Bladder cancer is one of the most common urologic cancers and is often first detected when patients notice blood in their urine. At our Glens Falls practice, we provide comprehensive evaluation, diagnosis, and management for patients with suspected or confirmed bladder cancer, with a strong focus on education and patient involvement in decision-making.
Evaluating Blood In Your Urine
The most common presenting symptom of bladder cancer is hematuria (blood in the urine), which may be visible to the naked eye (gross hematuria) or found only under the microscope (microscopic hematuria). Importantly, hematuria does not always mean bladder cancer is present—there are many possible causes such as infection, kidney stones, or an enlarged prostate. Because of this, it requires a thorough and reassuringly structured evaluation. This typically includes:
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Urinalysis and urine culture to rule out infection
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Imaging studies such as CT urogram or ultrasound to evaluate the kidneys and urinary tract
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Cystoscopy:A procedure using a small camera to look inside the bladder and directly visualize any abnormalities or lesions
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Cystoscopy is the gold standard for identifying bladder tumors, and it plays a central role in the evaluation process.
Initial Resection of a Bladder Lesion
If a bladder lesion is identified during cystoscopy, the next step is usually a transurethral resection of bladder tumor (TURBT). This is performed under anesthesia using a scope passed through the urethra. The tumor is removed and tissue samples are sent to pathology to confirm the diagnosis and determine the cancer’s stage and grade. In some cases, patients may be offered a single dose of intravesical chemotherapy is instilled into the bladder shortly after TURBT to help reduce the risk of early recurrence.
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The results of the TURBT guide further management and help distinguish between non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Repeat resections in the operating room may be necessary to confirm the diagnosis.
Bladder Cancer Management
Management depends on whether the cancer is confined to the bladder lining (non-muscle invasive) or has grown into the bladder muscle (muscle invasive).
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Non-Muscle Invasive Bladder Cancer (NMIBC)
Most bladder cancers are non-muscle invasive at diagnosis. Treatment focuses on preventing recurrence and progression and may include:
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Repeat TURBT: Sometimes needed to ensure complete tumor removal
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Intravesical therapy: Medications placed directly into the bladder, such as Bacillus Calmette-Guérin (BCG) or chemotherapy, to reduce recurrence risk
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Regular surveillance: Ongoing cystoscopies and urine tests, since recurrence is common
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Muscle-Invasive Bladder Cancer (MIBC)
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When cancer grows into the bladder muscle, treatment is more aggressive. Options may include:
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Radical cystectomy: Surgical removal of the bladder, often with reconstruction to create a new way for urine to leave the body
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Chemotherapy: Used before or after surgery to improve outcomes
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Bladder-sparing protocols: In select patients, a combination of TURBT, chemotherapy, and radiation may be considered
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Advances in bladder cancer care are happening rapidly, and newer therapies such as immunotherapy and targeted treatments are being developed and becoming available for patients with advanced or refractory disease. We stay up to date with these developments to help guide patients to the most appropriate care for their situation.
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We provide expert evaluation and management for patients with bladder cancer in Glens Falls, Saratoga, and the surrounding Capital and Adirondack regions. If you notice blood in your urine or have been diagnosed with a bladder tumor, contact us to schedule a consultation and learn more about your treatment options.