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Bladder Cancer
Overview

Bladder cancer overview

Understanding
Your Disease

When you first find out you have bladder cancer, you may feel angry, scared, powerless — or you may feel calm. It’s normal to have a wide range of emotions and for them to change quickly. Understanding your disease, talking about your feelings with friends and family, and finding supportive communities may help you through your journey. 

If your emotional reaction to cancer gets in the way of your ability to make decisions about your health, it’s important to talk with your doctor. Your cancer treatment center may offer psychological or financial services. 

For access to advocacy organizations and other helpful information — including our bladder cancer fact sheet — please visit our Resources page.

What Is Bladder
Cancer?

Reproduced from Bladder Cancer: A Patient-Friendly Guide to Understanding Your Diagnosis and Treatment Options. Copyright © 2017 David Pulver
Reproduced from Bladder Cancer: A Patient-Friendly Guide to Understanding Your Diagnosis and Treatment Options. Copyright © 2017 David Pulver

Bladder cancer is an uncontrolled, rapid growth of abnormal cells in the bladder. The disease usually begins in the lining of the bladder; however, cancerous cells may spread into the muscular wall of the bladder. Invasive bladder cancer may spread to lymph nodes, other organs in the pelvis (causing problems with kidney and bowel function), or other organs in the body, such as the liver and lungs.

Blood or blood clots in the urine (hematuria) is the most common symptom of bladder cancer. Other common symptoms include:

  • Pain during urination (dysuria)
  • Urinating small amounts frequently
  • Frequent urinary tract infections (UTIs)22 

Contact your doctor if you experience any of these symptoms, including new symptoms. They may indicate other bladder conditions.

How Many People Have Bladder Cancer?

In the U.S., about 1 out of every 20 patients diagnosed with cancer is diagnosed with bladder cancer.1 In 2014, there were more than 696,440 Americans living with bladder cancer.15

9 out of 10

people with bladder cancer are over the age of 55.1

1 out of 26

men has a chance of developing bladder cancer.1
For women, 1 in 88.

79,030

new cases of bladder cancer are estimated in 2017 alone.1

Bladder cancer is the fourth most common cancer in men, but it is less common in women. In 2017, the American Cancer Society estimates 60,490 men and 18,540 women will be diagnosed with bladder cancer and the disease will cause 16,870 deaths (12,240 men and 4,630 women).1

The rates of new bladder cancers and of cancer deaths have been dropping slightly in women in recent years. In men, incidence rates have been decreasing and death rates have been stable.1 Early detection is key to increasing survival rates.

Is All Bladder Cancer the Same?

No, all bladder cancer is not the same. Bladder cancer can differ in type, size, shape and depth. To separate and identify the different kinds of bladder cancer, doctors use a stage and grade classification system. The stage is determined by how far into the bladder wall the cancer is found and if any has spread to nearby tissues and/or other organs. The grade depends on how the cancer cells look under a microscope compared to healthy cells. The difference in appearance helps doctors predict how likely the tumor is to return (recurrence) or continue to grow and spread (progression). Physicians use this information to decide the best treatment options for bladder cancer patients.

Bladder cancer is classified into two types, depending on the depth of invasion in the bladder wall:

  • Non-muscle invasive bladder cancer is still in the inner layer of cells. These cancers are the most common (70 percent) of all bladder cancer cases and include the subtypes Ta, carcinoma in situ (CIS) and T1 lesions.
  • Muscle invasive bladder cancer is when the cancer has grown into deeper layers of the bladder wall. These cancers are more likely to spread to other organs and are harder to treat. These cancers include the subtypes T2, T3 and T4.22
Diagram showing the stages of cancer
Reproduced from Bladder Cancer: A Patient-Friendly Guide to Understanding Your Diagnosis and Treatment Options. Copyright © 2017 David Pulver

 About half of all bladder cancers are first found while the cancer is still confined to the inner layer of the bladder wall. About one in three bladder cancers have invaded into deeper layers but are still only in the bladder. In most of the remaining cases, the cancer has spread to nearby tissues or lymph nodes outside the bladder. Rarely (in about 4 percent of cases), it has spread to distant parts of the body.1

Diagnosis

To diagnose bladder cancer based on urinary symptoms, physicians will compile medical histories and perform urine tests and cultures to check for the presence of blood, infection and other abnormal cells.

If there are suspicions of bladder cancer or positive findings from testing, urologists will perform cystoscopies to look into patients’ bladders. If suspicious lesions are found, patients will then be referred for cystoscopic examinations in operating rooms, where suspected areas will be biopsied for histological confirmation and final diagnosis, including the disease’s stage and grade.

