Bladder cancer is any of several types of cancer arising from the tissues of the urinary bladder. It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body. The most common symptoms include blood in the urine and pain with urination.
[Risk factors for bladder cancer include smoking, prior radiation therapy, frequent bladder infections, and exposure to certain chemicals (paints, aniline dyes). The most common type is transitional (urothelial) cell carcinoma. Other much less common types include squamous cell carcinoma and adenocarcinoma.]
Diagnosis is typically by cystoscopy with tissue biopsies. Staging (how far the tumor has spread) of the cancer is typically determined by medical imaging such as abdominal/pelvic CT scan or MRI.
Treatment depends on the stage of the cancer. The basic staging of the disease is either invasive or non-invasive. If the latter, limited endoscopic surgical removal (transurethral resection) may be all that is required. If the tumor is high grade or multifocal (multiple areas) within the bladder then some form of intravesical therapy (medication instilled directly into the bladder) may reduce the frequency and severity of any recurrence as bladder tumors have a high propensity to return. If the tumor is invasive (i.e. into the bladder wall) treatment may include some combination of surgery, radiation therapy, chemotherapy, Surgical options may include additional transurethral resection, partial or complete removal of the bladder, with/without urinary diversion. Typical five-year survival rates in the United States are 77% for all grades/types of bladder cancer but less than 50% for those patients whose disease has penetrated (muscle invasive) into the bladder wall.
World-wide Bladder cancer, as of 2015, affects about 3.4 million people with 430,000 new cases a year. Age of onset is most often between 65 and 85 years of age. Males are more often affects than females. In 2015, bladder cancer resulted in 188,000 deaths.
In the past decade, considerable progress in patient survival has been made with the use of chemotherapy prior to bladder removal for those with invasive disease. Progress has also been made with the various forms of urinary diversion.
We recently took some time to actually talk to some of our Urologists.
As a practice, we all spend a lot of time together. Its that kind of family like relationship, where sometimes you cant stand your little brother, or get annoyed at your dad not letting you go out this or that night. Oh, the memories! After spending some time with our doctors, not interviewing them but just talking to them outside of their Doctor like environment we came to realize how much like you and me they are (yes behind the MD title there is a person too). They are people with the same concerns we have and then some. Namely, taking care of you as a patient and us as their employees.
In the last few months, we have talked to them for some time. While you may think its just urology, its amazing how passionate they are about the cases they are working on and about their trade. Urology, Medicine they’re trades too, also an art in some ways. These require attention and keeping tabs on new techniques and/or medications to treat you know who? You. They sometimes get together over coffee and discuss some of their patients with the other Doctor’s in the practice. They do so with the utmost concern and passion, which sometimes is very inspiring. We as administrative staff may not know the medical lingo the way they do, but its kinda funny to hear them talk about some technique or the other for a surgical case. They are excited about it, about the challenge that those surgical procedures entail and how they’re ready to help YOU beat what ails you. On occasion we’ve asked them how did it go with this patient and his kidney stones, or the other with their bladder tumor? How did it go with that urethral repair? Its great to see them happy with each successful case. As with every thing not all cases have a single treatment solution, but the doctors come back with more information to create the next step in treatment. No, not all cases are surgery. Some are office treatment courses, or studies that help them figure out problems.
On top of having the constant pressure of dealing with their day to day life, they are concerned about you their patient. Besides this, many of our Urologists also lecture at teaching hospitals. It had been our impression that their work day was mostly 9-5 when in the office and which ever surgery cases they had at the hospital. Well, its not just that. Many times they arrive at our office after teaching at the hospital, presenting some conference at 730am. When thinking about that, consider that some of the doctors in our practice come from Long Island or New Jersey!
Medicine is not all glamor. Understanding all they do puts everything into perspective. It takes a lot of sacrifice and dedication, that not many people are willing to make. After coming to this understanding about the doctors at our practice, we have new found respect for them. We may complain sometimes about a stressful day at the office, and that’s fine, but now when we do, we also remember that these doctors we’re working for, never leave the proverbial office because they’re always available in some form to take care of their/our patients.
To ALL Urologists in our practice, and doctors everywhere we have to say thanks for letting us assist in the privilege of caring for your patients!