Keeping on Top of Your Condition
The Bladder
The bladder is a hollow organ in the lower abdomen.
It stores urine,
the liquid waste produced by the kidneys.
Urine passes from each kidney into the bladder through a tube called a
ureter.
An outer layer of muscle surrounds the inner lining of the bladder.
When the bladder is full, the muscles in the bladder wall can tighten to
allow urination. Urine leaves the bladder through another tube, the urethra.
Understanding Cancer
Cancer is a group of many related diseases. All cancers begin in cells,
the body's basic unit of life. Cells make up tissues,
and tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs
them. When cells grow old and die, new cells take their place.
Sometimes this orderly process goes wrong. New cells form when the body
does not need them, and old cells do not die when they should. These extra
cells can form a mass of tissue called a growth or tumor.
Tumors can be benign
or malignant:
-
Benign tumors are not cancer. Usually, doctors can remove
them. Cells from benign tumors do not spread to other parts of the body.
In most cases, benign tumors do not come back after they are removed.
Most important, benign tumors are rarely a threat to life.
-
Malignant tumors are cancer. They are generally more serious.
Cancer cells can invade and damage nearby tissues and organs. Also,
cancer cells can break away from a malignant tumor and enter the
bloodstream or the lymphatic
system. That is how cancer cells spread from the original
(primary) tumor to form new tumors in other organs. The spread of cancer
is called metastasis.
The wall of the bladder is lined with cells called transitional
cells and squamous
cells. More than 90 percent of bladder cancers begin in the
transitional cells. This type of bladder cancer is called transitional
cell carcinoma. About 8 percent of bladder cancer patients have
squamous
cell carcinomas.
Cancer that is only in cells in the lining of the bladder is called
superficial
bladder cancer. The doctor might call it carcinoma
in situ. This type of bladder cancer often comes back after
treatment. If this happens, the disease most often recurs
as another superficial cancer in the bladder.
Cancer that begins as a superficial tumor may grow through the lining
and into the muscular wall of the bladder. This is known as invasive
cancer. Invasive cancer may extend through the bladder wall. It
may grow into a nearby organ such as the uterus
or vagina
(in women) or the prostate
gland (in men). It also may invade the wall of the abdomen.
When bladder cancer spreads outside the bladder, cancer cells are often
found in nearby lymph
nodes. If the cancer has reached these nodes, cancer cells may
have spread to other lymph nodes or other organs, such as the lungs,
liver, or bones.
When cancer spreads (metastasizes)
from its original place to another part of the body, the new tumor has the
same kind of abnormal cells and the same name as the primary
tumor. For example, if bladder cancer spreads to the lungs, the
cancer cells in the lungs are actually bladder cancer cells. The disease
is metastatic bladder cancer, not lung cancer. It is treated as bladder
cancer, not as lung cancer. Doctors sometimes call the new tumor "distant"
disease.
Bladder Cancer: Who's at Risk?
No one knows the exact causes of bladder cancer. However, it is clear
that this disease is not contagious. No one can "catch" cancer from
another person.
People who get bladder cancer are more likely than other people to have
certain risk
factors. A risk factor is something that increases a person's
chance of developing the disease.
Still, most people with known risk factors do not get bladder cancer,
and many who do get this disease have none of these factors. Doctors can
seldom explain why one person gets this cancer and another does not.
Studies have found the following risk factors for bladder cancer:
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Age. The chance of getting bladder cancer goes up as people
get older. People under 40 rarely get this disease.
-
Tobacco. The use of tobacco is a major risk factor. Cigarette
smokers are two to three times more likely than nonsmokers to get
bladder cancer. Pipe and cigar smokers are also at increased risk.
-
Occupation. Some workers have a higher risk of getting bladder
cancer because of carcinogens
in the workplace. Workers in the rubber, chemical, and leather
industries are at risk. So are hairdressers, machinists, metal workers,
printers, painters, textile workers, and truck drivers.
