Bladder Cancer Archive Questions

Below are Dr. Heather Mannuel’s answers to Bladder Cancer questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 15 of 20.

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Q : 1 12/26/2009	I have bladder cancer and received chemotherapy for breast cancer 22 years ago. I'm told that cytoxan causes bladder cancer. Is this true? It's an unfortunate fact that many of the chemotherapy agents used to treat and cure cancers can contribute to the development of secondary cancers. An increasing number of studies are suggesting that exposure to cytoxan (cyclophosphamide) and several other chemotherapy agents may increase the subsequent risk of bladder cancer, so although two decades is a fairly long time between exposure and second malignancy development, it's possible that this might be at least one contributing factor.
Q : 2 12/02/2009	What are the treatment options for patients with high grade cancer of the bladder with metastases to the lymph nodes? What is the survival rate? The answer depends on several factors, including how many lymph nodes are involved and whether there is any residual or leftover disease after surgery. Under the best circumstances with minimal lymph nodes involved and with the tumor completely surgically removed, the 5-year survival rate can be 50-60%. When multiple lymph nodes are involved or a complete surgical removal is impossible, the 5-year rate can drop to 20% or less. As with any cancer diagnosis, the individual patient has to be placed somewhere in those statistics by taking into account any other medical problems, age, ability to withstand surgery or other treatments, etc., so those percentages will only be a general estimate.
Q : 3 11/24/2009	Could you please tell me what the best natural supplements are for a patient with bladder cancer? Unfortunately there is very little concrete data available to advise for or against natural supplements in the treatment of bladder cancer. Although there are no absolute contraindications for using natural supplements during chemotherapy, it's best to make sure your oncologist is aware of any natural or over-the-counter medications you are taking so they can monitor for any potential interactions.
Q : 4 06/14/2009	I had a malignant tumor removed from my bladder and then had chemo treatment to the bladder for the following year. I still have frequent urination and burning, why is that? Is there anything I can do for this? Also I have been hoarse. Could the hoarseness be connected to the bladder cancer? I smoked for over 50 years. The topical chemo treatments to the bladder can often cause pain and frequency of urination for months after the completion of therapy. If you haven't seen your urologist in follow-up, you should make an appointment to get the symptoms checked. This will help to rule out any recurrence of your cancer and you can discuss possible medications and treatments to relieve the discomfort you're currently experiencing. Although many things can cause hoarseness, in patients who have had cancer I always want to rule out a recurrence of disease. I encourage you to discuss your symptoms with your primary care doctor who can refer you to the appropriate specialist to investigate your symptoms. And congratulations on no longer smoking - along with regular follow-ups with your physicians, that's the single most important thing you can do to prevent cancer, heart disease and a variety of other health problems!
Q : 5 06/05/2009	I was just diagnosed with a malignant tumor in my bladder. What are the best available treatments for this type of cancer with and without metastasis? Sorry that you have to deal with receiving a tough diagnosis. As you say, treatment options will vary depending on how localized the cancer is. If the cancer is confined completely to the bladder, you may need to have part or possibly all of the bladder removed in order to cure the cancer. At the other end of the spectrum, if the cancer has metastasized we generally give patients intravenous chemotherapy, which isn't curative but can produce good responses and prolong both the quantity and the quality of life. If your disease falls somewhere in between, you may end up requiring a combination of surgery, chemotherapy and possibly radiation depending on the recommendations of your doctors and your overall general health.
Q : 6 11/23/2008	My mother was treated with DES while pregnant with my brother and I in 1950's. At my same age, he developed bladder cancer. I recently saw "squamous epithelial cells Many" on my urinalysis. I am female, 51 yrs. old. Is this cause for concern? Epithelial cells can indicate that the urine specimen was contaminated by cells from your skin (squamous cells are typical skin cells). Generally it's more worrisome if there are red blood cells noted in the urine, as that may be an early sign of bladder cancer; nevertheless, it would probably be best to repeat the urine specimen to make sure you can get a "clean catch" uncontaminated specimen.
Q : 7 08/10/2008	My father, age 91, has had a small amount of hematuria. His doctor recommends that he goes to the nearest university hospital (not nearby) to have a cystoscopy. My father declined, because he has congestive heart failure. He is afraid that the travel and cystocopy could be too much of a strain for him. We are worried that if he has bladder cancer, he may miss the opportunity for early treatment. Are there recommendations whether cystoscopy is inappropriate after a certain age in persons with poor general health? You are the best judge regarding how your father's overall health is. The hematuria could be a number of things, including a urinary infection which could be easily tested where you are, or possibly a kidney, bladder or prostate- related problem. Work-up may involve imaging and cystoscopic evaluation. Based on what you have stated, it is difficult to guide you, but there are no specific guidelines regarding age cut-off to do proper work-ups. One has to use clinical judgment and common sense in deciding how "aggressive" to be in a 91 year old with poor overall health.
