Is there local Bladder Cancer Care?

J. Ben Wilkinson, MD, FACRO

Although not one of the main three or four cancers we tend to hear about, bladder cancer is actually quite common, especially among men. Every year in the United States, over 83,000 people are diagnosed with a bladder tumor and many of these cancers are related to a personal history of smoking or chemical exposure at work.

The most common symptoms associated with this type of cancer is blood in the urine. This can sometimes be seen after going to the restroom, but many times it is microscopic or only visible when using a microscope at a medical facility or laboratory. Other concerning symptoms include increased number of times someone needs to go the bathroom, increased urge to quickly go to the bathroom and, in more advanced cases, back or bone pain. Having these symptoms does not necessarily mean someone has bladder cancer, but if someone notices blood in the urine, it is worth bringing this symptom to the attention of your primary care doctor or a urologist to make sure there is not anything serious happening inside the bladder.

Fortunately, most bladder cancers are not very invasive and usually involve only the surface or first layer of the bladder. For these types of early-stage, superficial bladder tumors, treatments delivered inside the bladder by a urologist is generally the treatment of choice. The type of treatment depends on how deep the bladder tumor has grown and whether the tumor is new or has come back after a prior treatment.

There are more invasive cancers that extend deeper into the layers of the bladder or, in some cases, may have already spread to a lymph node, the lungs, or a bone. These deeper tumors account for about one third of the total bladder cancers each year and can require more intensive treatments. In many cases, this may mean surgery to remove the whole bladder, with or without chemotherapy. While this can be an effective treatment, patients with very good urinary function and relatively limited disease can talk with their doctors about other treatments where their bladder stays in place. This term is called “bladder preservation” and is part of an overall trend in cancer care where doctors try to keep a patient’s body as intact or normal as possible while still effectively treating the cancer.

In the United States, bladder-preserving therapy has mainly been championed by doctors at Massachusetts General Hospital (MGH), which is one of the medical centers affiliated with Harvard University. For several decades, doctors at MGH have offered many patients who have been diagnosed with a muscle or deeply invasive bladder cancer the option of keeping their bladder by including radiation in the treatment plan. The long-term results of this type of treatment have been impressive; over two-thirds of patients treated with this technique are cancer free at five years. And equally important as tumor control, over sixty percent of patients who eradicate the cancer report that they have good function of the bladder. Local removal of tumors that grow back or full surgery can still be required in some cases, but many patients are able to keep their natural bladder and urinary function.

The cancer team at Mission Hope Cancer Center is pleased to share with the community that this advanced form of bladder cancer treatment is available here on the Central Coast. If you or a loved one has been diagnosed with a deeply invasive bladder cancer, consultation with our medical and radiation oncologists may be a helpful part of your cancer journey. Please contact the Mission Hope Team at 805.219.HOPE (4673) for information or questions.

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