Bladder & Kidney Cancer

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Bladder Cancer

Bladder cancer that has not invaded the muscular layer of the bladder (or beyond) is called superficial bladder cancer. Superficial bladder cancer is highly favorable and typically allows for a much less invasive form of treatment. Nevertheless, even superficial bladder cancer can be a serious condition and requires the attention of a trained specialist for effective management.

Symptoms

Blood in the urine is by far the most common symptom reported by patients who are diagnosed with superficial bladder cancer. At times, the blood may only be detected on microscopic testing.

This is one reason that regular urine tests by a family doctor can be so important. Sometimes patients also complain of irritative voiding symptoms or bladder pain.  

Who is prone to bladder cancer?

Bladder cancer is more common in men than women, although it is common in both genders. In the United States, bladder cancer represents the fourth most common cancer in men and the ninth most common cancer in women.

Risk factors for bladder cancer include smoking, exposure to radiation, certain chemotherapy drugs (such as cyclophosphamide, which is used to treat other cancers), and chronic bladder inflammation. Caucasians are at greater risk than people of other racial backgrounds for developing bladder cancer.  

Diagnosis and treatment

In addition to performing tests on the urine and imaging studies, a urologist will perform a cystoscopy, which allows him to look into the bladder with a small scope. This helps determine if there is a bladder tumor.

Diagnosis is made by removing either a small piece of any suspicious tissue (a biopsy) or resection of the tumor seen during cystoscopy. If the urologist sees a tumor during cystoscopy, they will typically recommend a "TURBT," which stands for trans-urethral resection of a bladder tumor.  

TURBT is a minimally invasive procedure that may be performed as an outpatient surgery or may require a one- or two-night stay in the hospital, depending on the size of the tumor. The urologist uses a resectoscope to carefully shave off the tumor from the wall of the bladder. The tumor is then sent to the pathologist for analysis of tumor type and depth of invasion.

If the tumor does not penetrate the muscular layer of the bladder, the TURBT can be curative. The urologist may elect to place a liquid chemotherapy drug (mitomycin) in the bladder for one hour following the resection. This has been shown to reduce the risk of recurrence in certain cases. In general, this is a very well tolerated procedure with minimal side-effects. The results of the pathology will determine what type of follow-up and what type of further treatment (if any) will be needed.

Kidney Cancer

Kidney cancer is a relatively uncommon form of cancer, making up about 2 percent of all cancers diagnosed. Nevertheless, doctors have noted an increasing incidence in kidney cancer in the United States. This is thought to largely be related to the increased use of medical imaging studies (CT scans and ultrasounds) in recent years, thus increasing the detection rate of small tumors.

Historically, kidney cancers tended to be quite advanced by the time they were diagnosed. More recently, however, many patients are diagnosed before they have any symptoms.

Symptoms of kidney cancer

Typical symptoms of kidney cancer are blood in the urine, unexplained weight loss, and fatigue. Kidney cancer is more common in men and older patients. Like many cancers, smokers are at increased risk of developing kidney cancer compared to non-smokers.

Other risk factors include high blood pressure, renal failure, obesity, and genetic conditions (Von Hippel-Lindau disease and hereditary papillary renal cell carcinoma).  

Anyone who notices blood in his or her urine should notify a doctor promptly. Usually, kidney cancer is not the cause of the blood, but it is important to check. Typically patients will undergo an imaging study (CT scan or ultrasound) and referred to a urologist for cystoscopy (looking in the bladder with a small scope).  

Treating kidney cancer

If and when a kidney cancer is suspected, the most common form of treatment is surgery. This surgery may be directed to remove the affected kidney (nephrectomy) or in certain circumstances, to remove the tumor from the affected kidney (partial nephrectomy).

The application of laparoscopic surgery in urology has allowed many of these procedures to be performed in a minimally invasive manner that greatly eases the pain and recovery period for the patient.