Bladder Cancer: Basics of Diagnosis, Workup, Pathology, and Treatment
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- เผยแพร่เมื่อ 29 พ.ค. 2024
- Dan Reznicek MD, a Urologist in Bellingham Washington, covers the basics of bladder cancer. Bladder cancer is common and is one of the top 5 cancers diagnosed every year in the US. In addition to this video, see resources available at www.nccn.org, www.bcan.org, and visit our website at www.pacificnorthwesturology.com.
Basics:
What is bladder cancer?
How does bladder cancer happen?
What are the symptoms?
What is the workup?
How is it treated?
What is bladder cancer?
Bladder cancer is a the development of a group of cells in the lining of the bladder that begin to grow and divide uncontrollably. They are in the urothelium of the bladder.
What is the urothelium
This layer prevents you from reabsorbing the salts in the urine and the waste products that have been excreted. It is also a barrier from bacteria and infection.
The vast majority of bladder cancers in this country come from the lining of the urothelium and are known as urothelial carcinoma. Historically, it was also called transitional carcinoma.
The other bladder cancers that will not be covered in this video are small cell carcinoma, adenocarcinoma, and squamous cell carcinoma. These are quite rare, and their outcomes and treatments are different from urothelial carcinoma.
Risk factors include smoking, male sex, and exposures to certain chemicals used in the dye and textile industry.
What are symptoms of bladder cancer?
Most people are diagnosed with bladder cancer after seeing blood in the urine (also called hematuria). Sometimes your urine may look normal, but blood is seen on a urine test at your doctor’s office and that is called microscopic hematuria. See a doctor if you note blood in your urine.
Usually there is no pain with bladder cancer in early stages. In some people, they can develop irritative voiding symptoms such as burning with urination, more frequent urination, difficulty urinating or a weak stream, and the sudden urge to urinate. These symptoms will seem like a urinary tract infection but no bacteria is seen on a culture. These symptoms are less common but can occur.
If bladder cancer is caught late and spread to other areas of the body, patients may experience back pain, weight loss, tiredness, swelling, bone pain, and other symptoms.
What is the workup?
A medical history and perform a physical exam. Other tests that may be performed include urine tests with a culture, cancer markers, or microscopic exam. Imaging tests such as a CT scan, Ultrasound, or MRI may be recommended. A cystoscopy should be performed if bladder cancer is suspected or possible.
How is it treated?
Treatment depends on the stage of the cancer. TNM staging of bladder cancer is covered in the video.
Cancers that are in the lining of the bladder alone are known as non-muscle invasive bladder cancer (NMIBC). These are treated with endoscopic removal (transurethral resection of a bladder tumor [TURBT]) and may require further local therapies with drugs instilled into the bladder.
Some cancers involve the muscle of the bladder and require further treatment. Muscle invasive bladder cancer is treated with surgery, chemoradiation, or a combination of therapies. If left untreated, muscle invasive bladder cancer can be deadly and we highly recommend treatment.
Metastatic cancer is less common and describes bladder cancer that has spread beyond the bladder and into other organs. 4% of cancers are diagnosed at this stage. At this point in time, metastatic bladder cancer is incurable, but new treatments are being discovered each year. Treatments at this stage are focused on slowing the cancer growth and lengthening survival. - วิทยาศาสตร์และเทคโนโลยี
My husband has 3 bladder tumors that we have seen through the scope and removal of the tumors have been scheduled. This video helped us completely understand the information the doctor has gone over with us so thank you for your easy to understand information. Praying for no cancer in the muscle!
Cat scan showed that I have three tumors in my bladder, urologist did the camera thing, after words he said he’d bet the farm that it was cancerous. After he left the room, I asked his assistant, she said it’s cancer. He wanted to do the Surgery in a week, a week past and I called, they said wait on the hospital to call you! So the date has been set November the 4th. Five weeks after the Cat scan. Oh’ the cystoscope ? I hurt like hell for three or four days while peeing. But wish me luck guys! Your video was very informative! Thanks.
Good luck tomorrrow 🍀 Hope everything goes well for you ☺
What stage and did they remove your bladder and prostate? Any chemo?
