Bladder Cancer
Bladder cancer starts in the lining of your bladder, the organ that stores urine. It ranges from small surface tumors to aggressive cancers that grow into the bladder muscle and spread to other parts of the body. Bladder cancer is one of the more common urologic cancers and is among the top ten causes of cancer death in the United States.
At Riverstone Urology Specialists in Cypress, Dr. Russell Libby evaluates blood in the urine and other warning signs with a focus on early detection, bladder preservation when possible, and long term health.
What Is Bladder Cancer?
Bladder cancer happens when cells in the bladder grow in an uncontrolled way and form a tumor.
Most Cases Are Urothelial (Transitional Cell) Carcinoma, Which Starts In The Inner Lining Of The Bladder. Tumors Can Be
- Non muscle invasive, limited to the inner layers of the bladder
- Muscle invasive, growing into the bladder wall and more likely to spread
Early diagnosis often gives more treatment choices and better outcomes.
Symptoms Of Bladder Cancer
Early Bladder Cancer May Cause Few Or No Symptoms. The Most Common Early Sign Is Painless Blood In The Urine.
You Should Watch For
- Blood in urine that looks pink, red, or cola colored
- Blood found only on a urine test
- Frequent urination
- Burning or pain when you urinate
- Feeling that you need to urinate right away, even when little comes out
- Waking up often at night to urinate
- Pain in your lower abdomen or back, especially on one side
These symptoms also show up with urinary infections, stones, or an enlarged prostate, so you need a proper evaluation to find the real cause.
Advanced Bladder Cancer May Also Cause
- Ongoing flank or pelvic pain
- Unexplained weight loss
- Fatigue or weakness
- Swelling in the legs or feet
Risk Factors
Anyone can develop bladder cancer, yet some patterns raise your risk.
Key Risk Factors Include
- Smoking or past tobacco use
- Older age
- Male sex
- White race
- Long term workplace exposure to certain dyes, rubber, leather, or chemical fumes
- Prior pelvic radiation or certain chemotherapy drugs
- Chronic bladder irritation, infections, or long term catheter use
- Family history of bladder cancer or certain inherited conditions
Having these risk factors does not mean you will develop cancer, but it does mean you should take blood in the urine and urinary changes seriously.
When To See Dr. Libby
You Should Schedule A Visit With Riverstone Urology If
- You see blood in your urine, even once
- You have burning or pain with urination that keeps coming back
- You urinate more often than usual without a clear cause
- You have repeated “UTIs” with negative cultures or only brief relief
- An imaging test or ultrasound mentions a “bladder mass” or “lesion
Blood in the urine is never normal. Even if it turns out to be from a stone or infection, you should get a clear answer.
How Bladder Cancer Is Diagnosed
There Is A Standard Workup For Blood In The Urine And Suspected Bladder Cancer.
History And Exam
Dr. Libby will ask about
- When you first saw blood in the urine
- Any pain, burning, or urgency
- Smoking history and workplace exposures
- Past urinary infections, stones, or pelvic treatments
A physical exam looks for tenderness, masses, or swelling.
Urine Tests
You will usually have
- Urinalysis to check for blood, infection, and other changes
- Urine culture when infection is a concern
- Sometimes urine cytology to look for cancer cells in the urine
Imaging
Imaging helps evaluate your kidneys, ureters, and bladder
- CT urogram or MRI urogram to look at the entire urinary tract
- Ultrasound in selected cases
These tests show tumors, stones, or other causes of bleeding.
Cystoscopy
Cystoscopy is the key test.
- A thin camera passes through the urethra into the bladder
- Dr. Libby inspects the bladder lining directly
- Any suspicious area can be biopsied or removed during a later procedure
Cystoscopy is usually done in the office with local anesthesia and has a short recovery time.
Transurethral Resection Of Bladder Tumor, TURBT
If cystoscopy shows a tumor, the next step is often TURBT in the operating room
- The tumor is removed through the urethra using a resectoscope
- Tissue goes to the pathologist to confirm the diagnosis, grade, and depth of invasion
This procedure both treats many early tumors and provides the information needed for staging and planning.