Additional information on staging can be found from tests including:

Male cystoscopic procedure illustration
Male cystoscopic procedure
Female cystoscopic procedure illustration
Female cystoscopic procedure

Treatment

Though bladder cancer is one of the most commonly diagnosed cancers,15 it is also very treatable. Depending on the stage and grade of your bladder cancer, your treatment options may include:

Questions for Your Doctor

For Primary Care Physicians

  • What causes bladder cancer?
  • Is it treatable? How is it treated?
  • What can I expect?

For Urologists

  • What is the outlook?
  • What are my treatment options?
  • Can I get blue light cystoscopy?

Prescribing Information

Cysview is an optical imaging agent indicated for use in the cystoscopic detection of carcinoma of the bladder, including carcinoma in situ (CIS), among patients suspected or known to have lesion(s) on the basis of a prior cystoscopy, or in patients undergoing surveillance cystoscopy for carcinoma of the bladder. Cysview is used with the KARL STORZ D-Light C Photodynamic Diagnostic (PDD) system to perform Blue Light Cystoscopy (BLCTM) as an adjunct to the white light cystoscopy.

Important Safety Information About Cysview® (hexaminolevulinate HCl)

Cysview is not a replacement for random bladder biopsies or other procedures used in the detection of bladder cancer. 

Anaphylactoid shock, hypersensitivity reactions, bladder pain, cystitis, and abnormal urinalysis have been reported after administration of Cysview. The most common adverse reactions seen in clinical trials were bladder spasm, dysuria, hematuria, and bladder pain. 

Cysview should not be used in patients with porphyria, gross hematuria, or with known hypersensitivity to hexaminolevulinate or any derivative of aminolevulinic acid. Cysview may fail to detect some malignant lesions. False-positive fluorescence may occur due to inflammation, cystoscopic trauma, scar tissue, previous bladder biopsy and recent BCG therapy or intravesical chemotherapy. No specific drug interaction studies have been performed. 

Safety and effectiveness have not been established in pediatric patients. There are no available data on Cysview use in pregnant women. Adequate reproductive and developmental toxicity studies in animals have not been performed. Systemic absorption following administration of Cysview is expected to be minimal. There are no data on the presence of hexaminolevulinate in human or animal milk, the effects on a breastfed infant, or the effects on milk production. The development and health benefits of breastfeeding should be considered along with the mother’s clinical need for Cysview and any potential adverse effects on the breastfed infant from Cysview or from the underlying maternal condition. 

Cysview is approved for use with the KARL STORZ D-Light C Photodynamic Diagnostic (PDD) system. For system set up and general information for the safe use of the PDD system, please refer to the KARL STORZ instruction manuals for each of the components. 

Prior to Cysview administration, read the Full Prescribing Information and follow the preparation and reconstitution instructions.

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Prescribing Information

Cysview is an optical imaging agent indicated for use in the cystoscopic detection of carcinoma of the bladder, including carcinoma in situ (CIS), among patients suspected or known to have lesion(s) on the basis of a prior cystoscopy, or in patients undergoing surveillance cystoscopy for carcinoma of the bladder. Cysview is used with the KARL STORZ D-Light C Photodynamic Diagnostic (PDD) system to perform Blue Light Cystoscopy (BLCTM) as an adjunct to the white light cystoscopy.

Important Safety Information About Cysview® (hexaminolevulinate HCl)

Cysview is not a replacement for random bladder biopsies or other procedures used in the detection of bladder cancer. 

Anaphylactoid shock, hypersensitivity reactions, bladder pain, cystitis, and abnormal urinalysis have been reported after administration of Cysview. The most common adverse reactions seen in clinical trials were bladder spasm, dysuria, hematuria, and bladder pain. 

Cysview should not be used in patients with porphyria, gross hematuria, or with known hypersensitivity to hexaminolevulinate or any derivative of aminolevulinic acid. Cysview may fail to detect some malignant lesions. False-positive fluorescence may occur due to inflammation, cystoscopic trauma, scar tissue, previous bladder biopsy and recent BCG therapy or intravesical chemotherapy. No specific drug interaction studies have been performed. 

Safety and effectiveness have not been established in pediatric patients. There are no available data on Cysview use in pregnant women. Adequate reproductive and developmental toxicity studies in animals have not been performed. Systemic absorption following administration of Cysview is expected to be minimal. There are no data on the presence of hexaminolevulinate in human or animal milk, the effects on a breastfed infant, or the effects on milk production. The development and health benefits of breastfeeding should be considered along with the mother’s clinical need for Cysview and any potential adverse effects on the breastfed infant from Cysview or from the underlying maternal condition. 

Cysview is approved for use with the KARL STORZ D-Light C Photodynamic Diagnostic (PDD) system. For system set up and general information for the safe use of the PDD system, please refer to the KARL STORZ instruction manuals for each of the components. 

Prior to Cysview administration, read the Full Prescribing Information and follow the preparation and reconstitution instructions.

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