Bladder Cancer Frequently Asked Questions

Bladder cancer can sometimes be detected early and when it is, it is usually very treatable. Screening is an important aspect of early detection, but is usually only done for patients who are at high risk for developing bladder cancer, for example those patients who have a history of smoking or chemical exposures.

Once you receive a diagnosis of bladder cancer, doctors will work to determine if the cancer has spread and how far.

The stages of bladder cancer are graded using the TNM staging system.

Tumor (T): How big is the tumor and where is it located?
Nodes (N): Has the tumor spread to the lymph nodes? If so, in what part of the body and how many?
Metastasis (M): Has the cancer metastasized (spread)? If so, in what part of the body and how much?

From there, the cancer will be graded on a scale of 0 to 4 with 0 being the least advanced and 4 being the most advanced.

The staging system for bladder cancer is particularly involved but your doctor will go over it with you in more detail to ensure you’re able to make informed decisions regarding your treatment.

If your doctor diagnoses the cancer in its early stages, you’ll have a variety of treatment options to choose from. Depending on the stage, you might be able to opt for a transurethral resection of bladder tumor (TURBT), a surgery in which bladder tumors are removed from the bladder wall, accompanied by chemotherapy, radiation therapy, or immunotherapy.

If the cancer continues to spread despite treatment, complete or partial bladder removal, known as cystectomy, may be recommended.

Potential side effects of treatment vary depending on the type of treatment. However, some common side effects of treatment may include:

• Nausea and vomiting
• Symptoms in the bladder, such as pain or burning during urination which can last many weeks after a bladder tumor resection
• Low blood counts
• Fatigue
• Increased risk of infection
• Bowel obstruction/leak or urinary tract obstruction/leak after cystectomy and urinary diversion

Side effects associated with chemotherapy include hair loss and mouth sores while those associated with radiation therapy include changes in the skin around the treatment area.

If your doctor determines you have late stage bladder cancer, your original tumor has likely grown and pushed through the bladder walls. The cancer cells may have spread to other nearby organs, such as the liver or lungs and you will likely be recommended to undergo chemotherapy.

Patients may struggle with frequent urination or incontinence. If you require radical cystectomy - removal of the entire bladder as well as nearby lymph nodes – you will need reconstructive surgery to create another way to store and pass urine. Most men after cystectomy also lose the ability to obtain an erection.

This depends entirely on the type of treatment you undergo. If you have early stage cancer and opt for a transurethral resection of bladder tumor (TURBT) can experience mild side effects, such as bleeding or pain during urination. Luckily, these side effects are usually temporary.

However, it the cancer recurs and the TURBT needs to be repeated more than once, your bladder could scar which will likely affect the amount of urine you’re able to hold. This can lead to permanent side effects, including frequent urination or incontinence.

If your cancer recurs or spreads, your treatment options will depend on how far your cancer has spread, what treatments you’ve tried, and whether you’d like to pursue additional treatment. When non-invasive bladder cancer returns, doctors typically recommend you repeat the initial treatment.

If the cancer recurs continuously, your doctor may want to discuss potential bladder removal. You might also be referred to a clinical trial to learn about whether you’d be a good candidate to try a new treatment altogether.