-
Infections. Being infected with certain parasites
increases the risk of bladder cancer. These parasites are common in
tropical areas but not in the United States.
-
Treatment with cyclophosphamide
or arsenic.
These drugs are used to treat cancer and some other conditions. They
raise the risk of bladder cancer.
-
Race. Whites get bladder cancer twice as often as African
Americans and Hispanics. The lowest rates are among Asians.
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Being a man. Men are two to three times more likely than women
to get bladder cancer.
-
Family history. People with family members who have bladder
cancer are more likely to get the disease. Researchers are studying
changes in certain genes
that may increase the risk of bladder cancer.
-
Personal history of bladder cancer. People who have had
bladder cancer have an increased chance of getting the disease
again.
Chlorine
is added to water to make it safe to drink. It kills deadly bacteria.
However, chlorine by-products sometimes can form in chlorinated water.
Researchers have been studying chlorine by-products for more than 25
years. So far, there is no proof that chlorinated water causes bladder
cancer in people. Studies continue to look at this question.
Some studies have found that saccharin, an artificial sweetener, causes
bladder cancer in animals. However, research does not show that saccharin
causes cancer in people.
People who think they may be at risk for bladder cancer should discuss
this concern with their doctor. The doctor may suggest ways to reduce the
risk and can plan an appropriate schedule for checkups.
Bladder Cancer Symptoms
Common bladder cancer symptoms include:
-
Blood in the urine (making the urine slightly rusty to deep red),
-
Pain during urination, and
-
Frequent urination, or feeling the need to urinate without
results.
These symptoms are not sure signs of bladder cancer. Infections, benign
tumors, bladder stones, or other problems also can cause these symptoms.
Anyone with these symptoms should see a doctor so that the doctor can
diagnose and treat any problem as early as possible. People with symptoms
like these may see their family doctor or a urologist,
a doctor who specializes in diseases of the urinary system.
Diagnosis of Bladder Cancer
If a patient has bladder cancer symptoms, the doctor may
check general signs of health and may order lab tests. The person may have
one or more of the following procedures:
-
Physical exam -- The doctor feels the abdomen and pelvis
for tumors. The physical exam may include a rectal
or vaginal
exam.
-
Urine tests -- The laboratory checks the urine for blood,
cancer cells, and other signs of disease.
-
Intravenous
pyelogram -- The doctor injects dye into a blood vessel. The
dye collects in the urine, making the bladder show up on x-rays.
-
Cystoscopy
-- The doctor uses a thin, lighted tube (cystoscope)
to look directly into the bladder. The doctor inserts the cystoscope
into the bladder through the urethra to examine the lining of the
bladder. The patient may need anesthesia
for this procedure.
The doctor can remove samples of tissue with the cystoscope. A pathologist
then examines the tissue under a microscope. The removal of tissue to look
for cancer cells is called a biopsy.
In many cases, a biopsy is the only sure way to tell whether cancer is
present. For a small number of patients, the doctor removes the entire
cancerous area during the biopsy. For these patients, bladder cancer is
diagnosed and treated in a single procedure.
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A patient who needs a biopsy may want to ask the doctor some of
the following questions:
-
Why do I need to have a biopsy?
-
How long will it take? Will I be awake? Will it hurt?
-
How soon will I know the results?
-
Are there any risks? What are the chances of infection or
bleeding after the biopsy?
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If I do have cancer, who will talk with me about treatment?
When? |
Staging
If bladder cancer is diagnosed, the doctor needs to know the stage,
or extent, of the disease to plan the best treatment. Staging
is a careful attempt to find out whether the cancer has invaded the
bladder wall, whether the disease has spread, and if so, to what parts of
the body.
The doctor may determine the stage of bladder cancer at the time of
diagnosis, or may need to give the patient more tests. Such tests may
include imaging
tests -- CT
scan, magnetic
resonance imaging
(MRI), sonogram,
intravenous
pyelogram, bone
scan, or chest x-ray. Sometimes staging is not complete until the
patient has surgery.
