Bladder Cancer Questions & Answers

Updated: Jan 09, 2020
  • Author: Gary David Steinberg, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
  • Print
Questions & Answers

Overview

What is bladder cancer?

What are the treatment options for non-muscle-invasive bladder cancer?

What are some signs and symptoms of bladder cancer?

Which urine studies are used to diagnose bladder cancer?

What is the role of urinary cytology in the diagnosis of bladder cancer?

What is the role of cystoscopy in the diagnosis of bladder cancer?

What is the role of upper urinary tract imaging in the diagnosis of bladder cancer?

What is the diagnostic strategy for patients with negative cystoscopy for bladder cancer?

Which blood tests are performed in the diagnosis of bladder cancer?

What are the treatment options for muscle-invasive bladder cancer?

What are chemotherapeutic regimens used to treat metastatic bladder cancer?

What is squamous cell carcinoma (SCC) bladder cancer?

What is bladder cancer?

What is transitional (urothelial) cell carcinoma (TCC) bladder cancer?

What are the less common types of bladder cancer?

What are the phenotypes of urothelial carcinoma bladder cancer?

What is the clinical course of bladder cancer?

How does the presentation of bladder cancer vary?

What are the treatment options for carcinoma in situ (CIS) bladder cancer?

How common in bladder cancer recurrence?

Where can more information on bladder cancer be found?

What anatomy of the bladder is helpful in understanding bladder cancer?

How does the anatomy of the bladder differ in males and females?

What role does the vascular system play in the anatomy of the bladder?

What role does the lymphatic system play in the anatomy of the bladder?

Where in the bladder does cancer originate?

What is the description of bladder cancer?

What terms should be used for bladder cancer?

How does the WHO classify bladder cancers?

What is the pathophysiology of transitional cell carcinoma (TCC) bladder cancer?

What is the most common molecular biologic pathway for transitional cell carcinomas (TCCs) in the bladder?

How are urothelial tumors associated with transitional cell carcinomas (TCCs) in the bladder?

What is pathophysiology of squamous cell carcinoma (SCC) of the urinary bladder?

What is the pathophysiology of rare forms of bladder cancer?

What pathways are responsible for the development of noninvasive and invasive bladder tumors?

What is the role of genetic mutation in the pathogenesis of bladder cancer?

What is the role of TP53 gene alterations in the pathogenesis of bladder cancers?

Which genetic alterations are common in bladder cancers?

What are mechanisms that can lead to tumor progression in bladder cancer?

Which factors promote tumor growth in bladder cancer?

What is the role of environmental factors in the etiology of bladder cancer?

Which factors increase the risk of developing bladder cancer?

Which occupational exposures increase the risk of bladder cancers?

How is geography a risk factor for bladder cancers?

What is the role of arsenic exposure in the development of bladder cancer?

What are the medical risk factors for bladder cancer?

What role does genetics play in the development of bladder cancer?

What is the role of schistosomiasis in the etiology of bladder cancer?

How does schistosomiasis infection cause bladder cancer?

What are the risk factors for squamous cell carcinoma (SCC) bladder cancer?

What is the incidence of bladder cancers in the US?

How does the prevalence of bladder cancer vary by sex in the US?

How does the incidence of bladder cancer vary by race in the US?

What are the demographic predilections of small cell carcinoma of the bladder?

What is the global prevalence of bladder cancer?

What are the 5-year survival rates by bladder cancer stage?

What are the morbidities of untreated bladder cancer?

What is the recurrence rate for superficial transitional cell carcinoma (TCC) bladder cancer?

What are the most significant prognostic factors for bladder cancer?

What is the prognosis of metastatic urothelial cancer?

What are the risks of progression of bladder cancer by tumor grade?

What is the prognosis in carcinoma in situ (CIS) bladder cancer?

What is the prognosis of squamous cell carcinoma (SCC) bladder cancer?

What is the prognosis in small cell carcinoma bladder cancer?

What is the recurrence rate for bladder cancers?

What are the risk factors for recurrence and progression of bladder cancer?

Presentation

What are the signs and symptoms of bladder cancer?

What physical findings are characteristic of bladder cancer?

DDX

What is the significance of spontaneous resolution of gross or microscopic hematuria during the evaluation of bladder cancer?