@@venomx4093 It was like a TA stage one. I still have my bladder and prostate. I go every 3 months for a checkup now. They say it’s one of the fastest growing cancer’s in people. I knew things weren’t right with my body. If I wouldn’t of peed blood, I would of never known.
@@jerrylee830 Look into Burdock Root, Turmeric/curcumin, vitamins D and E, black cumin seed oil and ORGANIC wheat grass.
@@jerrylee830 was peeing blood the only symptom you had ? Please help 🙏
My best friend has just diagnosed about 2 hours ago that she has bladder cancer. She said it was spreading. I need more clarity on this. BUT I do know that when she was admitted to the ICU4 days ago they did find tumors on her kidneys, liver, and bladder.. She had to get off the phone right away as one of her doctors had gotten there.. G and I have known each other since 1986. She is my sister. She and I have been through SO much together. She has no one. There are some friends of ours and myself. We are her family, I plan on taking every and any step she allows of this journey with her, Bur my heart is heavy tonight,, Yet I believe in miracles. You have to have faith. IN whatever you have faith in.. .. Doctor, you are a great speaker.. Thank you for this video.
How is she doing now?
My neighbor, is in his seventies. He had prostrate cancer, and had the prostrate gland removed about ten yrs ago. His cancer has returned and he has bladder cancer. He is having hormone therapy, with female ones, for 3 months, and then radiation. He doesnt want chemotherapy again.. It was gruelling for him. He drives to Sloan Kettering, in White plains, NY, every 3 months. Hes retired in Brookfield, CT.He never dreamed that the cancer would return
I have bladder cancer and found this very informative. Thank you.
Thank you so much for this information. My father has bladder cancer and what you have said in this video has helped me more fully understand what he has and in how to relate with understanding to his Doctor. I am going to send this to him and my mother, who is 81 and father is 82.
Thank you for making such a detailed video
You explained this very well.plain and simple.thank you.
Thank you for such an easy to understand video.
Thanks you so much for this series of videos on bladder cancer. Very informative and professionally done.
Excellent presentation. Easy to understand and provides guidance on questions to ask your doctor.
thanks for explaining bladder cancer and its stages
Congratulations for excellent presentation
Thanks. Excellent video! Really well paced, great diagrams and good to see the actual turbt footage. I am in my 50s, recently diagnosed with early stage bladder cancer (G3Ta NMIBC). My symptoms were blood in wee (small clot, happened twice over a couple of weeks). Looking back on it, I realise that I had some unusual urinary urgency a few times too. Looking forward to second turbt soon. Good luck everyone!
Thank you for the excellent review concerning bladder cancer. I'm thankful for the videos to learn more about the disease.
Thanks so much for this informative video. It is VERY helpful.
Very good explanation.
Thanks
Wow this was very easy to understand! Thank you
Thank you for explaining this information it was very helpful.
Useful information.Thank you.
Thank you for presenting this information
May God bless you 🧡
Wow very calm and informative.
I am newly diagnosed, and you answered a lot of my questions thanks for the video!!
Thankyou, this was very informative. Having suffered the dreaded cystoscopy, I had a recent bladder cancer diagnosis. Booked in for a resection and hopefully caught it early. Fingers crossed.
Very helpful, I was recently diagnosed. Worried sick before surgery happens. I’m already a young Cardiac patient I worry about chemo with this...
Hi there , sorry to hear about your diagnosis, and wish you a speedy recovery, may I ask what your symptoms were and when you first noticed something was wrong
How old are you if I may ask?
Hello, hope everything went okay, can you confirm im worried about a loved one.
I have been diagnosed with a bladder tumor and I am scheduled for TURBT surgery. your video was very informative. Thank you
Hey Robert, hope you are doing well, may I know what was the symptoms you had, was there constant blood in the urine?
I got diagnosed with bladder cancer in January iv had 4 operations so far , last month it looked like it was back again so had another biopsy and the results come back last week and it wasn't cancer,iv got to go back in 3 months for another checkup.
@@nizamekhan2736 For me i passed blood in my urine only once luckily i went and got checked
@@tgk3624 was there pains? Or anything else?
@@nizamekhan2736 No but it was caught really early because im on blood thinners so i bleed early, get yourself checkup if i was you.
Thanks for the information much appreciated
Excellent video. Thank you.
