What is a bladder tumor?

A bladder tumor is the excess growth of cells that line the inside of the bladder.

A tumor may be either cancerous or noncancerous. A noncancerous tumor is usually a small, wartlike growth that does not spread. If it is a cancerous tumor, the cancer cells may spread to the bladder wall or to other organs through the bloodstream. Bladder cancer affects men three times as often as women.

Bladder tumors are the second most frequent tumor of the reproductive and urinary tracts, after prostate tumor.

Bladder tumors are most likely to develop in white men over the age of 50.

How does it occur?

In many cases, bladder tumors occur when the cells lining the urinary tract are exposed to chemicals known to cause cancer. These chemicals are associated with:

• tobacco smoking

• exposure to certain carcinogenic, or cancer-causing, chemicals, especially those used in the rubber and dye industries.

In other cases, bladder tumors are associated with the following:

• chronic, or on-going, urinary tract infections

• schistosomiasis, a parasitic infection common in the tropics.

What are the symptoms?

Symptoms of a bladder tumor include:

• blood in the urine (in 75% of cases)

• painful or burning urination

• loss of appetite and weight

• back or abdominal pain

• frequent urination in small amounts

• persistent fever.

How is it diagnosed?

To diagnose a tumor in the bladder, the doctor will give you a physical exam and review your symptoms. The doctor will want a urine sample so he or she can test you for a urinary tract infection or blood in your urine. The doctor may also look for cancerous cells (cytology).

The doctor may do a cystoscopy. During this test the doctor passes a slender tube with a light up the urethra and into the bladder to look inside your bladder.

The doctor may also do a biopsy. This involves removing a small piece of bladder lining tissue. The tissue is examined under a microscope to see if it is cancerous.

The doctor may also order the following x-rays:

• an intravenous pyelogram (an x-ray study of the whole urinary tract using dye injected into your arm)

• a chest x-ray

• a CT scan of the pelvis, abdomen, and possibly the chest.

If a cancerous tumor is found, the doctor may do a bone scan to see if the cancer has spread.

How is it treated?

Treatment of a bladder tumor depends first on whether it is cancerous. For 'superficial' bladder cancer (an early, small tumor), the most likely kind, your doctor will try to destroy the tumor by burning it off with a high-frequency electrical current passed through a special cystoscope. This process is called fulguration. For small tumors this may be the only treatment that is needed. In another process, chemicals are used to destroy cancer cells.

Large tumors that have invaded the muscle of the bladder wall must be surgically removed through the abdomen. Sometimes to remove the tumor, all or part of the bladder is removed. This type of surgery is called a cystectomy. It is performed under general anesthesia. This surgery includes attaching the ureters (tubes draining urine from the kidney) to a surgically devised reservoir and then to an external opening. A bag is attached to this opening to collect urine. If the whole bladder is removed, the bag, or external bladder, will be permanent. In some cases a new bladder may be made from a piece of intestine (this is called a continent diversion).

Other treatments for cancerous tumors include radiation therapy and chemotherapy to help destroy cancer cells that have spread outside of the bladder.

How long will the effects last?

As with other forms of cancer, the treatments for bladder cancer that are most successful are those that begin before the disease has spread. See your doctor as soon as you detect any symptoms of bladder tumor.

If you have superficial bladder cancer, your chances of recovery are good. You should, however, have regular cystoscopy exams because small tumors recur in 80% of cases.

The removal of a large invasive tumor by partial bladder resection reduces the size of the bladder, which then holds less urine. This usually means more frequent urination.

How can I take care of myself?

Follow your doctor's instructions and take the full course of your prescribed medications.

If your entire bladder is removed, keep the external opening clean to prevent infection. To prevent kidney problems, empty the external bladder bag before it gets too full.

Early in your treatment, consider talking with a counselor about the changes in your body and your body image. Some people become depressed over these changes, so talking with someone early can help you avoid more involved problems later.

Maintain a positive outlook. If necessary, make lifestyle changes that include a nutritious diet, regular exercise and rest, reduction of stress, and time for recreation that you enjoy.

Can I help prevent a bladder tumor?

• Stop smoking, if you smoke.

• Use protective measures when you are likely to be exposed to industrial chemicals.

• Treat any urinary tract infection early.