Q : 8 03/09/2008	I am a 54-year-old non-smoker in good health with no industrial exposure. Urologist found microscopic blood in urine on routine exam and suspicious growth on ultrasound. Performed cystoscopy and visualized "malignant bladder cancer - transitional cell carcinoma." Performed a TURBT. Pathology results revealed urothelial papilloma with cystitis cystica and glandularis, and focal intestinal metaplasia. Urologist recommended quarterly cystoscopies for minimum of 2 years. Pathologist who examined slides said it is a benign inverted papilloma, not cancer and virtually no risk of recurring as malignancy. Should any further work-up be done (CT, PET, blood screen panel? Any preventive care indicated beyond cysto's? From the description, it appears the plan outlined by your urologist is very reasonable. The pathology does not appear to be malignant at this stage, and I believe detailed imaging is not likely to provide additional information. If you have not had a CT, then it would be reasonable to get one as baseline in view of the fact that blood in the urine could also be due to an "upper tract" lesion.
Q : 9 05/24/2007	My sister-in-law was recently diagnosed with squamous cell bladder cancer; she had a cystectomy and urostomy. When they did the surgery, the surgeon saw cancer on her man-made vagina from her previous surgery, a hysterectomy secondary to cervical cancer 34 years ago. There were no pelvic lymph nodes to test as they had all been removed with the previous cancer. He thinks he removed all of the cancer. What should the next step be? Should she have a PET scan, bone scan? Is it harder/impossible to stage the cancer without nodes to test? I think it would be important to get CT scans, and also obtain Radiation Oncology's opinion regarding possible radiation therapy to help consolidate the surgical treatment. Whether chemotherapy should be used or not would depend upon the staging scans.
Q : 10 05/15/2007	My husband has recently been diagnosed with urethral cancer T4 staging with lymph node involvement and lung metastasis. The local perineal mass is quite advanced (7x4 cm.) What is the prognosis and best treatment advice? Your husband may need some local therapy (perhaps radiation based, although not knowing his imaging studies it is difficult to clearly advise) for the urethral cancer to help control locoregional symptoms/complications that could potentially arise with time. In addition, given that he has metastasis to the lungs, systemic therapy (chemotherapy based) may be warranted.
Q : 11 05/03/2007	I have bladder cancer and will soon commence a 6-week BCG treatment. I have read that BCG can be potentially infectious. My daughter is pregnant with twins. Is it safe to be around her and her babies while having this treatment? BCG should be safe unless one is immunocompromised. I would also check with your urologist about this issue.
Q : 12 04/17/2007	My husband has a neo bladder due to bladder cancer. This was made from a piece of his small intestine. It has been a few years, but he now has a reocurring infection and is frequently given antibiotics. He is a 66-year-old and they are ready to start giving him antiobiotics daily since they can't find what is causing this infection. Do you have any thoughts on this topic? Occasionally patients with indwelling catheters and recurrenct UTIs are put on daily antibiotics, although this is generally discouraged because of risk of selecting resistant organisms. Such issues are always difficult to resolve, and unfortunately there are differences of opinion among the experts as to whether patients should or should not be maintained on chronic antiobiotic suppression. Having said this, I think it would not be unreasonable to put your husband on antiobiotics given his history, although I suggest you seek advice from infectious disease and urology before deciding.
Q : 13 01/18/2007	My husband has been diagnosed with Invasive urothelial transitional cell carcinoma. High grade(Grade III of III) The depth of invasion is to the muscularis popria. Angio-lymphatic invasion present, rare foci. No associated carcinoma. >3cm tumor in situ was removed and area was cauterized. It has been recommended that he have a cystectomy and concurrent neobladder reconstruction. He is in relatively good health otherwise. Active 56-yo white male. Should we get a second opinion? His doctor is a urogist with oncology as a sub specialty. Should we see an oncologist? Would you agree with the course of treatment they had layed out? Any other advice? Given your husband's young age, I believe the best course of action with invasive bladder cancer is surgery as recommended to you. There is about a 50% chance of cure with this approach, whereas with chemotherapy and concurrent radiation the numbers tend to be lower. Further, he may potentially benefit from chemotherapy post surgery, depending upon what the findings are at surgery. It would be a good idea to get an oncologist's opinion as well.
Q : 14 07/25/2006	Could you please tell me what causes bladder cancer? My husband had kidney cancer 2 years ago, and has had several small cancers removed from the bladder in the past year. With all this cancer (kidney and bladder), it never showed in the urine or blood. We were told it was low grade, Stage I. The most common cause for bladder cancer is smoking. Exposure to certain chemicals and the underlying genetic background are also etiologic factors.
Q : 15 07/07/2006	My father-in-law has stage 4 bladder cancer. He is 74, white and has been in good health other than cancer. I understand treatments work differently for different people and that there is no way to 100% know any answer. What is your estimate for survival rate for someone this age and stage? I am trying to get estimations from different sources to get a better understanding of what to expect. Thank you for your time. Generally, the average survival is around 12 to 13 months in advanced bladder cancer treated with chemotherapy, and around 6 months without chemotherapy.

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