Bladder cancer is the most common cancer of the urinary tract. The bladder is an organ located in the pelvic cavity that stores and discharges urine. Urine is produced by the kidneys, carried to the bladder by two tubes called ureters, and discharged from the bladder through the urethra.

There are three types of bladder cancer that may form:

• Papillary tumors stick out from the bladder lining on a stalk. The tumors tend to grow into the bladder cavity, away from the bladder wall, instead of deeper into the layers of the bladder wall.
• Sessile tumors lie flat against the bladder lining. Sessile tumors are much more likely than papillary tumors to grow deeper into the layers of the bladder wall.
• Carcinoma in situ (CIS) is a cancerous patch of bladder lining. The patch may look almost normal or may look inflamed.

Each type of tumor can present in one or more areas of the bladder, and more than one type can be present at the same time.

Symptoms

The primary symptom of bladder cancer is blood in the urine. When blood is present in urine is called Hematuria. Hematuria may be visible to the naked eye or visible only under a microscope and is usually painless. Other symptoms include frequent urination and pain upon urination.

Once symptoms occur the following diagnostic tests may be performed to evaluate whether or not cancer is present in the bladder:

• Urine cytology: urine is examined through a microscope for cancer cells.
• Intravenous pyelogram (IVP): a series of special x-rays is taken of the kidneys and bladder after injecting a contrast agent (dye) into a vein.
• CT scan or CT urogram: a series of special x-rays taken of the abdomen, pelvis with particular attention to the kidney, ureters and bladder.
• Cystoscopy: a telescope like instrument is inserted through the urethra to closely examine the inside of the bladder.
• Biopsy: the removal of tissue to be examined under a microscope.

Treatment

Treatment of bladder cancer depends on the stage of the disease, the type of cancer and the patient’s age and overall health. Treatment options include surgery, chemotherapy, radiation and immunotherapy. In some cases, treatments are combined.

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