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Bladder Cancer: Diagnosis and Treatment
Katharine C DeGeorge1, Harry R Holt1, Stephanie C Hodges1
1University of Virginia School of Medicine, Charlottesville, VA, USA.
American Family Physician
|November 3, 2017
Summary
Bladder cancer is a significant health concern, often presenting with hematuria. Current guidelines do not recommend screening asymptomatic adults due to insufficient evidence on screening benefits versus harms.
Area of Science:
- Oncology
- Urology
Background:
- Bladder cancer is the sixth most common cancer in the US, causing over 16,000 deaths annually.
- Asymptomatic hematuria is a common presentation, necessitating prompt medical evaluation.
Purpose of the Study:
- To outline the diagnostic and treatment approaches for bladder cancer.
- To review current recommendations regarding bladder cancer screening.
Main Methods:
- Diagnostic evaluation includes cystoscopy, renal function tests, and upper urinary tract imaging.
- Treatment strategies vary based on disease invasiveness, from transurethral resection to radical cystectomy.
- Intravesical therapies like bacille Calmette-Guérin or chemotherapy are used for non-muscle-invasive disease.
Main Results:
- Transurethral resection provides diagnosis, staging, and initial treatment.
- Muscle-invasive bladder cancer typically requires radical cystectomy and neoadjuvant chemotherapy.
- No major organizations recommend screening asymptomatic adults for bladder cancer.
Conclusions:
- Early evaluation of hematuria is crucial for timely bladder cancer diagnosis and treatment.
- Current evidence does not support screening asymptomatic individuals for bladder cancer.
- Treatment decisions are guided by the stage and invasiveness of the bladder tumor.
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