Bladder cancer is a malignant overgrowth of cells in the bladder. In the United States, the most common kind of bladder cancer is transitional cell carcinoma of the bladder (over 90%), which is derived from the cells that line the urinary tract and the bladder. Most often, patients present with blood in the urine (also called hematuria). Bladder cancer can also cause painful urination (also known as dysuria), urinary urgency, and urinary frequency, lower abdominal pain and low blood count (also known as anemia). In its advance forms there may be spread of the cancer into bones (bony metastasis) which can cause severe bone pain and tenderness. Anemia can also cause lethargy, weight loss (unintentional) and fatigue, and all of these would be bad signs.
Bladder cancer is initially treated endoscopically (which is going through the urethra with a small camera). This approach is generally done to diagnose and potentially treat the patient. Another name for endoscopy of the bladder is cystoscopy. Currently, patients have a cystoscopy done in the office, as the scopes are small and flexible, thus not causing much pain and discomfort. Once a tumor has been identified, usually the patient is scheduled for an operation to remove the tumor in the operating room. There, generally a rigid form of the cystoscope is used to remove the tumor and this operation is called TURBT (or Trans-Urethral Resection of Bladder Tumor).
If TURBT shows that the cancer has spread to the muscle layer of the bladder, most often the patient is offered a radical cystectomy (which means removal of the bladder) and a urinary diversion (which means routing the urine out of the body). A urinary diversion has many forms which may exit the body through an opening from the abdominal wall (called an ileal conduit) or from the urethra (called an orthotopic ileal pouch – which itself has many iterations).