Why Choose Cedars-Sinai Marina del Rey Hospital for Bladder Cancer Treatment?
The highly skilled urologists and oncologists at Cedars-Sinai Marina del Rey Hospital are well-trained in the evaluation of patients with bladder cancer. Taking into account the type of cancer and its stage, a most suitable treatment approach is considered. Surgical removal of the bladder may be required to completely treat this condition. Your oncologist will be able to help you decide on the most appropriate treatment option.
Bladder cancer starts when your urinary bladder cells begin to divide without control. As more and more cells form, they can accumulate to develop into a tumor and slowly may spread to nearby structures and lymph nodes or to other parts of your body such as lungs, liver, and bones. The bladder wall is made up of several layers of different types of cells. Most commonly, bladder cancer starts in the innermost lining of the bladder called the transitional epithelium or urothelium. Once cancer spreads into or through the other layers of the bladder wall, it becomes advanced and can be difficult to treat.
Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital for Bladder Cancer
At Cedars-Sinai Marina del Rey Hospital, one of the following surgical procedures may be done to treat bladder cancer.
- Transurethral resection (TUR) with fulguration: In this surgical procedure, a thin tube with a light source at its end (a cystoscope) is passed into your bladder through the urethra. The cystoscope also consists of a special tool (a small wire loop) at its end to cut and remove cancer or to burn away the tumor using high-energy electricity (fulguration).
- Radical cystectomy: This procedure involves the removal of the bladder, lymph nodes and surrounding organs that are cancerous. This is indicated when superficial cancer involves an extensive part of the bladder or if cancer has invaded the muscle wall of the bladder. The nearby organs that will be removed in men include the prostate gland and the seminal vesicles, whereas, in women, the uterus, the ovaries, and a portion of the vagina are removed. After bladder removal, your surgeon will create another pathway for the urine to exit your body.
- Partial cystectomy: This procedure is also called segmental cystectomy, and is done to treat a low-grade tumor that involves the bladder walls, but is restricted to only a part of your bladder. After recovery, you will be able to urinate in a normal way as only a portion of your bladder is removed.
- Urinary diversion: This procedure involves the creation of a new path for your body to store and excrete urine.
Drugs and Other Treatment Needed for Bladder Cancer
Few bladder cancer patients may require chemotherapy to get rid of cancer cells that persist even after surgery.
Internal radiation therapy »
Biologic Therapy »
External radiation therapy »
Regional chemotherapy »
The different types of cancer that develop in the bladder are described below.
(transitional cell carcinoma) »
Squamous Cell Carcinoma »
Symptoms of Bladder Cancer
The major signs and symptoms of bladder cancer are bloody urine and painful urination. Other symptoms caused due to bladder cancer include:
- Frequent urge to pass urine
- Burning sensation while passing urine
- Difficulty to pass urine or having a weak stream of urine
- Feeling the need to pass urine even when the bladder is not full
- Pain in the lower back region
In advanced stages of bladder cancer in which the tumor expands or spreads to distant parts of your body, the following symptoms may develop:
Most of these symptoms may also occur with other conditions apart from bladder cancer; therefore, it is necessary to undergo a complete evaluation of your problem.
Diagnosis of Bladder Cancer
If your doctor suspects bladder cancer, the following tests and procedures may be done to evaluate your condition and confirm the diagnosis:
- Physical examination and past medical history: Your doctor will perform a careful physical examination to check for signs of cancer such as any lumps in any other parts of your body. Your doctor may also ask questions about your general health, past illnesses, and any previous treatments.
- Urine analysis: This comprises of tests to check for the presence and amount of red blood cells, pus cells, sugar, and protein.
- Urine cytology: This test involves microscopic examination of a urine sample in the laboratory to check for the presence of abnormal cells.
- Cystoscopy: This test allows your doctor to view the inner portion of your bladder and urethra to check for abnormal masses. A thin, flexible tube with a light source and a lens-cystoscope is inserted into the urethra, and then passed upwards to reach the bladder. Your bladder may be filled with a fluid to allow your doctor to have a clearer image of the internal wall of your bladder. The cystoscope may have special tools to obtain samples of the internal wall tissues of the bladder, which are later examined under a microscope to check for the presence of changes suggesting cancer.
- Intravenous pyelogram (IVP): In this test, a contrast dye is injected into your bloodstream through a vein. As this dye passes through your kidneys, ureters, and bladder, a series of X-rays are taken to check out the presence of cancerous changes or blockages.
- Biopsy: Biopsy involves the collection of a tissue sample or suspected cells, which are later examined under a microscope to rule out signs of cancer. Biopsy is often done during the cystoscopy procedure.
Risk Factors for Bladder Cancer
There are several risk factors that may increase your chances of developing bladder cancer. Certain risk factors such as smoking can be changed, whereas a person’s age or family history cannot be changed.
Risk factors that can be changed
- Smoking: Almost half of all bladder cancers develop because of the cigarette smoking habit. Smokers are thrice more likely to develop bladder cancer than nonsmokers.
- Certain medications or herbal preparations: The prolonged use of an antidiabetic drug called pioglitazone is linked to a higher risk of getting bladder cancer. Herbal supplements that contain aristolochic acid are associated with an increased risk of developing urothelial cancers.
- Occupational exposure to hazardous chemicals: Certain chemical substances such benzidine and beta-naphthylamine that are used in the dyes can cause bladder cancer. Workers at industries manufacturing goods such as leather, rubber, garments, and paint products carry an increased risk of developing bladder cancer.
- Drinking insufficient amount of water and other fluids: People who do not drink enough fluids, especially water are at a higher risk of bladder cancer.
