Bladder Cancers are primarily Transitional Cell Cancers. Transitional cells are the type of cell that lines the inside of the bladder, the ureters and the inside of the collecting system of the kidney. Transitional cell cancers can develop in any of these areas, but are most often found in the bladder. These tumors usually present with gross (you can see the blood) painless hematuria. The blood may be minimal or very transient to very severe with clots. Diagnosis is usually made by cystoscopy, looking in the bladder with a small scope made for that purpose. Other tools for diagnosis and management are urine cytology, and various types of x-rays or ultrasounds.
Bladder Cancer is most common in men and tends to be more frequent with age. It is clearly associated with smoking and second hand smoke. There are other associations as well.
The majority of these tumors are low grade papillary tumors. Visually they look like white to pink broccoli. They often can be managed by removing the tumor through a scope. We increasingly use bladder treatments afterward to reduce the number and frequency of recurrences. Higher grade more aggressive tumors are serious and dangerous cancers. Determination of the tumor type, grade and stage are made by biopsy and removal of the tumor and by imaging studies. The proper approach to the tumor can then be determined. They usually require removal of the bladder and reconstruction of a new bladder. Surgical options for more advanced tumors can include ileal conduits, continent urinary reservoirs and neobladders. Chemo therapy is often used along with surgery in these cases. Radiation therapy is used much less often with this particular type of cancer.