Staging And Risk Groups
After Turbt, Bladder Cancer Is Staged Based On
- How deeply the tumor invades the bladder wall
- Whether it involves lymph nodes
- Whether it has spread to other organs
Broad Categories Include
- Non muscle invasive bladder cancer, limited to the inner layers
- Muscle invasive bladder cancer, grown into the muscle layer
- Metastatic bladder cancer, spread beyond the bladder
Non muscle invasive cancers are also grouped by risk of coming back and growing deeper. This risk level guides how intensive follow up and treatment should be.
Treatment Options At Riverstone Urology
Treatment depends on stage, grade, number of tumors, and your overall health and goals. Many bladder cancers respond well when you treat them early.
Non Muscle Invasive Bladder Cancer
For cancers confined to the inner bladder layers, the main tools are TURBT, medicines placed inside the bladder, and close follow up.
TURBT
- Removes visible tumors
- Provides tissue for accurate staging
- Sometimes repeated if the first resection was incomplete or the tumor is high grade
Intravesical Therapy, Medicine In The Bladder
After TURBT, Dr. Libby may recommend medicine placed directly into the bladder through a catheter. Common options include
- Chemotherapy solutions to kill leftover cancer cells and lower recurrence risk
- Immunotherapy, such as BCG, to stimulate your immune system to attack cancer cells
Treatments are usually done in a series over several weeks, followed by maintenance in selected patients.
Surveillance
Because non muscle invasive bladder cancer often recurs, you need regular follow up
- Cystoscopy at set intervals
- Periodic urine tests and imaging when indicated
This close watch lets your team find and treat new tumors while they are still small.
Muscle Invasive Bladder Cancer
When cancer invades the bladder muscle, treatment becomes more aggressive.
Common options include
- Radical cystectomy, removal of the bladder and nearby lymph nodes
- Creation of a new way for urine to leave your body, such as an ileal conduit or a reconstructed internal bladder
- Chemotherapy before surgery to shrink the tumor and treat any early spread
- Combined chemoradiation in selected patients who want to try to preserve the bladder
These decisions involve careful discussion of cancer control, recovery, and lifestyle changes.
Metastatic Or High Risk Disease
For advanced bladder cancer or disease that comes back after local treatment, systemic therapy plays a central role
Intravenous chemotherapy
- Immunotherapy drugs that help your immune system attack cancer cells
- Targeted treatments and newer drug delivery systems for selected cases
Radiation may help relieve pain or control specific spots. Care usually involves a team that includes urology, medical oncology, and sometimes radiation oncology.
Bladder Cancer And Long Term Health
Bladder Cancer Care Does Not End After One Surgery Or A Single Round Of Treatment. You Need Structured Follow Up To Watch For
- New or recurrent tumors in the bladder
- Changes in kidney function
- Side effects from chemotherapy, immunotherapy, or radiation
- Emotional stress, anxiety, or depression after a cancer diagnosis
Follow Up Usually Includes
- Regular cystoscopy
- Urine tests
- Imaging at intervals based on your stage and risk
Lifestyle steps such as stopping smoking, staying active, and managing blood pressure support better outcomes over time.
Bladder Cancer Care At Riverstone Urology
At Riverstone Urology In Cypress, Serving The Greater Northwest Houston Region, You Receive
- Prompt evaluation of blood in the urine and other urinary changes
- Clear explanations of your diagnosis, stage, and treatment choices
- Advanced endoscopic care, including TURBT and intravesical therapy
- Coordination with oncology partners for chemotherapy, immunotherapy, and radiation when needed
- Long term surveillance plans tailored to your risk level
If you have seen blood in your urine, have persistent urinary symptoms, or already know you have bladder cancer and want a second opinion, contact Riverstone Urology to schedule a consultation with Dr. Libby. Early, informed decisions give you the best chance to treat bladder cancer effectively while protecting your quality of life.