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Bladder Cancer

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The bladder is a hollow organ in the pelvis that stores urine before it leaves the body. Urine is carried to the bladder through tubes called ureters. Bladder cancer begins when cells in the bladder start to grow uncontrollably. These cancerous cells can form a tumor and potentially spread to other parts of the body.

Types of Bladder Cancer

  • Transitional cell carcinoma (TCC)
    Transitional cell cancer begins in the cells lining the inside of the bladder. This type of cell also lines the other parts of the urinary tract, including the kidneys, ureters, and urethra. TCC is the most common kind of bladder cancer, occurring in about 95 percent of cases, and can be low- or high-grade. Low-grade often recurs after treatment, but typically does not spread into the bladder's muscle layer or other body parts. Just 10 percent of bladder cancers become high-grade or invasive.

  • Squamous cell carcinoma
    This type of cancer begins in squamous cells. These are thin, flat cells in the tissue that lines hollow organs within the body, as well as the passages of both the respiratory and digestive tracts. About 1 to 2 percent of bladder cancers are squamous cell carcinomas, usually caused by long-term infection or irritation.

  • Adenocarcinoma
    This rare type of cancer begins in glandular (secretory) cells found in the lining of the bladder. Adenocarcinomas account for only about 1 percent of bladder cancers.

  • Small Cell Carcinoma
    Less than 1 percent of bladder cancers are small cell carcinomas. These start in nerve-like cells – called neuroendocrine cells that grow quickly and they require treatment with chemotherapy similar to that used in cases of small cell carcinoma of the lung.

Primary Stages of Bladder Cancer

The treatment used for bladder cancer depends on many factors, including the diagnosis stage, whether it has spread beyond the bladder, how old the patient is, and the patient’s wishes. The stages of bladder cancer include:

  • Superficial bladder cancer: Bladder cancer limited to the lining of the bladder.

  • Invasive bladder cancer: Bladder cancer that has spread through the lining of the bladder and invaded the muscle wall.

  • Metastatic bladder cancer: Bladder cancer that has spread to nearby organs and lymph nodes.

Why Choose Sylvester Comprehensive Cancer Center?


Advanced radiation oncology tools. Sylvester is one of only five medical centers in the country with ViewRay — MRI-guided radiation therapy. And, our RapidArc® radiotherapy system delivers intensity modulated external radiation therapy (IMRT). This leads to more efficient and effective treatments, shorter treatment times, pinpoint accuracy in tumor targeting, and less damage to surrounding healthy tissue.

More cancer clinical trials than any other South Florida hospital. If appropriate for your cancer and stage, our clinical trials provide you with the very newest ways to treat and potentially cure your cancer.

One of only four designated Cancer Centers of Excellence in Florida. We treat cancer, and only cancer, giving you the best potential outcomes. The likelihood of surviving cancer five years after treatment from a Dedicated Cancer Center is 17 percent higher than at other hospitals.

Multidisciplinary care teams with nationally recognized expertise. Your care team is made up of experts in your exact type of cancer, and every single aspect of it.

High-tech imaging expertise using the most advanced technology available. Our leading-edge diagnostic equipment allows us to distinguish between normal and abnormal findings, providing you with an accurate diagnosis. We work with you to develop a personalized treatment plan that offers you the best results.

Access to sophisticated reconstruction techniques. In some cases that require the removal of the whole bladder, our specialists can construct a new one. If you're a candidate for this type of surgery, you can lead a normal lifestyle without external appliances.

One of the most experienced teams in the U.S. in nerve-sparing bladder cancer removal. You are far less likely to have side effects due to nerve damage in the abdominal region.

A top-ranked program for kidney and bladder cancer treatment. We offer advanced care for urologic cancers and are ranked among the top five kidney and bladder cancer programs in the country. Our urologists are dedicated to identifying cancer early so we can provide more effective treatment. We were the first — and only — medical center in South Florida to use enhanced Blue Light Cystoscopy with Cysview imaging technology to detect and identify bladder cancer.

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Treatments


Most people diagnosed with bladder cancer have superficial and noninvasive tumors. Treatment for these tumors is often very effective with an excellent prognosis. Depending on the diagnosis, bladder cancers can often be managed with a single therapy or combination of treatments, including:

  • Transurethral Resection

    A thin, lighted tube called a cystoscope ) is inserted into the bladder through the urethraand. A tool with a small wire loop is then used to remove the tumor or the cancerous tissue is burnetumord away with high-energy electricity.