These are the main features of each stage of the disease:
-
Stage 0 -- The cancer cells are found only on the surface of the
inner lining of the bladder. The doctor may call this superficial cancer
or carcinoma in situ.
-
Stage I -- The cancer cells are found deep in the inner lining of the
bladder. They have not spread to the muscle of the bladder.
-
Stage II -- The cancer cells have spread to the muscle of the
bladder.
-
Stage III -- The cancer cells have spread through the muscular wall
of the bladder to the layer of tissue surrounding the bladder. The
cancer cells may have spread to the prostate (in men) or to the uterus
or vagina (in women).
-
Stage IV -- The cancer extends to the wall of the abdomen or to the
wall of the pelvis. The cancer cells may have spread to lymph nodes and
other parts of the body far away from the bladder, such as the
lungs.
Bladder Cancer Treatment
Many people with bladder cancer want to take an active part in
decisions about their medical care. They want to learn all they can about
their disease and their treatment choices. However, the shock and stress
that people often feel after a diagnosis of cancer can make it hard for
them to think of everything they want to ask the doctor. Often it helps to
make a list of questions before an appointment. To help remember what the
doctor says, patients may take notes or ask whether they may use a tape
recorder. Some patients also want to have a family member or friend with
them when they talk to the doctor -- to take part in the discussion, to
take notes, or just to listen.
The doctor may refer patients to doctors who specialize in treating
cancer, or patients may ask for a referral. Treatment generally begins
within a few weeks after the diagnosis. There will be time for patients to
talk with the doctor about treatment choices, get a second opinion, and
learn more about bladder cancer.
Getting a Second Opinion
Before starting treatment, a patient may want to get a second opinion
about the diagnosis, the stage of cancer, and the treatment plan. Some
insurance companies require a second opinion; others may cover a second
opinion if the patient requests it. Gathering medical records and
arranging to see another doctor may take a little time. In most cases, a
brief delay does not make treatment less effective.
There are a number of ways to find a doctor for a second opinion:
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The doctor may refer patients to one or more specialists. Specialists
who treat bladder cancer include surgeons,
urologists,
medical
oncologists, radiation
oncologists, and urologic
oncologists. At cancer centers, these doctors often work
together as a team.
-
The Cancer Information Service, at 1-800-4-CANCER, can tell callers
about treatment facilities, including cancer centers and other programs
supported by the National Cancer Institute.
-
People can get the names of specialists from their local medical
society, a nearby hospital, or a medical school.
-
The Official ABMS Directory of Board Certified Medical
Specialists lists doctors' names along with their speciality and
their educational background. This resource is available in most public
libraries. The American Board of Medical Specialties (ABMS) also has
telephone and Internet services. The public can use these services to
check whether a physician is board certified. The telephone number is
1-866-ASK-ABMS (1-866-275-2267). The Internet address is http://www.abms.org/newsearch.asp.
Preparing for Bladder Cancer Treatment
The doctor develops a treatment plan to fit each patient's needs.
Treatment depends on the type of bladder cancer, the stage of the disease,
and the grade
of the tumor. (The grade tells how closely the cancer cells resemble
normal cells. It suggests how fast the cancer is likely to grow. Low-grade
cancers usually grow and spread more slowly than high-grade cancers.) The
doctor also considers other factors, including the patient's age and
general health.
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These are some questions a patient may want to ask the doctor
before treatment begins:
-
What kind of bladder cancer do I have?
-
What is the stage of the disease? Has the cancer spread?
-
What is the grade of the tumor?
-
What are my treatment choices? Which do you recommend for me?
Why?
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What are the expected benefits of each kind of treatment?
-
What are the risks and possible side effects of each
treatment?
-
What is the treatment likely to cost? Is this treatment covered
by my insurance plan?
-
How will treatment affect my normal
activities? |
People do not need to ask all of their questions or understand all of
the answers at once. They will have other chances to ask the doctor to
explain things that are not clear and to ask for more information.
