Bladder & Kidney Cancer

The American Cancer Society estimates over 70,000 people in the United States are diagnosed with bladder cancer every year and about 58,000 new cases of kidney cancer are discovered. The earlier we find these genitourinary cancers, the better your chances of successful treatment. When you’re diagnosed, every day counts. We’ll help you review and understand your care options quickly.

You can trust us with early detection and screening, for education, what to expect and next steps after a diagnosis.

Bladder cancer detection and diagnosis

Sometimes the first sign of bladder cancer is an abnormal result on a urine test, a test that might be part of your annual preventive care visit. Or you may have symptoms, such as difficulty urinating, pain during urination, more frequent urination than usual or blood in your urine.

If bladder cancer is a possibility, your doctor will do exams and diagnostic tests, which may include:

• Physical exam – A check for a bladder tumor
• Biopsy – A sample of tissue that is examined for the presence of cancer cells
• Cystoscopy – A thin, flexible tube is used to view the urinary tract, particularly the bladder, the urethra and the openings to the ureters
• Intravenous pyelogram (IVP) – Imaging that looks at the kidneys and ureters
• Urine cytology – Lab test that screens urine for abnormal cells

Treatment questions

Talking with healthcare providers about a bladder cancer diagnosis can be overwhelming. It helps to be prepared with questions to ask during your appointments.

Kidney cancer detection and diagnosis

Kidney cancer, or renal cancer, is one of the ten most common cancers in both men and women. Although small kidney tumors won’t usually cause any noticeable signs or symptoms, larger ones might. Kidney cancer can cause symptoms such as blood in your urine, low back pain on one side, a lump on one side of your lower back, feeling tired, losing weight (especially if you aren’t trying to lose weight) or a fever that does not go away and is not from a cold.

Talk to a doctor if you notice any of these symptoms. Your doctor will ask additional questions about your health and other symptoms you might have and then do an exam. Unlike most types of cancer, kidney cancer can often be diagnosed without a biopsy.

Kidney cancer may be diagnosed through the following methods:

• Physical exam and a review of your medical history
• Imaging tests, including ultrasound, a computed tomography (CT) scan or magnetic resonance imaging (MRI)
• Blood screenings to look for abnormal hormone or chemistry levels in your body
• Urinalysis to screen the urine for any abnormalities
• Liver function test to measure for any abnormal levels of enzymesIntravenous pyelogram or IVP, an imaging test used to look at the kidneys and ureters

Treatment questions

Talking with healthcare providers about a kidney cancer diagnosis can be overwhelming. It helps to be prepared with questions to ask during your appointments.

What to expect

After an initial diagnosis of bladder or kidney cancer, you’ll likely have other tests to see if the cancer has grown into nearby areas or spread to other parts of your body. These additional tests are important as they will help your healthcare team decide the best course of treatment for you. This testing may even mean working with more than one healthcare provider or lead you to a second opinion to help you choose a treatment.

Innovative technology and techniques offered

We target bladder and kidney tumors with some of the most advanced treatments and technology available. Our cancer programs may offer:

• Advanced bladder reconstruction techniques
• Chemoprevention for bladder cancer
• Cryoablation, radiofrequency ablation and active surveillance for kidney cancer
• Immunotherapy, including BCG (Bacillus Calmette-Guérin), interferon and interleukin-2
• Innovative and personalized chemotherapy for bladder cancer
• Laparoscopic surgery, minimally invasive robotic-assisted surgery that doesn’t require the large incisions used for traditional surgery
• Targeted therapies for kidney cancer, including Sutent® (sunitinib), Nexavar® (sorafenib), Torisel® (temsirolimus), and Avastin® (bevacizumab)

You will need to call your local hospital to learn which of these options are available in your area.

How We Treat Genitourinary Cancer

No two patients are alike. So our team of specialists creates personalized treatment plans for every person we see. You’ll benefit from the combined expertise of specialists in radiology, surgery, pathology, pharmacology, oncology and therapists in fields like physical therapy and psychology.

Your recommended treatment will be based on best practices that have worked for other patients, specific aspects of your cancer/tumor, the results of all your tests, the stage of your cancer and your personal preferences.

Bladder and kidney cancers are typically treated through a combined approach that may include radiation therapy, targeted therapy, infusion and chemotherapy, immunotherapy or other specialized therapies. Surgery is commonly done to remove the tumor. Your plan may also involve tumor ablation, embolization and surveillance (monitoring).

Cancer Surgery

Surgery is done for many cancers, including bladder and kidney cancers. The type of surgery you’ll have depends on the type and stage of your cancer.

Bladder cancer surgery

Surgery, alone or along with other therapies, is a key component of the treatment plan for most bladder cancers. While surgery can often remove early-stage bladder tumors, new cancers often form in other parts of the bladder over time. Having your entire bladder removed (known as a radical cystectomy) is one way to avoid this, but comes with major side effects. If the entire bladder is not removed, other medical treatments will likely be needed to reduce your risk of new cancers.

