, or biological therapy. Some patients get a combination of therapies.

Dr. Herman or Dr. Kester will describe your treatment choices and discuss the expected results of treatment.

SURGERY
Surgery is a common treatment for bladder cancer. The type of surgery depends largely on the stage and grade of the tumor. Dr. Herman or Dr. Kester can explain each type of surgery and discuss which is most suitable for you. The most common surgical procedure is in office laser. This is performed through a cystoscope and is virtually painless. There is no cutting and it is quick and very effective.

These are some questions a patient may want to ask the doctor about surgery:

• What will you do for me if I have pain?
• Will I have any long-term effects?
• When can I get back to my normal activities?
• Will I urinate in a normal way?
• Will the surgery affect my sex life?
• How often will I need checkups?

RADIATION
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. Like surgery, radiation therapy is local therapy. It affects cancer cells only in the treated area.

These are some questions a patient may want to ask the doctor about radiation therapy:

• Why do I need this therapy?
• How will the radiation be given?
• Will I need to stay in the hospital? For how long?
• When will the treatments begin? When will they end?
• How will I feel during therapy? Are there side effects?
• What can I do to take care of myself during treatment?
• How will we know if the radiation is working?
• Will I be able to continue my normal activities during treatment?
• How often will I need checkups?

CHEMOTHERAPY

Chemotherapy uses drugs to kill cancer cells. The doctor may use one drug or a combination of drugs.

Intravesical Chemotherapy - For patients with superficial bladder cancer, the doctor may use intravesical chemotherapy. The medical assistant usually inserts a tube (catheter) through the urethra and into the bladder. Then a liquid chemotherapy agent is put through the catheter into the bladder where it remains for at least 30 minutes. The effects of this form of chemotherapy is limited to the bladder and is virtually painless. Usually, the patient has this treatment once a week for several weeks. Sometimes, the treatments continue once a month for up to a year or longer.

Call us immediately to schedule an appointment with Dr. Herman or Dr. Kester for the relief you deserve.