What is bladder cancer?
Bladder cancer begins when healthy cells in the bladder lining change and grow out of control, sometimes forming a mass called a tumour. Urothelial carcinoma is the most common type of bladder cancer. Squamous cell carcinoma, small cell carcinoma, and adenocarcinoma are less common types. Urothelial carcinoma can also start in the ureters, which bring urine from the kidney to the bladder, and spread to the kidneys. Bladder cancer is also described as non- muscle-invasive or muscle-invasive, depending on whether it has grown into or through the muscle of the bladder wall.
What is the function of the bladder?
The bladder is an expandable, hollow organ in the pelvis that stores urine before it leaves the body. The bladder is part of the urinary tract, which is also made up of the kidneys, ureters, and urethra.
What do stage and grade mean?
The stage is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. There are 5 stages for bladder cancer: stage 0 (zero) and stages I through IV (1 through 4). The tumour may also be given a grade, which describes how much cancer cells look like healthy cells when viewed under a microscope.
How is bladder cancer treated?
The treatment of bladder cancer depends on the type, stage, and grade of the tumour; possible side effects; and the patient’s preferences and overall health. For people with non-muscle-invasive bladder cancer, the tumour is usually completely removed during a procedure called cystoscopy and transurethral bladder tumour resection (TURBT). The doctor may recommend additional local treatments to reduce the risk of recurrence. These treatments can include chemotherapy or immunotherapy. They are often given through a bladder catheter. This is known as intravesical therapy.
For people with muscle-invasive bladder cancer, surgery to remove the entire bladder and nearby lymph nodes is usually recommended. This is called cystectomy. The surgeon will create a new way to pass urine out of the body, called urinary diversion. Chemotherapy before or after surgery is also common. An approach using chemotherapy with radiation therapy may provide the same benefits as bladder removal. This is called bladder preservation. Talk with your doctor about all treatment options. The side effects of bladder cancer treatment can often be prevented or managed with the help of your health care team. This is called palliative or supportive care and is an important part of the overall treatment plan. Regular communication is important in making informed decisions about your health care. It can be helpful to bring someone along to your appointments to take notes and understand.
Consider asking your health care team the following questions:
1. What type of bladder cancer do I have?
2. Can you explain my pathology report (laboratory test results) to me?
3. What stage is the bladder cancer? What does this mean?
4. Is the cancer invasive?
5. What treatment plan do you recommend? Why?
6. What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?
7. Who will be part of my treatment team, and what does each member do?
8. How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?
9. Will this treatment affect my ability to become pregnant or have children?
10. What long-term side effects may be associated with my cancer treatment?
11. If I’m worried about managing the costs of cancer care, who can help me?