In what ways do the symptoms of bladder cancer and urinary tract infection (UTI) overlap?

How is carcinoma in situ (CIS) bladder cancer diagnosed?

Which tests are used to diagnose bladder cancer?

What are the main differential diagnoses for small cell carcinoma bladder cancer?

What are the differential diagnoses for Bladder Cancer?

Workup

What is the role of urine studies in the evaluation of bladder cancer?

What is the role of urinary cytology in the diagnosis of bladder cancer?

Which cytology findings are diagnostic of bladder cancer?

What is the role of cystoscopy in the diagnosis of bladder cancer?

What is the role of imaging studies in the diagnosis of bladder cancer?

What is the role of molecular and genetic markers in the diagnosis of bladder cancer?

What is the role of blood tests in the diagnosis of bladder cancer?

What is the role of CBC count in the evaluation of bladder cancer?

What is the role of a chemistry panel in the diagnosis and management of bladder cancer?

What is the role of renal function testing in the management of bladder cancer?

What is the significance of hematuria in detecting patients with bladder cancer?

What is the AUA recommended definition of microscopic hematuria?

What is the role of voided urine cytology in the diagnosis of bladder cancer?

What is the sensitivity and specificity of cytology in detecting bladder cancer?

Which factors affect the sensitivity of cytology in detecting bladder cancer?

What is the role of urine cytology in the diagnosis of carcinoma in situ (CIS) bladder cancer?

What effect does instrumentation have on urine cytology findings in the evaluation of bladder cancer?

How can the accuracy of urine cytology for detecting bladder cancer be improved?

What role does noninvasive urine markers play in the diagnosis of bladder cancer?

What are the guidelines for use of urinary tumor markers in the diagnosis of bladder cancer?

What is cystoscopy and how is it used for detecting bladder cancer?

What are the recommended actions following a negative cystoscopy in the evaluation of bladder cancer?

What is the global prevalence of each types of bladder cancer?

Which histologic finding is characteristic of carcinoma in situ (CIS) bladder cancer?

How is cellular atypia distinguished from carcinoma in situ (CIS) bladder cancer?

What is the role of CT scanning in the diagnosis of bladder cancer?

What is intravenous pyelography (IVP) and how is it used in detecting bladder cancer?

What is the role of ultrasonography in the diagnosis of bladder cancer?

How is bladder cancer staged?

What is the tumor, node, and metastases (TNM) staging system for bladder cancer?

What is the prevalence of each stage of bladder cancer at diagnosis?

What is the likelihood of bladder cancer metastasis?

What is the significance of stage and grade in bladder cancer?

How is carcinoma in situ (CIS) bladder cancer defined and graded?

How is carcinoma in situ (CIS) bladder cancer designated in?

Treatment

What are the treatment options for non-muscle-invasive and muscle-invasive bladder cancer?

What are the principal treatments for muscle-invasive bladder cancer?

What is the role of radical cystectomy in the treatment of bladder cancer?

What is the role of trimodality therapy for bladder cancer?

What is the efficacy of trimodality therapy for bladder cancer?

How might biomarkers affect treatment selection for bladder cancer in the future?

What are treatment options for low-grade, low-stage bladder cancer?

When are chemotherapies and immunotherapies indicated in the treatment of bladder cancer?

What is the role of transurethral resection of bladder tumor (TURBT) in the treatment of bladder cancer?

What are the EAU treatment guidelines for bladder cancer?

What is the role of radiation therapy in the treatment of bladder cancer?

What is the criterion standard for the treatment of patients with stage T2-T4 bladder cancer?

When is lymph node dissection indicated in the treatment of bladder cancer?

What are the treatment options for small cell carcinoma bladder cancer?

What is the treatment for adenocarcinoma bladder cancer?

What is the treatment for squamous cell carcinoma (SCC) bladder cancer?

Which lifestyle changes decrease the risk of bladder cancer recurrence and progression?

What is the treatment for high-risk Ta, T1, and carcinoma in situ (CIS) bladder cancer?

How is intravesical instillation of bacillus Calmette-Guérin (BCG) vaccine or chemotherapy administered in the treatment of bladder cancer?

What is the role of interferon alpha or gamma in the treatment of bladder cancer?

What is the role of bacillus Calmette-Guérin (BCG) plus interferon in the treatment of bladder cancer?

