Topics in This Section
Fox Chase is a Blue Distinction Center for Bladder Cancer Treatment
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BCAN is the first national advocacy organization dedicated to improving public awareness of bladder cancer and increasing research directed towards the diagnosis, treatment and cure of the disease.
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American Bladder Cancer Society
Raising awareness about bladder cancer, and providing a place for discussion and community through blog posts, forum boards, YouTube, and more.
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The Resource and Education Center
What is Bladder Cancer?
The bladder is a hollow pelvic organ with flexible, muscular walls that stores urine.
Bladder cancer is a disease in which cancerous cells form in the tissues of the bladder.
Types of Bladder Cancer
World-class pathologists at Fox Chase Cancer Center look at tissues under a microscope to diagnose the type of bladder cancer, as follows:
- Urothelial carcinoma or transitional cell carcinoma—accounting for 90% of bladder cancers
- Squamous cell carcinoma
- Small cell
Patients with bladder cancer sometimes have a similar type of cancer in the lining of the kidneys (called the renal pelvis), the ureters or the urethra. Fox Chase Cancer Center specialists provide a comprehensive evaluation of the urinary system for all patients diagnosed with kidney cancer, bladder cancer, ureteral cancer or urethral cancer.
Treatment Options for Bladder Cancer
Between 65 and 80% of transitional cell carcinomas are non-muscle invasive (or superficial) while 20-35% are invasive. Surgeons at Fox Chase Cancer Center are highly skilled in treating all types. Bladder cancer may be treated with surgery, radiation therapy, chemotherapy, biologic therapy or a combination of methods.
Non-Muscle Invasive Bladder Cancer
Surgical Treatment for Early Stage Bladder Cancer
In the majority of cases of non-muscle invasive bladder cancer, surgery takes place at the time of diagnosis using a procedure called transurethral resection (TUR). About half of all superficial bladder cancer cases will recur within the bladder following the initial resection and diagnosis. Recurrent superficial transitional cell carcinoma of the bladder may be treated using intravesical chemotherapy (medication placed within the bladder to prevent the recurrence of bladder cancer). Certain patients with high risk pathologic features or those who recur following intravesical treatment may be a candidate for removal of the bladder (cystectomy).
Intravesical Chemotherapy for Bladder Cancer
The most common treatment for superficial bladder cancer is BCG, a type of biologic therapy which boosts the body's immune system to fight the tumor; although, other drugs available include mitomycin-C, thiotepa, interferon and alternative agents, such as valrubicin.
Using intravesical chemotherapy, anticancer drugs are placed in the bladder through a tube called a catheter that is inserted through the urethra. When given in this way, the anticancer agents remain in the bladder for 1-2 hours and have little toxicity throughout the body. Side effects are usually local bladder symptoms. Treatment is usually done once a week for several weeks and can be repeated several times if the cancer comes back.
Treatment for Muscle-Invasive Bladder Cancer
Invasive bladder cancer is much more aggressive and can potentially be life-threatening. Treatment often requires a combination of systemic chemotherapy, surgery, and sometimes radiation and requires a multi-disciplinary approach. At Fox Chase, urologists, medical oncologists, and radiation oncologists work together to identify a personalized treatment plan individualized to each patient that is evaluated.
Chemotherapy for Bladder Cancer
Systemic chemotherapy administered before planned surgery (neoadjuvant chemotherapy) has been shown to improve survival for patients with invasive bladder cancer that has not spread compared to surgery alone. Chemotherapy administered following surgery or as an alternative to up front surgery in patients with metastasis at presentation may also be appropriate in select patients with aggressive disease.
Surgery for Bladder Cancer
In a procedure called cystectomy, the surgeon removes the bladder and associated pelvic organs (the lymph nodes and prostate in males; the uterus, tubes and ovaries in females) followed by urinary diversion. Surgeons at Fox Chase Cancer Center try to preserve erectile function, and prefer to perform minimally invasive (robotic or laparoscopic) surgery, whenever possible. In carefully selected patients, a partial cystectomy (removal of just the tumor) may be possible, thereby preserving normal bladder function.
Types of urinary diversions include:
Ileal conduit—surgery to drain the kidneys through an opening on the abdomen, thus bypassing the bladder.
Continent urinary diversion—when the bladder is removed or the normal structures are being bypassed and an opening is made in the urinary system to divert urine.
Orthotopic neo-bladder reconstruction—the creation of a new bladder using the patient's own intestines or colon. In selected patients, a partial cystectomy may be possible, thereby preserving normal bladder function.
Radiation Therapy and Chemotherapy for Bladder Cancer
In patients who are unable to tolerate surgery, a combination of radiation and chemotherapy (cisplatin) may help preserve the bladder and control the tumor. More than half of patients who opt for this treatment experience recurrence of the tumor (the bladder cancer coming back) and may require additional surgery or chemotherapy.
Fox Chase Cancer Center offers patients access to several clinical trials to treat metastatic carcinoma of the bladder (occurs when the cancer spreads outside the bladder). This generally includes a systemic form of therapy with several advanced chemotherapeutic agents, or drugs.
Biologic Therapy for Bladder Cancer
Biologic therapy, or immunotherapy, is a form of treatment that uses the body's natural ability to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct or restore the body's natural defenses against disease. Biological treatment is sometimes called biological response modifier (BRM) therapy. Biological therapy for bladder cancer is most often used when the disease is in its early stage. Biological therapy may be used alone to treat bladder cancer or after TUR (transurethral resection) to help prevent the cancer from coming back. Fox Chase doctors are studying the use of these forms of biological therapy for other stages of bladder cancer.