Also see Ureteric cancers in the Kidney cancer section Urinary bladder cancer is usually picked in patients with blood in the urine (Hematuria) which could visible (seen by the patient) or non-visible (picked up by a doctor from urine test). A small number of patients with this cancer get to be diagnosed due to other symptoms as well ( fore.g urinary symptoms, pain , incidental finding etc.).
Usually picked up at a cystoscopy( camera examination of the urinary bladder), the diagnosis is confirmed after a tumour resection with a help of a rescetoscope ( TURBT- Transurethral resection of Bladder Tumour). The removed tissue is examined by a pathologist who then gives a grade and possible stage of the disease. In addition, the examination by the urologist during anesthesia as well as additional scans ( CT or MRI) will help us understand the stage and extent of the disease.
The most common type of the cancer is called Transitional cell carcinoma (TCC). The well established risk factors are smoking and working with chemicals. It arises from the lining of the urinary tract. The same lining exists from the urine collecting system in the kidney ( renal pelvis and ureter), in the urinary bladder and extends to the proximal aspect of the water pipe (urethra).
Once a clear cut grade and stage is obtained, the treating urologist will discuss with you the next follow up about treatment plan . For low to intermediate grade disease, patients usually require a periodic examination with a camera and resection as and when necessary. In addition , instillation of certain chemicals in the bladder at times helps.
For high grade+\- invasive disease removing the bladder (radical cystectomy) is one of the best choices of treatment. This is a major operation and the pros and cons of this operation needs to weighed carefully with a urological surgeon. This operation (Cystectomy) can be done by a Robotic or by open method. The urological surgeon will guide you about the best method depending on various factors.
In addition the surgeon will also discuss the best method of diverting the urine which could be achieved by a neobladder reconstruction, or an ileal conduit diversion or a continent urinary diversion. Once again, a detailed discussion with your surgeon will help you understand the advantages and disadvantages of each method.
The patients with these cancers needs periodic follow up depending upon the grade , stage of the cancer and the method of treatment offered.