Bladder Cancer Treatmemt Methods
People with bladder cancer have many treatment options. They may have
surgery,
radiation
therapy, chemotherapy,
or biological
therapy. Some patients get a combination of therapies.
The doctor is the best person to describe treatment choices and discuss
the expected results of treatment.
A patient may want to talk to the doctor about taking part in a clinical
trial, a research study of new treatment methods. Clinical trials
are an important option for people with all stages of bladder cancer.
Surgery is a common treatment for bladder cancer. The type of
surgery depends largely on the stage and grade of the tumor. The doctor
can explain each type of surgery and discuss which is most suitable for
the patient:
-
Transurethral
resection: The doctor may treat early (superficial) bladder
cancer with transurethral resection (TUR). During TUR, the doctor
inserts a cystoscope into the bladder through the urethra. The doctor
then uses a tool with a small wire loop on the end to remove the cancer
and to burn away any remaining cancer cells with an electric current.
(This is called fulguration.)
The patient may need to be in the hospital and may need anesthesia.
After TUR, patients may also have chemotherapy or biological
therapy.
-
Radical
cystectomy: For invasive bladder cancer, the most common
type of surgery is radical cystectomy.
The doctor also chooses this type of surgery when superficial cancer
involves a large part of the bladder. Radical cystectomy is the removal
of the entire bladder, the nearby lymph nodes, part of the urethra, and
the nearby organs that may contain cancer cells. In men, the nearby
organs that are removed are the prostate, seminal
vesicles, and part of the vas
deferens. In women, the uterus, ovaries,
fallopian
tubes, and part of the vagina are removed.
-
Segmental
cystectomy: In some cases, the doctor may remove only part
of the bladder in a procedure called segmental cystectomy. The doctor
chooses this type of surgery when a patient has a low-grade cancer that
has invaded the bladder wall in just one area.
Sometimes, when the cancer has spread outside the bladder and cannot be
completely removed, the surgeon removes the bladder but does not try to
get rid of all the cancer. Or, the surgeon does not remove the bladder but
makes another way for urine to leave the body. The goal of the surgery may
be to relieve urinary blockage or other symptoms caused by the cancer.
When the entire bladder is removed, the surgeon makes another way to
collect urine. The patient may wear a bag outside the body, or the surgeon
may create a pouch inside the body with part of the intestine.
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These are some questions a patient may want to ask the doctor
about surgery:
-
What kind of operation will it be?
-
How will I feel afterward?
-
What will you do for me if I have pain?
-
How long will I have to stay in the hospital?
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Will I have any long-term effects?
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When can I get back to my normal activities?
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Will I urinate in a normal way?
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Will the surgery affect my sex life?
-
How often will I need checkups? |
Radiation therapy (also called radiotherapy) uses high-energy
rays to kill cancer cells. Like surgery, radiation therapy is local
therapy. It affects cancer cells only in the treated area.
A small number of patients may have radiation therapy before surgery to
shrink the tumor. Others may have it after surgery to kill cancer cells
that may remain in the area. Sometimes, patients who cannot have surgery
have radiation therapy instead.
Doctors use two types of radiation therapy to treat bladder cancer:
-
External
radiation: A large machine outside the body aims radiation
at the tumor area. Most people receiving external radiation are treated
5 days a week for 5 to 7 weeks as an outpatient. This schedule helps
protect healthy cells and tissues by spreading out the total dose of
radiation. Treatment may be shorter when external radiation is given
along with radiation implants.
-
Internal
radiation: The doctor places a small container of a radioactive
substance into the bladder through the urethra or through an incision
in the abdomen. The patient stays in the hospital for several days
during this treatment. To protect others from radiation exposure,
patients may not be able to have visitors or may have visitors for only
a short period of time while the implant is in place. Once the implant
is removed, no radioactivity is left in the body.