Excellent presentation
Thank you so much for this video... helped me to deal with my new diagnosis of Bladder cancer and what to start to look fwd to
Very Good information given. Thank you
Great presentation it was easy to make notes📝..!!
Very nice and professional video. Good stuff
Thank you for a wonderful tutorials... I'm currently diagnosed a non invasive bladder tumour (cancer) and the doctor said we need to act fast.
I peed blood, heavily and painlessley, exactly once. Thank God my primary care doc insisted on a urology workup, because I had a large, high-grade, but as yet NON muscle invasive tumor, which my excellent urologist has treated aggressively. I'm about 20 months out, I'm still cancer-free, but I'm under heavily surveillance and have one more immunotherapy course to go.
You may be squeamish about getting a cystoscopy, but I've found they're not painful because they use a lidocaine lube gel to numb you. The only odd thing is a bit of a weird 'goosiing' fieeling as the probe goes through your prostate, but it's easily tolerable. JUST DO IT. You're uncomfortable after the surgery, but I was pretty much fully recovered within two weeks. Give yourself time to take it easy, though -- any surgery is rough on the body, but it beats an agonizing death any time.
after surgery you can be out of danger?
@@AwaisKhanAm143 - It is the most recurrent of all cancers, so you need to be followed closely. If you can get BCG immunotherapy treatments -- there's a shortage so it can be hard to come by -- it does help reduce the risk significantly.
@@johnthorstensen6582 Already done the BCG. for 6 weeks now the doctor will check up again next month with screening
Thanks for your comments. I’m on session 22 of BCG. 3rd year all clear. Hoping for many years of life!
I went to Dr the day after peeing blood and clots, but the UA was clear. He said to see a Urologist if it happened again. It didn’t happen again for 27 mos, now I had a med size urothelial carcinoma removed, Stage 1a. Go to a Uro after your first Hematuria! Starting BCG next week.
Excellent video, Dr. This is very useful
Ĥad bladder cancer had too my bladder removed wear a bag the test of my life what a pain in ass 😩
I have ehlers danlos , interstitial cystitis and neurogenic bladder. Hoping my scope and biopsy next month are good.
Thank you Very informative. I was just diagnosed with bladder cancer that has grown into the outer muscle layer. I am now trying to find what my options are. Having my first meet at Moffitt Cancer Center in Tampa, FL. in two days. I will follow up later to convey recommendations received.
How are you doing
That' was very enlightening, I wish someone had explained this to me St the start, I was told nothing, I didn't even know I was having local chemotherapy, if I new I would have more than likely refused or asked about other options
Forced poisons like this is why I refuse to go. I am against chemo and radiation and these phucks want to force you to take it?
Thank u for making this video
Excellent information
Excellent job!
Very good information.
I've been seeing some possible symptoms. Worried because I already have an enlarged kidney from a birth defect which was an almost blocked urethra. Had surgery to fix it 31yrs ago. Looking for an urolologist already. This video was very helpful as to what to possibly expect. Thank you so much for making and posting this video.
Please get yourself check if you got symptoms
She
Does a biopsy taken that is found during cystoscope in Drs office , tell the grade and if I spread to other layers other than Urotheial layer ?
i had bladder cancer it did not spread thank goodness although it has come back again it was at the early stages. i have been clear now for 5 years
GOD Bless you and your family. 🙏 Tomorrow is the first time I go to Hospital for Radiotherapy or else I don’t know for my bladder cancer…sad.
How are you today ?
Please upload video how operation of bladder
how about the treatment for spindle cell tumor in the bladder (low grade). I already undergo for 2 turbt.
Thank you for the video family member scan shows a cancerous tumor TURBT tomorrow were praying it was caught early though the concern is 1 kidney is not functioning well. Please do a video onnthe link between low kidney function and Bladder cancer.
Thank you again!
Thank you for explaining this in detail. My brother has just got out of surgery from having a tumour removed from his bladder, still unsure of the grading as biopsy has yet to return.
Jenny what was his symptoms?
How is he today after biopsy
How is he and could you tell me if he had a bening tumor or malign
Thank you. I have had to tumor. On cheno treatments once a month now.
