None Invasive Bladder Cancer

I was diagnosed with Bladder Cancer April 8th, 2008. It is the 5th most commonly diagnosed cancer in the United States. Men are three times more likely to be diagnosed with bladder cancer than women. However, the chances of a woman dying of bladder cancer are considerably higher. That is, the five year rate for women is equal to the ten year rate for men.

What are the warning signs of Bladder Cancer? For me, on April 7^th , 2008 I had the urge to urinate after lunch. Five minutes later I felt like I had to urinate again, however, no urine came out. On April 8^th, I went to the bathroom in the morning to urinate. Instead of urine, I had a flow of bright red blood for over a minute. According to reports the following are the most common warning signs: 1. Frequent urination particularly in small amounts. 2. When urinating, blood is seen rather than urine. 3. Pain or burning sensation during urination. 3. Frequent bladder infections can also be a sign. 4. Some other signs may include pain in the lower back near kidneys, swelling in the legs or a mass may present itself. These are not the only signs, but the most common. When in doubt always consult a physician.

How is Bladder Cancer diagnosed? Doctors will often perform a cystoscopy. This involves inserting a catheter thru the urethra into the bladder. At the end of the catheter is a scope which allows the doctor to look at the bladder. In more advanced facilities the image is projected onto a monitor and filmed. Other diagnostic tools include washing the bladder with a solution. After extracting the solution thru the catheter it is examined for cancer cells. Your doctor may also order CT scans which will be taken with and without contrast. All the above are done without anesthesia. A little discomfort may be present during the tests. I never experienced any pain.

If the doctor is suspicious of anything he sees on any test he will schedule a surgical biopsy. This is done with anesthesia and a cystoscopy scope that has a viewing apparatus and the ability to insert surgical tools. This surgery is also referred to as a TURBT. Since you are under anesthesia you won't feel anything. Depending on the amount of samples and or the size of the tumor if one is seen you may have to have a catheter for a few days in order to make urinating easier. This is where you may feel discomfort. It can include some burning or cramping. The doctor will prescribe medication to help you deal with the pain.

For myself and my family the next part is always the hardest. It is the wait in anticipation of the results. When the diagnosis is confirmed you and your doctor will develop a plan of attack. This plan will be based on the results of the biopsies and cytology. Bladder cancer has a high control rate in the early stages especially if it is diagnosed as non-invasive muscle bladder cancer as opposed to muscle invasive. Fortunately, the pathology reports showed my tumor as being non invasive.

What are the treatments for non invasive bladder cancer? If you had a biopsy you have gone thru the first part of the treatment plan. That is the removal of the tumor or tumors. Next comes the Chemo treatment. The most common treatment for non invasive bladder cancer is the infusion into the bladder once a week for six weeks with a drug called BCG. BCG is a modified bovine or cow tuberculous vaccine inserted through a catheter into your bladder. After the serum is delivered to the bladder you will be asked not to urinate for two hours. During that time you will lie down and turn your body one quarter turn every fifteen minutes. For the next few days you may feel tired, have a temperature of up to 101 and have aching muscles. It is very much like the flu. With each treatment the reaction is more intense.

What comes next? The doctor will wait about a month after your last treatment. He will then do another cystoscopy. If everything is good he will wait another couple of months and repeat the procedure with 3 to six weeks of BCG. This may continue for a period of three years. The length between treatments and the number of treatments will decrease with time. After that your doctor will have you come in, depending on his protocol, every six months to a year for a cystoscopy. The results of this standard test to look in the bladder for cancer will dictate what your next step will be in fighting this disease.

This is the protocol for standard non invasive bladder cancer when the BCG is effective. Many other protocols exist. They include other drugs and or surgeries. Many individuals choose to have surgery to remove their bladders. This is a very personal decision made together with their team of doctors, surgeons and their families. Today it is even possible for a doctor to build a new bladder for you out of your intestine.

My suggestions regarding bladder cancer are based on my personal experiences. First, get a second opinion. Second, go to a teaching hospital and or a NCI-designated Comprehensive Cancer Center. NCI stands for National Cancer Institute. These can be found on the internet by going to the National Cancer Institute web site at, www.cancer.gov . Another excellent resource is the Bladder Cancer Advocacy Network also know as BCAN, www.bcan.org .