Some patients with bladder cancer receive both kinds of radiation
therapy.
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These are some questions a patient may want to ask the doctor
about radiation therapy:
-
Why do I need this therapy?
-
How will the radiation be given?
-
Will I need to stay in the hospital? For how long?
-
When will the treatments begin? When will they end?
-
How will I feel during therapy? Are there side effects?
-
What can I do to take care of myself during treatment?
-
How will we know if the radiation is working?
-
Will I be able to continue my normal activities during
treatment?
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How often will I need checkups? |
Chemotherapy uses drugs to kill cancer cells. The doctor may use
one drug or a combination of drugs.
For patients with superficial bladder cancer, the doctor may use intravesical
chemotherapy after removing the cancer with TUR. This is local therapy.
The doctor inserts a tube (catheter)
through the urethra and puts liquid drugs in the bladder through the
catheter. The drugs remain in the bladder for several hours. They mainly
affect the cells in the bladder. Usually, the patient has this treatment
once a week for several weeks. Sometimes, the treatments continue once or
several times a month for up to a year.
If the cancer has deeply invaded the bladder or spread to lymph nodes
or other organs, the doctor may give drugs through a vein. This treatment
is called intravenous
chemotherapy. It is systemic
therapy, meaning that the drugs flow through the bloodstream to
nearly every part of the body. The drugs are usually given in cycles so
that a recovery period follows every treatment period.
The patient may have chemotherapy alone or combined with surgery,
radiation therapy, or both. Usually chemotherapy is an outpatient
treatment given at the hospital, clinic, or at the doctor's office.
However, depending on which drugs are given and the patient's general
health, the patient may need a short hospital stay.
Biological therapy (also called immunotherapy) uses the body's
natural ability (immune
system) to fight cancer. Biological therapy is most often used
after TUR for superficial bladder cancer. This helps prevent the cancer
from coming back.
The doctor may use intravesical biological therapy with BCG
solution. BCG solution contains live, weakened bacteria.
The bacteria stimulate the immune system to kill cancer cells in the
bladder. The doctor uses a catheter to put the solution in the bladder.
The patient must hold the solution in the bladder for about 2 hours. BCG
treatment is usually done once a week for 6 weeks.
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Patients may want to ask these questions about chemotherapy or
biological therapy:
-
Why do I need this treatment?
-
What drug will I get? How will it be given? What will it
do?
-
Will I have side effects? What can I do about them?
-
How long will I be on this treatment?
-
How often will I need checkups? |
Side Effects of Cancer Treatment
Because cancer treatment may damage healthy cells and tissues, unwanted
side
effects sometimes occur. These side effects depend on many
factors, including the type and extent of the treatment. Side effects may
not be the same for each person, and they may even change from one
treatment session to the next. Doctors and nurses will explain the
possible side effects of treatment and how they will help the patient
manage them.
Surgery
For a few days after TUR, patients may have some blood in their urine
and difficulty or pain when urinating. Otherwise, TUR generally causes few
problems.
After cystectomy, most patients are uncomfortable during the first few
days. However, medicine can control the pain. Patients should feel free to
discuss pain relief with the doctor or nurse. Also, it is common to feel
tired or weak for a while. The length of time it takes to recover from an
operation varies for each person.
After segmental cystectomy, patients may not be able to hold as much
urine in their bladder as they used to, and they may need to urinate more
often. In most cases, this problem is temporary, but some patients may
have long-lasting changes in how much urine they can hold.
If the surgeon removes the bladder, the patient needs a new way to
store and pass urine. In one common method, the surgeon uses a piece of
the person's small
intestine to form a new tube through which urine can pass. The
surgeon attaches one end of the tube to the ureters and connects the other
end to a new opening in the wall of the abdomen. This opening is called a
stoma.
A flat bag fits over the stoma to collect urine, and a special adhesive
holds it in place. The operation to create the stoma is called a urostomy
or an ostomy.