Great video 👍
I served during the nam era and was at camp lejune, well over 30 days. I been diagnosed with bladder cancer and done the TURBT thing. The VA said it was from smoking, I said it was from the toxic water. Also I had hogkins which the VA admitted it was from my water exposure. What is happening here, how many cancers does one must go through before I can play the song "This is the end" ? Any advise regarding this issue? One very tired soilder here.
MY Bladder cancer symptoms.
1st sign. waking in night wanting to urinate and couldnt get back to sleep
2nd sign. pain in lower back
3r sign. sudden pain and wanting to urinate in day or night
these all happened in a 2 week period then I found it hard to sleep at all, i ws averaging 2 hour a night,
4th sign. i urinated blood and a clot came out, i panicked and urinated in a cup and took it to doctors. i had a bloods and ct scan and all was ok ?, i was given antibiotics for a upper UTI, in the 7 days taking the antibiotics i was urinating every 30 minutes for 5 days, im now in my 7th week and in the mean time i bought some urine strips of amazon to test my own urine, and there is a trace of blood in my urine everyday, some days more than others, i drink 3 litres of water a day to help, ive still lower back pain and fatigued, ive just had prostate checked and bloods and all ok,
ive just seen the urologist and im awaiting cystoscopy to check my bladder etc, all will be revealed hopefully soon.
Any updates?
Hello are u okay now
Do you have any info on ureteral cancer that starts there? Was diagnosed as bladder but upon TURBT they concluded Ureteral cancer
Very comprehensive....
I do wish you would explain how a catheter in a spinal cord injury can cause Squamous cell carcinoma. You explain everything very well.
We don't know for sure. Squamous cell carcinomas can be found in multiple areas of the body where there is chronic inflammation. That can be true in chronic wounds, schistosomiasis infections, or chronic catheters.
I was diagnosed with bladder cancer 3 years ago. The cancerous tumor was removed, and I went through a series of BCG treatments. I thought I got rid of it for good, but it came back. Same process all over again.
STAY AWAY FROM SUGAR!!!! CANCER THRIVES OFF OF SUGAR!!! Please eliminate sugars!!! Watch EVERYTHING consumed!!!
If the mass is 3.5 cm big is it more likely that it is the invasive type?
Is it possible for testicular cancer to bring about some of the same symptoms?
Ive had urinary bladder cancer diagnosed a year ago 4 cystoscopys under anesthesia removed 1tumor then more cane after Tried mytimycun ,helped some but now going to oncologist
Could you please let me know, once urine sample is taken for the test, then how fast the test has to be done so that cancer cell couldn't dead?
What about targeted therapy and immune therapy ? Good teacher.
I just had the scope thing no cancer but what is a good remedy for getting over the pain for urination I’ve been trying TC and I had the antibiotic before the CAT scan had nothing on it which was great no UTI. I’m just in some pain.
It should go away probably tomorrow I’m gonna schedule for a follow up
My 93 yr old has been told by her urologist, she has 5 cancer lesions. From her description of dr’s explanation, the lesions are not localized but rather scattered about bladder wall. My concern is the cancer has already spread. Any comment?
I seem to have a continuous bladder infection. My Dr. told me I have numerous bacteria but that they don’t usually treat bladder infections in patients my age(75). I have urgency’s, but at night laying down , no feeling of needing to urinate, but I have aching in the bladder, fire in my feet, which then leads to a hot flash. Which is new because they were pretty much gone 3-5 yrs ago.
I am very worried having an infection all the time will lead to cancer.?
Am from india
Your video very helpfull me
Great, glad you liked it.
How are u
Can you talk about I. c.? Interstitial Cystitis, I have this awful condition!!
My grandmother just had turbt done and u fortunately the cancer is pretty invasive so she has to have her whole bladder removed now. She's super scared and I'm trying to get as much education on this as possible so I can reassure her it's going to be ok and she'll be better after.
May the Lord watch over her and protect her, in Jesus name, amen.
@@venomx4093 thank you so much! God bless 🙏🏻❤️
@Jayson Argonaut wow that’s amazing! Congrats on beating it 💪
If you don’t mind me asking, what was your experience? What procedure did you have done? She had her bladder removed and now as an ostomy bag, she’s experiencing pain in her mid section though and I’m afraid that may be the cancer metastasizing.
Hope she and your family are doing well.
