Bladder Cancer

Bladder Cancer

Bladder Cancer is a commonly diagnosed cancer that typically requires long-term care and disease management. Our experts here at Kentucky Lake Urologic Associates are experts in diagnosing, treating, and managing bladder cancer.

Bladder Cancer Statistics United States

  • More than 700,000 men and women have bladder cancer(1)
  • Third most common cancer for men(2)
  • Incidence is four times higher in men than women(3)
  • Incidence is almost 2 times higher in Caucasian men than in African American men(3)

Inside the Bladder

  • Bladder cancer occurs in one or more of the four layers of the bladder lining.(4)
  • The deeper the layer, the more difficult the cancer is to treat.(4)
  • About half the time, it is limited to the uppermost layers (categorized as non-muscle-invasive).(5)
  • Approximately a third of cases spread into the third layer, which is muscle (muscle-invasive).(5)
  • In most of the remaining cases, the cancer has spread to nearby tissue or lymph nodes outside the bladder.(5)
  • In about 4% of cases, it has spread to distant body parts.(5)

Beyond the Bladder(6)

  • Bladder cancer can spread beyond the bladder.
  • In men, the prostate and seminal vesicles are at risk.
  • For women, the risk is to their cervix, uterus, and vagina.
  • Can go beyond the pelvic area to lymph nodes around the heart.
  • Other organs most commonly at risk are the lung, liver, and bones.

Common Risk Factors(7)

  • Smoking: Smokers have double the chances of getting bladder cancer than those who don’t smoke.
  • Chemical exposure: Some have been directly linked to bladder cancer, while others are merely suspected.
  • Race: Caucasians are at greater risk than African Americans; and Asians have the lowest incidence.
  • Age: Risk increases with age, but bladder cancer can occur at any age.
  • Gender: Men are at greater risk than women.
  • Chronic bladder inflammation: While urinary tract infections, kidney stones and bladder stones don’t cause bladder cancer, they have been linked to it.

Common Signs(s)

  • Blood in the urine – even if painless, light, infrequent, or invisible to the naked eye
  • Urination irregularities – irritation, urgency, frequency, and/or a constant need to urinate
  • A simple urine test or culture can determine whether the signs are serious or not

Means of Diagnosis

  • A urine cytology, where a doctor uses a microscope to look for cancer cells in the urine
  • An internal bladder exam called a cystoscopy
  • A biopsy on suspicious tissue or tumors removed from the bladder

The Cystoscopy(8)

  • The gold standard in evaluating the bladder and urethra, as well as diagnosing and monitoring bladder cancer
  • Conducted using a long, thin camera (a cystoscope) inserted through the urethra into the bladder
  • Done in an operating room under general anesthesia or in a medical office with moderate sedation or pain management
  • A standard cystoscopy uses everyday white light to help the doctor visually assess the general health of the bladder and find irregularities to be further investigated

Blue Light Cystoscopy with Cysview® (hexaminolevulinate HCl)(9)

  • Here at HCMC’s Kentucky Lake Urologic Associates our urologists have the option to enhance a cystoscopy procedure with the latest technology – blue light equipment and an optical imaging agent called Cysview.
  • Cysview makes bladder cancer glow bright pink under blue light.
  • The addition of blue light and Cysview can significantly improve detection of non-muscle-invasive bladder cancer compared to white light alone.
  • With enhanced visibility, more cancer can be removed.

Staging and Grading(10)

Staging identifies location of a bladder cancer tumor in relation to the bladder’s inner lining. Knowing the stage helps the doctor can plan the best treatment.

  • Is the cancer limited to the bladder lining?
  • Has the cancer invaded the bladder wall?
  • Has the cancer spread beyond the bladder?
  • Where else has the cancer spread?

These are the different stages of bladder cancer:

  • T0: No tumor
  • Ta: Papillary tumor that has not invaded the bladder wall
  • TIS (CIS): Carcinoma in situ, which is a non-invasive, flat, high-grade (G3) cancer
  • T1: Tumor that has invaded the connective tissue under the surface lining of the bladder
  • T2: Tumor has invaded the muscle layer
  • T3: Tumor has penetrated the bladder wall and invaded the fat layer
  • T4: Tumor has invaded other organs

References: 1. National Cancer Institute. SEER Stat Facts: Bladder Cancer 2017. Accessed January 25, 2019.
2. Globocan. Prevalence by population 2018. Available at: table?v=2018&mode=cancer&mode_population=continents&population=900&populations=840&key=asr&sex=0&cancer=39&type=2&statistic=5&prevalence=1&population _group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&nb_items=5&group_cancer=1&include_nmsc=1&include_nmsc_other=1#collapse-group-0-2. Accessed February 26, 2020. 3. American Cancer Society. Cancer Facts and Figures 2017. statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf. Accessed July 15, 2019. 4. Bladder Cancer Advocacy Network. What is Bladder Cancer? Accessed July 15, 2019. 5. American Cancer Society. Key Statistics for Bladder Cancer 2019. Accessed March 25, 2019. 6. Baylor College of Medicine. Bladder Cancer. Accessed July 15, 2019. 7. Bladder Cancer Advocacy Network. Bladder Cancer Symptoms, Signs and Risk Factors. Accessed July 15, 2019. 8. Bladder Cancer Advocacy Network. Diagnosing and Monitoring Bladder Cancer. Accessed July 15, 2019. 9. Cysview [prescribing information]. 2018:1-14. 10. Bladder Cancer Advocacy Network. Diagnosing and Monitoring Bladder Cancer. Accessed July 15, 2019.

Cysview (hexaminolevulinate HCl) Indication
Cysview is an FDA-approved optical imaging agent indicated for use in the cystoscopic detection of non-muscle invasive bladder cancer including carcinoma in situ (CIS) among patients suspected or known to have lesion(s) on the basis of a prior cystoscopy. Cysview is used with the KARL STORZ Photodynamic Diagnostic (PDD) system to perform BLC as an adjunct to White Light Cystoscopy.