What is the role of fluorescence in situ hybridization (FISH) assays in the management of bladder cancer?

What is the role of valrubicin (Valstar) in the treatment of bladder cancer?

What is the role of docetaxel in the treatment of bladder cancer?

What are the guidelines for surgical treatment of bladder cancer?

What are the EAU recommendations for surgical treatment of bladder cancer?

What is the role of radical cystectomy in the treatment of bladder cancer?

What is the role of cystectomy in the treatment of non-muscle-invasive bladder cancer?

What is the criterion standard for the treatment of stage T2-T4 bladder cancer?

What is the role of radical cystoprostatectomy in the treatment of bladder cancer?

What are the benefits of robot-assisted radical cystectomy in the treatment of bladder cancer?

What is the impact on survival of a longer interval between diagnosis and radical cystectomy for bladder cancer?

When is bilateral pelvic lymphadenectomy (PLND) indicated in the treatment of bladder cancer?

What are the benefits of extended bilateral pelvic lymphadenectomy (PLND) in the treatment of bladder cancer?

What are the contraindications for continent urinary diversion following cystectomy for bladder cancer?

What is the most common incontinent urinary diversion procedure in the treatment of bladder cancer?

How is an ileal conduit created following cystectomy for bladder cancer?

What is the most common continent urinary diversion procedure in the treatment of bladder cancer?

How is an orthotopic neobladder created following cystectomy for bladder cancer?

How do continent urinary reservoirs for the treatment of bladder cancer vary?

What is the role of cisplatin-based neoadjuvant chemotherapy in the treatment of bladder cancer?

What is the evidence of efficacy for neoadjuvant chemotherapy in the treatment of bladder cancer?

When is adjuvant chemotherapy indicated for treatment of bladder cancer?

What impact does combination therapy have on the mortality risk of bladder cancer?

What is the role of epithelial growth factor receptors (EGFRs) in the treatment of bladder cancer?

What are the benefits to adjuvant chemotherapy in the treatment of bladder cancer?

Which combination regimens are used in the treatment of metastatic bladder cancer?

What is the role of programmed cell death inhibitors in the treatment of metastatic bladder cancer?

What is the efficacy of second line therapy for metastatic bladder cancer?

What is the role of atezolizumab (Tecentriq) in the treatment of metastatic bladder cancer?

What is the role of nivolumab in the treatment of metastatic bladder cancer?

What is the role of durvalumab (Imfinzi) in the treatment of metastatic bladder cancer?

What is the role of avelumab (Bavencio) in the treatment of metastatic bladder cancer?

What is the role of pembrolizumab (Keytruda) in the treatment of metastatic bladder cancer?

What is the role of erdafitinib in the treatment of metastatic bladder cancer?

What is the role of enfortumab vedotin in the treatment of metastatic breast cancer?

What is the role of external beam radiation therapy (EBRT) in the treatment of bladder cancer?

What is the efficacy of combination EBRT, chemotherapy and surgery in the treatment of bladder cancer?

What is recurrence rate of bladder cancer following radiation therapy?

What are the most common complications to radical cystectomy for bladder cancer?

What is the overall complication rate of radical cystectomy for bladder cancer?

What are complications in men of radical cystectomy for bladder cancer?

What are complications of urinary diversion following cystectomy for bladder cancer?

What are complications of orthotopic neobladder following cystectomy for bladder cancer?

Which patients require follow-up following treatment for non-muscle invasive bladder cancer?

What are the EAU guidelines for follow-up of patients with bladder cancer?

What are the NCCN recommendations for follow-up after radical cystectomy for bladder cancer?

Guidelines

Which organizations have issued guidelines for the diagnosis and management of bladder cancer?

What is the evidence basis for the AUA-SUO bladder cancer guidelines?

What is the evidence basis for the EAU bladder cancer guidelines?

What is the evidence basis for the ESMO bladder cancer guidelines?

What is the evidence basis for NCCN bladder cancer guidelines?

What is the USPSTF recommendation for bladder cancer screening?

What is the most established risk factor for bladder cancer?

How much does quitting smoking reduce the risk for bladder cancer?

What is the second most important risk factor for bladder cancer?

Which tests are performed in the diagnosis of bladder cancer?