My fathers bladder has operated 3times withing 3 years,bcg was treated ...For 1st nd secnd then doc decided to treat MMC rather than bcg and the lst tumour is not invasive also but he is in trouble in urinating because he passes urine each evry 15 minuts almost and unable to do the imunotherphy mmc treatment as well.....Please guid me sir
Very helpful
Thank you doc. I just went through my second surgery of scrapping by Dr Anton Galich in overland Park Kansas. I go in on February 15 for my bcg treatment. Dr Galich said he had to read the report from the pathologist 5 times because of there non silence. Is this common?.
What did your doctor, or you, mean by "non silence"?
@@bigpardner sorry there nonsince
@@michaelmcintire8018 If your doctor thought the pathologist report was nonsense then that is unacceptable and of great concern. Did he call the pathologist and ask for an explanation?
@@bigpardner not sure
Scheduled for turbt in 2 days. Gross blood in urine for 10 weeks!
How are you now, if you don't mind me asking?
Just had kidney stones removed and it turns out I have bladder cancer. Thank goodness they got the whole tumor out. Fingers crossed it stays gone.
Hope you are healing, sending prayers your way.
Sir please suggested medicine treatment for my father he diagnosed with 4cm tumours
Depends on the pathology, usually removed by transurethral resection prior to deciding on other options. Watch the other video on non-invasive bladder tumors if it is non-invasive: th-cam.com/video/Uom5GAwL1zo/w-d-xo.html
Good info. Glad the doc kept the worst for the last.
I have lynch syndrome which started in my back/spine area & hip, then it was in the lower right eyelid & upper left eyelid. Then breast cancer then urothelial cancer. However after going through surgery BCG treatments & another surgery all within 12 wks, dr decided to have a stent put unto a non functioning kidney through the tube & into bladder. Went for a second opinion & found out that the tumor was actually in the tube. I had the kidney, tube & partial bladder resection. Bladder had no cancer. 3 months later, 5 tumors in the bladder. Dr removed them but I feel the tumors were actually misdiagnosed by pathology because of the sebaceous carcinoma. Now it will be 6 months & time for another cystoscope. If cancer is found, Drs are saying I will need bladder removed. If no cancer, another round of BCG treatments.
I am not sure of all if this, mainly because there isn’t much info on sebaceous carcinoma, tumors starting in the tube between kidney & bladder & putting a stent through a tumor… oh and kidney had atypical cells when biopsy was done. I also have 2-3 nodules in my right kidney but no biopsy just an ultrasound…
I know most do videos on regular types of bladder cancer but what about the 5% that have this type?
Praying for you just diagnosed w ureteral cancer. 2 years later it's my understanding it's rare to originate in tube. Awaiting the biopsy results now please any info so I know what to expect. Thank you so much!
I had gone to turbit and 3 session chemo therapy 2 years now my question do I need again chemotherapy
We can't make medical recommendations over comments online. Also would need your full history. I would recommend talking with a urologist and if you are concerned about the recommendation get a second opinion.
The higher the risk of bladder cancer comes from increased exposure to carcinogen. Does it mean that we shouldn't hold our pee for too long/ discharge our pee as frequently as we can? (Just to minimise the exposure of our bladder to the waste product/carcinogen in the urine)
❤thnks
My wife has been diagnosed with T2-3 bladder cancer N-0. I have read about sound waves being used to destroy cancer cells. Is there anything to this treatment? Thank you.
I have not heard about sound waves specifically for bladder cancer. It is not in the current AUA or NCCN guidelines for bladder cancer and is likely investigational/under research. Check www.clinicaltrials.gov to see if there are any clinical trials pertaining to your question.
How is she now?
I heard about this invention called the "Harmonic Egg" You may want to google it?
Hello, I don't understand the language of the videos. I am Iranian. My father is 60 years old and has been suffering from bladder cancer for two years. He says he will not do surgery. He does not even give a sample. He has only been able to reduce the growth of this tumor a little with medicinal plants such as nettle and turmeric, and he is not satisfied with surgery. I do not know whether Does it work correctly, does it not require surgery or not? If you have experience with it, please advise. Thank you
Believe me how many times I planned to go and have bath
Or shower but I couldn't because my tummy hearts and is bloated
and the weight of my body and the knee which resently was open its mouth , it was so painful that couldn't be quite , exactly like a nerve in a tooth that hearts .
is thickening of the bladder wall a symptom?
