Bladder cancer that has not invaded the muscular layer of the bladder (or beyond) is called superficial bladder cancer. Non-invasive bladder cancer is highly favorable and typically allows for a much less invasive form of treatment.
Nevertheless, even superficial bladder cancer can be a serious condition and requires the attention of a trained specialist for effective management.
Blood in the urine is by far the most common symptom reported by patients who are diagnosed with superficial bladder cancer. At times, the blood may only be detected on microscopic testing.
This is one reason that regular urine tests by a family doctor can be so important. Sometimes patients also complain of irritative voiding symptoms or bladder pain.
Bladder cancer is more common in men than women, although it is common in both genders. In the United States, bladder cancer represents the fourth most common cancer in men and the ninth most common cancer in women.
Risk factors for bladder cancer include smoking, exposure to radiation, certain chemotherapy drugs (such as cyclophosphamide, which is used to treat other cancers), and chronic bladder inflammation. Caucasians are at greater risk than people of other racial backgrounds for developing bladder cancer.
In addition to performing tests on the urine and imaging studies, a urologist will perform a cystoscopy, which allows him to look into the bladder with a small scope. This helps determine if there is a bladder tumor.
Diagnosis is made by removing either a small piece of any suspicious tissue (a biopsy) or resection of the tumor seen during cystoscopy. If the urologist sees a tumor during cystoscopy, they will typically recommend a “TURBT,” which stands for trans-urethral resection of a bladder tumor.
TURBT is a minimally invasive procedure that may be performed as an outpatient surgery or may require a one- or two-night stay in the hospital, depending on the size of the tumor. The urologist uses a resectoscope to carefully shave off the tumor from the wall of the bladder. The tumor is then sent to the pathologist for analysis of tumor type and depth of invasion.
If the tumor does not penetrate the muscular layer of the bladder, the TURBT can be curative. The urologist may elect to place a liquid chemotherapy drug (mitomycin) in the bladder for one hour following the resection. This has been shown to reduce the risk of recurrence in certain cases. In general, this is a very well tolerated procedure with minimal side-effects. The results of the pathology will determine what type of follow-up and what type of further treatment (if any) will be needed..