Bladder Cancer (cont.)
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More Bladder Cancer Overview
A cancer is “staged” using a system developed by consensus among specialists in cancer.
It describes the extent of the cancer when it is first found or diagnosed. This includes the depth of invasion of a bladder cancer, and whether or not the cancer is still only in the bladder, or has already spread to tissues beyond the bladder including lymph nodes, or distant organs.
Bladder cancers are classified by how deeply they invade into the bladder wall, which has several layers. Typically we subdivide bladder cancer into superficial and invasive diseases.
In addition to how deeply the cancer penetrates in the bladder wall, the grade of the bladder cancer provides important information and can help guide treatment. The tumor grade is based on the degree of abnormality observed in a microscopic evaluation of the tumor. Cells from a high-grade cancer have more changes in form and have a greater degree of abnormality when viewed microscopically than do cells from a low-grade tumor. This information is provided by the pathologist, a physician trained in the science of tissue analysis and diagnosis.
In addition to papillary tumors, bladder cancer can develop in the form of a flat, red (erythematous) patch on the mucosal surface. This is called carcinoma-in-situ (CIS). Although these tumors are superficial, they are often high-grade and have a high risk for becoming invasive.
Of all types of cancer, bladder cancer has an unusually high propensity for recurring after initial treatment if that treatment was only a local removal or excision typically by transurethral resection. Bladder cancer treated in that fashion has a recurrence rate of 50% to 80%. The recurring cancer is usually, but not always, of the same type as the first (primary) cancer. It may be in the bladder or in another part of the urinary tract (kidneys or ureters).
Bladder cancer is most common in industrialized countries. It is the fifth most common type of cancer in the United States. It is the fourth most common in men and the ninth in women.
Gary David Steinberg, MD
Mark H. Katz, MD
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