I didn't have any blood in urine except a tiny amount on the day they did an ultrasound and put pressure on bladder several times but CT showed masses on liver and trying to diagnose where they came from if mets.
@@bquietspirit764How are you doing?
I've been. Told. Long term foley catheter use can also raise cancer risk. My urologist told me. That.
Gud day..my father diagnosed last year,he undergo laser treatment on 2021.the doctor said my father has carcinoma on his bladder and on its stage 1..and now 2023 my father noticed that he has a bad feeling..and now his doctor wants to undergo ct scan and the results is total removal of bladder..my father cant accept the operation..what should we do?? Is there a possible cure or treat for not undergo operation? Please we need ur advice..thank you
How is your father doing, reconstruction from my layman perspective explained may put his fears a bit at ease.
I'm a C-6 incomplete quadriplegic for 34yrs & pretty sure I have this..... Damn it
I just wanna express my gratitude to Dr.Ono on TH-cam for curing my HSV 1&2. God will bless you Dr Ono
I dont have any blood when i pee but i have pain when i start my urination
I'm a 45 year old male with a painful bladder deep when I urinate and in souht africa doctors can not help me i walk with this pain for many years
I have so much pain when I go to the bathroom and walking around .
What is the survival rate of bladder cancer ?
Suffering with it now had operation 1 week ago and in terrible pain catheter not being taken out till 20 july, thank you for putting video on here,
Depends on the type and stage. Stages 3-4 has a bad 5 year life expectancy. Chemo will most likely make those last few years hell. At least without chemo, you won't suffer from the evil side effects from the drug.
In one branch of our family all members, males or females alike (including me and my children) have consistent and permanent presence of blood in the urine, discovered in virtually all the urine tests. The amount of blood (in counts) periodically increases, then decreases again. Strangely, nobody of these people, living or dead, has developed bladder cancer so far...
The treatment for me is putting the medication into the bladder itself here in the UK
How do you feel about FISH testing? I have had two false positives.
Seeing as how this is now year 2021 and not 1950, when a urologist performs a cystoscopy or TURBT and sees something pathological or unusual, wouldn't they save those images as a visual record?
I just had surgery to remove cancer in bladder. Doctor told me today that my whole bladder is cancerous. That there isn’t one spot that doesn’t have cancer. He said bcg once a week and 2-3 more surgeries. I’m screwed
How are you ?
I feel terrible every single day , I can't do many things at home
because i'm to heavy , bloated , my knee hurts and lower legs.
Sometimes I'm even scerd to walking around in our house because
my knee is swollen and the pressure of my body weight and bloated tummy coursing the problem because properly have some
Connection with my left knee , the right knee is okay , thanks God, but in a lower legs is problems because they are swollen
, like I mention before . Down there where is palves I feel
Emptiness I don't feel any more the bride which was in my hips
to suport my whole belly , I feel everything in my upper tummy
Where is ( przepona ) situated and coursing enormous pressure,
to making me problems in brithing because it is so high , almost under the heart . It is uncomfortable feeling like someone is popping me and making me wider in my chest , and that is everyday , the horrible feeling , and that is why I can't do much at home and everything is on my husband Stas hands .Matthew Cetnar the same have some problems with bloating , he can't eat
Very big meals , big amount of food because he getting full
to quickly and that is why he is so skinny, plus he has problem
with his teeth , and Stas to and my teeth are a bit
not very good either. YES TERRIBLE THINGS WE have .
I hear you bloating all the time weight loss stomach plus bladder issues testing getting done now.hopefully nor cancer
It’s incredibly shocking to know doctors can diagnose and treat (a$ long as it’$ their way$) but not suggest people to stay away from carcinogenic substances (apart from cigarettes) that is so common in everything we eat, spray, inhale or use in this country 🇺🇸
My urine has microscopic blood and my doctor is taking it light saying it’s nothing he keep taking more and more test same result now ky left side is burning 🔥 and I can feel shooting pain like every day
Please speak to the gp about a cystoscopy
you may go for cityscan ask your doctor plz. My father was syntom like this but doctor told no problem 1 year later another dr do cityscan and suspected cancer last stage.