- The presence of arsenic in drinking water: In some countries, drinking water may have a high arsenic level, which is linked to a greater risk of bladder cancer. In the US, arsenic is not found in major amounts in drinking water sources.
Risk factors that cannot be changed
- Age: The risk of getting bladder increases as you grow older than 55.
- Gender: Men are at a greater risk of developing bladder cancer than women.
- Race and ethnic background: American Indians and Asian Americans are less likely to develop bladder cancer, whereas Caucasians are twice more likely to develop bladder cancer than Hispanics and African Americans.
- Genetics and family history: You will be at a higher risk of developing bladder cancer if any of your first-degree relatives (parents, siblings) have been diagnosed with bladder cancer. Certain genetic syndromes such as Cowden disease, a mutation of the retinoblastoma gene, and Lynch syndrome that may be inherited are associated with an increased risk of bladder cancer.
- Personal history of bladder cancer: Urothelial cancers may sometimes form in other portions of your bladder or in the lining of your kidneys, ureters, and urethra. If you have had cancer involving the lining of other portions of your bladder or urinary tract in the past, your risk of developing another cancer in the same area as before or at other parts is higher.
- Previous chemotherapy or radiation therapy: Long-term use of a chemotherapy drug called cyclophosphamide causes irritation of the bladder and thereby can increase your risk of bladder cancer. For this reason, people undergoing chemotherapy with this drug are often advised to drink large amounts of fluids to prevent bladder irritation. People who have received radiation therapy to the pelvic area are at a greater risk of developing cancer.
- Chronic infection or irritation of the bladder: Urinary tract infections, a stone in the kidney and bladder, catheters placed in the bladder for extended periods, and other causes of chronic irritation is associated with greater risk of developing bladder cancer.
- Congenital defects in the bladder: Cancer may begin in the birth defects that rarely occur in the bladder. A defect called urachus may develop if the connection between your bladder and belly button persists even after birth. Cancer that begins in the urachus is adenocarcinoma.
Causes of Bladder Cancer
The exact cause of bladder cancer is not known. But, changes in the DNA of normal cells of the bladder prompt the abnormal growth of these cells, which result in cancers.
Acquired gene mutations: The gene mutations linked to bladder cancer are acquired during one’s life rather than being inherited. Exposure to harmful chemicals and radiation can result in gene mutations. For instance, the chemicals present in tobacco smoke get absorbed into the bloodstream, filtered through the kidneys, and excreted in the urine that collects in your bladder, where its cells can get affected. Changes in certain genes such as the FGFR and RAS oncogenes and the TP53 or RB1 tumor suppressor genes are involved in the development of bladder cancers.
Inherited gene mutations: Bladder cancer usually does not run in families. Inherited gene changes are never a major cause of this cancer. A small number of people may inherit a lowered ability to detoxify and get rid of certain carcinogenic chemical substances. Such people are sensitive to the tobacco smoke and certain industrial chemical fumes.
Naturopathic medicine is an alternative treatment approach that consists of natural, safe and harmless therapies that treat a person as a whole, and also encourage self-healing processes. Some of the natural therapies that reduce the side effects of cancer treatments and boost your immune system include:
Herbal and botanical supplements: These include herbal teas and extracts such as ginger tea, ginger oil gel caps, candied ginger, or other botanical preparations that help prevent or relieve nausea. Extracts of green tea have the ability to cause hindrance to a process that facilitates the spread of early-stage cancer.
Dietary nutritional supplements: Diets rich in vitamins, minerals such as selenium, amino acids, and enzymes may be advised. Broccoli contains glucosinolates that can turn into isothiocyanates - the compounds that help fight bladder cancer. Phytochemicals such as flavonoids are helpful in both the prevention and treatment of bladder cancer. For example, silibinin is a flavonoid that occurs naturally, and can be isolated from milk thistle.
This type of treatment approach involves the use of very low amounts of plant extracts and minerals that are gentle enough in strengthening your body's healing ability as well as in boosting your immune response. Some of the homeopathic supplements are available both in the form of liquid as well as powder, in case you have difficulty in swallowing pills.
It is important to consult your doctor before taking natural supplements as vitamins, minerals, and herbs can have strong effects on your body. Some of these supplements can interact with your chemotherapy drugs and other cancer treatments, or else may be contraindicated for the type of cancer you have.
Acupuncture is an ancient Chinese treatment approach that involves gentle pricking at certain points identified in our body as “trigger points”, using a fine needle. This treatment approach is used in patients with cancer to control symptoms such as pain, nausea and vomiting, fatigue, hot flashes, dry mouth, anxiety, depression, neuropathy, and disturbed sleep.
Chiropractic treatment includes hands-on spinal adjustment, stretching, massage, electronic stimulation of muscles, traction, and application of heat or ice. Chiropractic care can relieve symptoms associated with bladder cancer such as nausea, headache, and neuropathy.
Generally, the action that is taken to reduce your chances of getting cancer is called cancer prevention. By doing this, the emergence of newer cases of cancer can be lowered. Cancer leads to emotional distress in addition to the physical problems and is a group of interrelated diseases rather than a single disease. Several factors such as our lifestyle, genes, and the environment play an important role in both increasing and decreasing our risk of developing bladder cancer.
Here are some measures that could help prevent or reduce the risk of developing bladder cancer:
- Dietary and lifestyle changes
- Avoiding or controlling exposure to things that are known to cause cancer
- Screening of precancerous conditions at an early stage
- Taking medications that can treat a precancerous lesion or inhibit the development of cancerous cells
If you have any symptoms related to bladder cancer or if you need any information or guidance regarding bladder cancer, consult our urologists at Cedars-Sinai Marina del Rey Hospital.