  • Segmental Cystectomy

    The surgeon takes out a small portion of the bladder that contains the cancerous tissue. This procedure is most effective when there is only a single site of cancer cells in the bladder.

  • Radical Cystectomy

    This procedure entails removal of the bladder, lymph nodes near the bladder, and any nearby organs that contain cancer cells. Your doctor may recommend this approach if there are several areas of cancer in the bladder and if there is metastasis (cancer spread) to other sites. In women, removal of the uterus through a hysterectomy is typically performed at the same time because the uterus would otherwise lose its support. Chemotherapy is often given before cystectomy when the bladder cancer is invasive.

  • Neobladder Construction

    In certain patients who are younger without certain chronic conditions, and for whom the chances of recurrence are low, a replacement bladder is made from intestinal tissue. Instead of creating an opening to divert urine to the skin, the surgeon puts replaces the cancerous bladder with the new bladder and connects it to the urethra. This technique is available for both men and women, allowing them to achieve near-normal continence.

  • External Beam Radiation Therapy

    Advanced technology tools working for you include RapidArc®, an advanced technology used with a linear accelerator to deliver intensity modulated external radiation therapy (IMRT). This shortens treatment times to one-half to one-eighth that of conventional radiation therapy, resulting in better tumor targeting, allowing higher doses to the tumor and less damage to surrounding healthy tissue.

  • Internal Radiation Therapy

    Both internal and external radiation, or one or the other, may be used in bladder cancer treatment. With internal radiation, a radiation implant in the bladder offers direct impact on cancer cells. External radiation, however, utilizes a machine outside the body to direct rays at a broader area.

  • Biological or Immunotherapy

    This treatment relies on the patient's immune system to fight cancer. The patient is treated with an intravesical biologic therapy called BCG (Bacillus Calmette-Guérin) after the cancer is scraped out. BCG is in a solution placed directly into the bladder with a catheter, for a short period, and repeated through a series of treatments. In non-invasive bladder cancer, this biologic approach is usually a single remedy.


Tests


Besides a careful and complete medical history and physical examination, procedures for diagnosing bladder cancer may include the following:

  • Digital Rectal or Vaginal Exam

    The healthcare provider inserts a gloved finger into the rectum or vagina, which allows them to check for lumps or other abnormalities.

  • Laboratory Tests

    A urine sample is checked for blood, chemicals, bacteria, and cells. The urine may be examined microscopically to look for cancer cells, or grown in a culture to check for infection.

  • Bladder Tumor Marker Studies

    These tests look at cellular characteristics and markers or substances released by bladder cancer cells into the urine.

  • Cystoscopy

    A tool called a cystoscope is inserted through the urethra directly into the bladder to check for abnormal areas like tumors or stones. The thin, tube-like instrument has a light and a lens for viewing. It can also have a tool to remove (biopsy) suspicious tissue samples. Pathologists review these samples with a microscope to look for signs of cancer.

  • Bladder Biopsy

    Tissue samples can be taken from the bladder using a needle or during surgery if not removed with cystectomy. Pathologists review these samples with a microscope to look for signs of cancer or abnormal tissue.

  • Intravenous Pyelogram (IVP)

    Colored dye is injected into a vein. A series of X-rays are used to look for cancers in the kidneys, ureters, and bladder and to check for any abnormalities or blockages. These can also rule out other diseases or check for the cancer spread (metastasis) to additional parts of the urinary tract.

  • Ultrasound

    High-frequency sound waves and a computer help create images of blood vessels, tissues, and organs. Ultrasounds are relied upon to view internal organs as they function, as well as to assess how blood flows through various vessels..

  • A Computed Tomography (CT) Scan

    CT scans rely on a combination of X-rays and computer technology to produce horizontal, or axial, images of pelvic organs and are more detailed than general X-rays.

  • Magnetic Resonance Imaging (MRI)

    This type of scan involves using a combination of large magnets and radio waves with a computer to create elaborate images of organs and other structures in the body.

  • Positron Emission Tomography (PET)

    PET scans, which use a special glucose tracer, can show areas of cancer not seen on an MRI or CT scan.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • CompCare (Comprehensive Behavioral Care)
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry Vista Medicare HMO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Global Health Claims Services
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana HUMx
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care