For some patients, the doctor is able to use a part of the small
intestine to make a storage pouch (called a continent
reservoir) inside the body. Urine collects in the pouch instead of
going into a bag. The surgeon connects the pouch to the urethra or to a
stoma. If the surgeon connects the pouch to a stoma, the patient uses a
catheter to drain the urine.
Bladder cancer surgery may affect a person's sexual function. Because
the surgeon removes the uterus and ovaries in a radical cystectomy, women
are not able to get pregnant. Also, menopause
occurs at once. Hot flashes and other symptoms of menopause caused by
surgery may be more severe than those caused by natural menopause. Many
women take hormone replacement therapy (HRT) to relieve these problems. If
the surgeon removes part of the vagina during a radical cystectomy, sexual
intercourse may be difficult.
In the past, nearly all men were impotent
after radical cystectomy, but improvements in surgery have made it
possible for some men to avoid this problem. Men who have had their
prostate gland and seminal vesicles removed no longer produce semen,
so they have dry
orgasms. Men who wish to father children may consider sperm
banking before surgery or sperm
retrieval later on.
It is natural for a patient to worry about the effects of bladder
cancer surgery on sexuality. Patients may want to talk with the doctor
about possible side effects and how long these side effects are likely to
last. Whatever the outlook, it may be helpful for patients and their
partners to talk about their feelings and help one another find ways to
share intimacy during and after treatment.
Radiation Therapy
The side effects of radiation therapy depend mainly on the treatment
dose and the part of the body that is treated. Patients are likely to
become very tired during radiation therapy, especially in the later weeks
of treatment. Resting is important, but doctors usually advise patients to
try to stay as active as they can.
External radiation may permanently darken or "bronze" the skin in the
treated area. Patients commonly lose hair in the treated area and their
skin may become red, dry, tender, and itchy. These problems are temporary,
and the doctor can suggest ways to relieve them.
Radiation therapy to the abdomen may cause nausea, vomiting, diarrhea,
or urinary discomfort. The doctor can suggest medicines to ease these
problems.
Radiation therapy also may cause a decrease in the number of white
blood cells, cells that help protect the body against infection. If the
blood counts are low, the doctor or nurse may suggest ways to avoid
getting an infection. Also, the patient may not get more radiation therapy
until blood counts improve. The doctor will check the patient's blood
counts regularly and change the treatment schedule if it is necessary.
For both men and women, radiation treatment for bladder cancer can
affect sexuality. Women may experience vaginal dryness, and men may have
difficulty with erections.
Although the side effects of radiation therapy can be distressing, the
doctor can usually treat or control them. It also helps to know that, in
most cases, side effects are not permanent.
Chemotherapy
The side effects of chemotherapy depend mainly on the drugs and the
doses the patient receives as well as how the drugs are given. In
addition, as with other types of treatment, side effects vary from patient
to patient.
Anticancer drugs that are placed in the bladder cause irritation, with
some discomfort or bleeding that lasts for a few days after treatment.
Some drugs may cause a rash when they come into contact with the skin or
genitals.
Systemic chemotherapy affects rapidly dividing cells throughout the
body, including blood cells. Blood cells fight infection, help the blood
to clot, and carry oxygen to all parts of the body. When anticancer drugs
damage blood cells, patients are more likely to get infections, may bruise
or bleed easily, and may have less energy. Cells in hair roots and cells
that line the digestive tract also divide rapidly. As a result, patients
may lose their hair and may have other side effects such as poor appetite,
nausea and vomiting, or mouth sores. Usually, these side effects go away
gradually during the recovery periods between treatments or after
treatment is over.
Certain drugs used in the treatment of bladder cancer also may cause
kidney damage. To protect the kidneys, patients need a lot of fluid. The
nurse may give the patient fluids by vein before and after treatment.
Also, the patient may need to drink a lot of fluids during treatment with
these drugs.
Certain anticancer drugs can also cause tingling in the fingers,
ringing in the ears, or hearing loss. These problems may go away after
treatment stops.
