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Treatment: Bladder Cancer

Bladder cancer prevention, screening and treatment: A single place to turn.

While cancer is never easy, now your choice for care is.

About 50,000 Americans develop bladder cancer each year (most of them men). While survival rates are improving, more than 10,000 Americans die from bladder cancer each year. Discovering and treating bladder cancer early offers the best chance for survival. That’s why we created the Van Elslander Cancer Center. Now, in a single, convenient location, you can obtain prevention information and screenings, receive treatment and get follow-up care. We made the Van Elslander Cancer Center convenient for patients; however, perhaps, more importantly, it is also convenient for your cancer care team. It’s a single place where your entire multidisciplinary team of physicians works together closely, focused on your care. They continually share information and ideas, providing the communication so essential to world-class care.

Highlights at the Van Elslander Cancer Center

One important key to successful fight against bladder cancer is early detection and treatment. Patients need treatment that offers every possible advantage, including fast diagnosis and the opportunity to review all treatment options quickly. The Van Elslander Cancer Center’s single location means patients can receive prevention, screening and quickly, with a staff committed to providing the fastest and most comprehensive services available. Here’s how:

  • A nutrition and lifestyle counselor is available immediately to assess your risk for bladder cancer and discuss ways to minimize your risk for the disease.
  • A full range of screening options provides the potential for quick and accurate detection.
  • Patients have access to all national clinical trials.
  • Our multidisciplinary team of physicians work closely together to provide the optimal treatment regimen for every patient with bladder cancer, providing important advantages for those who:
    • Have recently been diagnosed with bladder cancer.
    • Have previously untreated bladder cancer.
    • Have undergone prior treatment for bladder cancer and are now experiencing a recurrence.
    • Have been referred by their family physician or another surgeon for a second opinion about their bladder cancer.

How To Reach Us

To schedule a consultation, call (313) 647-3000 or toll free, 1-866-246-HOPE

Second Opinion

Patients who have been diagnosed with bladder cancer may come to the Van Elslander Cancer Center for a second opinion consultation. Second opinions are strongly recommended for all cancer diagnoses, so that you and your oncologist can choose the best treatment. Patients should ask their physicians to submit pathology materials for our review; each case receives a written evaluation.

If you are a Van Elslander Cancer Center patient and would like to obtain a second opinion, we can assist you as part of the University of Michigan Cancer Center Network. Because we are affiliated with their network, Van Elslander Cancer Center patients receive priority treatment.

Who’s On Your Team?

Our multidisciplinary approach to cancer care ensures that in a single visit, each patient receives a complete team of nationally recognized experts, including:

  • Urologist or urologic surgeon
  • Radiation Oncologist
  • Medical Oncologist
  • Occupational Therapist (if needed)
  • Oncology Nurse

Physician Listing

Specialized Services

  • Nutrition and Lifestyle Counseling: Our staff counselor can work with you to create lifestyle and exercise guidelines to minimize your risk for bladder cancer, as well as taking your medical history to check for risk factors and symptoms.
  • Intravenous Pyelograhpy (IVP): Contrast dye is injected intravenously, and x-ray images are taken at regular intervals as the dye travels through the kidneys and urinary tract. This enables the x-ray to highlight areas that do not ordinarily show on x-ray film.
  • Cystoscopy: A thin scope is inserted in order to provide a view of the bladder.
  • Urine cytology: The lab analyzes a urine sample or bladder washing (cells washed from the bladder) for pre-cancerous or cancerous cells.
  • Urine culture: The lab analyzes a urine sample for infection.
  • Flow cytometry or image cytometry: In a test often used to find recurring bladder cancer, the lab measures the amount of DNA in bladder cells taken from a urine sample, bladder washings, or tissue sample.
  • Biopsy: The doctor views a sample of bladder tissue under a microscope to determine if cancer is present and what type of bladder cancer it is.
  • Bladder tumor marker studies: The lab detects specific substances released by cancer cells into the urine.
  • Imaging Tests: Scans, MRI scans, x-rays, ultrasound, and bone scans can provide additional information and help determine whether the cancer has spread.

Staging

To determine how far the cancer has spread, your cancer care team uses a process of analysis known as staging. The stage of your cancer impacts your treatment and the prognosis for recovery. A number of different staging systems can be used to classify tumors. The TNM staging system assesses tumors in three ways: size of the primary tumor (T), whether it has spread to lymph nodes (N), and whether it has spread (metastasized) to other organs (M). Once the T, N, and M are determined, a number of I, II, III, or IV is assigned, with stage I being early stage and IV being advanced. In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV, denotes a more serious case. Your doctor will review your test results and tell you the stage of your cancer.

Treatment Options

Depending on the stage of the cancer, you and your multidisciplinary team may plan one of or a combination of the following treatments:

  • Intravesical Immunotherapy: Immunotherapy medications cause the body’s immune system to attack the bladder cancer. These medications are inserted directly into the bladder using a catheter. Treatments usually last six weeks. Side effects can sometimes cause a temporary burning sensation in the bladder or flu-like symptoms.
  • Chemotherapy: Anticancer medications are used to destroy cancer cells. These may be taken by mouth, injected into a vein or placed directly into the bladder. Chemotherapy is often used along with radiation after transurethral bladder surgery, to ensure all cancer cells are destroyed.
  • Radiation Oncology: High-energy radiation is used to kill cancer cells. This can be delivered in the form of external beam radiation, similar to an x-ray, or local radiation therapy, which places a small pellet of radioactive material directly into the cancer. If the cancer is caught early enough, radiation therapy may be the only treatment that is needed. Radiation is also often used along with chemotherapy after transurethral bladder surgery, to ensure all cancer cells are destroyed. In addition, radiation can be used to shrink tumors to make surgery easier, or to reduce discomfort from advanced bladder cancer. Side effects (usually temporary) can include mild skin irritation (similar to sunburn), nausea, bladder irritation, diarrhea, or fatigue.
  • Transurethral surgery: A transurethral resection (TUR) is a common type of surgery for early-stage cancers. A cystoscope is inserted through the urethra; no cutting into the abdomen is needed. Sometimes the cytoscope is also used to burn the base of the tumor to ensure any remaining cancer cells are destroyed. Transurethral surgery is performed at St. John Hospital and Medical Center.
  • Cystectomy: For invasive bladder cancer, the affected portion of the bladder is removed (partial cystectomy), or the entire bladder and nearby lymph nodes are removed (radical cystectomy). With a radical cystectomy, in men, the prostate is also removed, and in women, the ovaries, uterus, fallopian tubes and a small part of the vagina are also removed. Reconstructive surgery will also be needed. Cystectomy surgery is performed at St. John Hospital and Medical Center.
  • Reconstructive surgery: If the whole bladder is removed, the following options are available to store and remove urine. Reconstructive surgery is performed at St. John Hospital and Medical Center.
    • Urostomy: A portion of the intestine is removed and fashioned into a small sac, which is connected to the skin of the abdomen.
    • Continent Diversion: Urine is stored in the intestinal sac and emptied only when the patient places a drainage tube (catheter) into the hole. There is no bag on the outside.

Protocol

We designed the Van Elslander Cancer Center’s team and processes to help you assess your best treatment options and begin fighting your cancer quickly – usually within two weeks of your diagnosis:

  • If you experience symptoms of bladder cancer (see Reducing Your Risk, below), see your physician immediately. Your primary care physician may refer you to one of our urologists.
  • The urologist will collect a sample of bladder cells for screening. If the screening shows an abnormality, we will contact you (usually within 48 hours) to return for further testing.
  • Imaging tests (such as MRIs, x-rays or CT scans) will then be used to determine the extent of the cancer and examine the lymph nodes.
  • You will meet with our multidisciplinary team (see Who’s on your Team, above), and work with your doctor to develop the best plan for your treatment.
  • Your treatment can begin within a week and typically lasts six weeks.

Follow-Up Therapy

Once you have received treatment, your urologist will follow up with you on a regular basis for the first year.

If follow-up visits determine your treatment was successful, you will receive subsequent annual checkups through your primary care physician.

Your follow-up care can also include other services offered through the Van Elslander Center, such as occupational therapy. At the Van Elslander Cancer Center, we treat the whole person, not just your cancer, for complete healing of body, mind and spirit. Patients whose bladder function has been affected by surgery may have to re-learn tasks they once took for granted; our therapists will be there to help you maximize your quality of life.

We also offer many routes to spiritual strengthening at our special Healing Arts Center.

Reducing Your Risk

Here are a few of the ways the Van Elslander Cancer Center can help you prevent bladder cancer:

Lifestyle Counseling (see Specialized Services, above):
Of all the risk factors for bladder cancer, smoking is the highest. Smokers are more than twice as likely to get bladder cancer as nonsmokers. The best way to prevent bladder cancer is not to smoke. It is also important to drink plenty of fluids. In a recent study, people who drank at least 11 cups of fluids a day were half as likely to develop bladder cancer than people who drank fewer than 6 cups per day. Click here for more information.

Screening (see Specialized Services, above):
It is important to see your doctor immediately if you notice blood in your urine, which is painless and appears suddenly. The need to urinate frequently (and sometimes urgently), with or without pain may also indicate bladder cancer.

While these symptoms do not necessarily mean you have bladder cancer (it can also be an infection or kidney stones), the Van Elslander Cancer Center will be ready with prompt screening services to put your mind at ease or to help you begin fighting the disease as early as possible. While bladder cancer can occur at any age, it is seen most often in people aged 50 to 80.

  • Clinical Trials (see Clinical Trials, below): Ask your physician about participating in clinical trials, which offer access to promising new treatments.

Clinical Trials

The Van Elslander Center is one of only 13 facilities nationwide whose patients have access to all national clinical trials. In addition, qualified Van Elslander Cancer Center patients can participate in private trials sponsored by The University of Michigan Cancer Care Center Network.

Clinical trials are conducted to study promising new treatments that have shown potential value to patients. While there can be risks, these studies offer the most leading-edge treatment options and are often found to have great benefits to patients. Taking part in a clinical trial is up to you, and once you have joined the study, you are free to leave it at any time, for any reason.

A few examples of the many clinical trials for currently available to qualified bladder cancer patients at the Van Elslander Cancer Center are:

  • Testing whether combining chemotherapy with monoclonal antibodies such as trastuzumab kills more tumor cells than chemotherapy alone. Monoclonal antibodies locate tumor cells and either kill them or deliver tumor-killing substances to them without harming normal cells.
  • A study of the effectiveness of gene therapy in treating bladder cancer.
  • A study of individuals and families, age 1 to 95, at high risk of cancer, to identify genetic and environmental cancer risks. For a list of current clinical trials, click here or call the National Cancer Institute at 1-800-4-CANCER.

Other services

At the Van Elslander Cancer Center, we believe the strength of your mind and spirit is essential to your body’s healing process. Our Healing Arts Center is available for you to use, providing services such as massage, reflexology, meditation, music and art therapies and holistic assessment.

More Information

You can find more information on bladder cancer from:

  • The National Cancer Institute (NCI)

 

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