What are the guidelines recommendations for use of urinary cytology in the diagnosis of bladder cancer?

What are the AUA-SUO guidelines for use of cystoscopy in the diagnosis of bladder cancer?

What are the EAU guidelines for use of cystoscopy in the diagnosis of bladder cancer?

What are the NCCN guidelines for use of cystoscopy in the diagnosis of bladder cancer?

What is the role of upper tract imaging in the diagnosis of bladder cancer?

What are the NCCN diagnostic guidelines for noninvasive bladder cancer?

What is the NCCN recommended preferred approach for imaging of the upper tract in the diagnosis of bladder cancer?

What are the NCCN diagnostic guidelines for muscle-invasive bladder cancer?

What are EAU guidelines for the staging of muscle-invasive bladder cancer?

According to guidelines, what is the basis for a definitive diagnosis of bladder cancer?

How is bladder cancer staged?

What are characteristics of the different grades and stages of bladder cancer?

What are the levels of risk stratification used by EAU for non-muscle-invasive bladder tumors?

What are the NCCN recommendations for the treatment of low-grade Ta bladder tumors?

What are the NCCN and EAU recommendations for the treatment of high-grade Ta bladder tumors?

What are the NCCN recommendations for the treatment of T1 (low- and high-grade) bladder tumors?

What are the EAU recommendations for the adjuvant treatment of Ta and T1 bladder tumors?

What are the AUA/SUO recommendations for repeat TURBT in the treatment of bladder cancer?

What are the recommendations AUA/SUO recommendations for intravesical therapy for bladder cancer?

What are the NCCN recommendations for treatment of CIS bladder cancer?

What are the EAU recommendations for cystoscopic follow-up of Ta, T1 and CIS bladder cancer after TURBT?

What are the NCCN guidelines for cystoscopy and urinary cytology monitoring following treatment of bladder cancer?

What are the AUA/SUO guidelines for monitoring following treatment of bladder cancer?

What are the NCCN recommendations for the treatment of muscle-invasive bladder disease?

What are the NCCN recommended first-line chemotherapy regimens advanced or metastatic bladder disease?

What are the NCCN second-line therapy recommendations for the treatment of bladder cancer?

What does the EAU recommend as the curative treatment of choice for muscle-invasive bladder cancer?

What are the EAU recommendations for the treatment of muscle-invasive bladder cancer?

What are EAU recommendations for first-line chemotherapy for advanced or metastatic bladder cancer?

What are EAU recommended second-line treatments for advanced or metastatic bladder cancer?

What are the ESMO guidelines for the treatment of metastatic bladder cancer?

What are the NCCN recommendations for treatment of locally advanced/metastatic bladder cancer in platinum-ineligible with no PD-L1 expression patients??

What are the NCCN and EAU recommendations for the diagnosis of upper tract urothelial carcinoma (UTUC) bladder cancer?

What are the NCCN recommendations for the treatment of UTUC bladder cancer?

What are the EAU recommendations for management of UTUC bladder cancer?

What are the EAU recommendations for radical nephroureterectomy (RNU) in the treatment of UTUC bladder cancer?

What are the indications for conservative management of UTUC bladder cancer?

What are EAU recommendations for conservative treatment for UTUC bladder cancer?

What are the EAU recommendations for surveillance after treatment for UTUC bladder cancer?

Medications

Which mediations are the standard of treatment for metastatic bladder cancer?

What is the benefit of new combination regimens for the treatment of bladder cancer?

Which medications in the drug class PD-1/PD-L1 Inhibitors are used in the treatment of Bladder Cancer?

Which medications in the drug class Antineoplastics, Antimicrotubular are used in the treatment of Bladder Cancer?

Which medications in the drug class Antineoplastics, Alkylating are used in the treatment of Bladder Cancer?

Which medications in the drug class Antineoplastics, Anthracycline are used in the treatment of Bladder Cancer?

Which medications in the drug class Antineoplastics, Vinca Alkaloid are used in the treatment of Bladder Cancer?

Which medications in the drug class Antineoplastics, Antimetabolite are used in the treatment of Bladder Cancer?

Which medications in the drug class FGFR Inhibitors are used in the treatment of Bladder Cancer?

Which medications in the drug class Anti-Nectin-4 Monoclonal Antibodies are used in the treatment of Bladder Cancer?