The three main types of surgery for bladder cancer are:

• Transurethral resection (TUR) - Removes cancerous tissue from the bladder using high-energy electricity to burn away cancerous cells.
• Cystectomy - Removes the bladder, either partially or completely. A complete bladder removal may require removing nearby organs and tissues, including the uterus, ovaries and part of the vagina in women, and the prostate and seminal vesicles in men.
• Urinary diversion procedure - Reroutes the urinary tract and allows urine to exit the body through the colon or through a small opening in the abdomen and into an external catheter bag.

Kidney cancer surgery

Surgery known as nephrectomy is the most common treatment for kidney cancer, and often the only treatment required. Depending on your cancer, your surgeon may decide to remove a portion of your kidney (partial nephrectomy), the entire kidney (simple nephrectomy), or the entire kidney with nearby lymph nodes, adrenal glands and surrounding tissue (radical nephrectomy). When possible, this surgery is performed laparoscopically, a minimally invasive method that uses small cuts and tiny instruments so you have a shorter hospital stay and easier recovery.

Kidney surgical care can also include:

• Cryotherapy - Treats tumors through freezing (known as cryotherapy), eliminating the need to remove any portion of the kidney.
• Arterial embolization - Blocks the blood supply to the kidney and its tumor. This treatment can help shrink a tumor to relieve discomfort and is often offered when surgery is not possible. Arterial embolization is done by interventional radiology specialists.

Radiation treatment

Radiation therapy uses high-energy X-rays to kill or shrink cancer cells. Your doctor may use internal or external radiation, or both, to treat your cancer. This treatment can be used to shrink a tumor before surgery. Or it may be used after surgery to kill cancer cells that remain in the genitourinary system, which encompasses the urinary organs.

Chemotherapy

Chemotherapy and infusion therapy use powerful medicines to kill cancer cells all through the body. These treatments may be used to shrink a tumor before surgery or to kill any cancer cells that remain after local treatments. Chemotherapy may also treat tumors that have grown in other places in the body. Cancers that have spread are usually treated with chemotherapy, sometimes in combination with hormone therapy.

Chemotherapy doesn’t work well for kidney cancer. Therefore, it is typically only tried after other therapies have been shown to be ineffective.

Immunotherapy (biologic therapy)

Immunotherapy is the use of medicines to help a person’s own immune system recognize and destroy invading cancer cells. These medicines can be in the form of pills or injections or given through an IV.

Immunotherapy may be given after surgery. Or it may be given along with other cancer treatments.

Intravesical therapy for bladder cancer

This treatment is used with early-stage, superficial bladder cancer. During treatment, medicines are put directly into your bladder. These may be immunotherapy medicines, which make your body’s immune system fight the cancer, or chemotherapy medicines designed to kill cancer cells.

Targeted therapy for kidney cancer

Targeted therapy drugs target the changes in cells that cause cancer cells to form. These drugs affect the cancer cells in your body and leave your normal cells alone. This treatment course sometimes works when standard chemotherapy drugs don’t, and they often have different (and less severe) side effects. Targeted therapy drugs come as pills that you take at home.

Targeted drugs are proving to be particularly beneficial for people with kidney cancer as chemotherapy has not been shown to be effective. If fact, many times this treatment course is tried before chemotherapy is considered.

Ablation therapy for kidney cancer

Tumor ablation treatment destroys a tumor without surgically removing it from the body. This is often the medical recommendation when you’re too sick to have surgery. Ablation techniques include heating the tumor with radio waves (known as RFA), freezing the tumor (known as cryoablation), or killing the tumor by blocking certain blood vessels and cutting off the blood supply that feeds the kidney.

You should always talk to your doctor about your specific treatment plan and what you can expect.

Care and Support

Your care team

We know that a bladder or kidney cancer diagnosis can seem overwhelming and confusing. We try to offer everything you need during treatment and beyond – from genetic testing and spiritual care to support groups, financial counseling and survivorship – in one place. You can trust us to help manage your care and reduce every possible inconvenience during treatment. This will allow you to focus your energy on your journey, your loved ones and living each day to its fullest.

Life beyond bladder and kidney cancer

With earlier detection, more patients are surviving bladder and kidney cancer than ever before. Our survivorship program gives you access to specialists who partner with you for your post-treatment. This program focuses on nutritional goals, healthy living and emotional well-being. We’ll also help you set up regular medical checkups with your primary doctor to prevent, detect and manage any complications related to your cancer or cancer treatment. Because of your risk of future cancers, screening and surveillance are essential to your long-term health.

We also offer lymphedema therapy, if needed. Lymphedema is a complication that may occur months or years after surgery if you had lymph nodes removed.