Biological Therapy
BCG therapy can irritate the bladder. Patients may feel an urgent need
to urinate, and may need to urinate frequently. Patients also may have
pain, especially when urinating. They may feel tired. Some patients may
have blood in their urine, nausea, a low-grade fever, or chills.
Nutrition
Patients need to eat well during cancer therapy. They need enough
calories to maintain a good weight and protein to keep up strength. Good
nutrition often helps people with cancer feel better and have more
energy.
But eating well can be difficult. Patients may not feel like eating if
they are uncomfortable or tired. Also, the side effects of treatment, such
as poor appetite, nausea, or vomiting, can be a problem. Foods may taste
different.
The doctor, dietitian, or other health care provider can suggest ways
to maintain a healthy diet.
Rehabilitation
Rehabilitation is an important part of cancer care. The health care
team makes every effort to help the patient return to normal activities as
soon as possible.
Patients who have a stoma need to learn to care for it. Enterostomal
therapists or nurses can help. These health care specialists often
visit patients before surgery to discuss what to expect. They teach
patients how to care for themselves and their stomas after surgery. They
talk with patients about lifestyle issues, including emotional, physical,
and sexual concerns. Often they can provide information about resources
and support groups.
Followup Care
Followup care after treatment for bladder cancer is important. Bladder
cancer can return in the bladder or elsewhere in the body. Therefore,
people who have had bladder cancer may wish to discuss the chance of
recurrence with the doctor.
If the bladder was not removed, the doctor will perform cystoscopy and
remove any new superficial tumors that are found. Patients also may have
urine tests to check for signs of cancer. Followup care may also include
blood tests, x-rays, or other tests.
People should not hesitate to discuss followup care with the doctor.
Regular followup ensures that the doctor will notice changes so that any
problems can be treated as soon as possible. Between checkups, people who
have had bladder cancer should report any health problems as soon as they
appear.
Support for People with Bladder Cancer
Living with a serious disease such as cancer is not easy. Some people
find they need help coping with the emotional and practical aspects of
their disease. Support groups can help. In these groups, patients or their
family members get together to share what they have learned about coping
with the disease and the effects of treatment. Patients may want to talk
with a member of their health care team about finding a support group.
People living with cancer may worry about caring for their families,
holding on to their jobs, or keeping up with daily activities. Concerns
about treatments and managing side effects, hospital stays, and medical
bills are also common. Doctors, nurses, and other members of the health
care team will answer questions about treatment, working, or other
activities. Meeting with a social worker, counselor, or member of the
clergy can be helpful to those who want to talk about their feelings or
discuss their concerns. Often, a social worker can suggest resources for
help with rehabilitation, emotional support, financial aid,
transportation, or home care.
Materials on coping are available from the Cancer Information Service
(1-800-4-CANCER). The Cancer
Information Service can also provide information to help patients and
their families locate programs and services.
The Promise of Cancer Research
Doctors all over the country are conducting many types of clinical
trials. These are research studies in which people take part voluntarily.
Doctors are studying ways to treat bladder cancer and prevent it from
coming back. Research already has led to advances in these areas, and
researchers continue to search for more effective approaches.
Patients who join clinical trials have the first chance to benefit from
new treatments that have shown promise in earlier research. They also make
an important contribution to medical science by helping doctors learn more
about the disease. Although clinical trials may pose some risks,
researchers take many steps to protect their patients.
Doctors are studying surgery, radiation therapy, chemotherapy,
biological therapy, and combinations of these types of treatment. Another
approach under study is photodynamic
therapy, which uses drugs that start to work when exposed to
light. After the cancer cells absorb the drug, the doctor shines a special
light inside the bladder through a cystoscope. The drug becomes active and
kills the cancer cells.
Doctors also are studying whether large doses of vitamins or certain
drugs may prevent bladder cancer from coming back after treatment.
Keeping on Top of Your Condition
Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.
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