About Bladder Cancer
Facts About Bladder Cancer
Bladder cancer is the fourth most common cancer among men and the ninth most common among women in the United States.1
Bladder cancer most often occurs in older people: nearly 90% of patients are over age 55.2
Most bladder cancer tumors (74%) are found on the surface of the bladder lining.2 When found and treated early, these tumors can sometimes be stopped before they spread to other parts of the body.
On this Web site you will learn about a type of bladder cancer called carcinoma in situ (kar-sih-NOH-muh in SYE-too) and a treatment option called VALSTARTM (valrubicin) for patients. VALSTAR is for patients whose bladder cancer (CIS) did not respond to BCG therapy and cannot have surgery right away to take out the bladder.
References:
- AUA Foundation. Bladder Cancer. American Urological Association, 2005. Available at: UrologyHealth.org. Accessed July 13, 2009.
- American Cancer Society. Detailed Guide: Bladder Cancer. Available at: www.cancer.org. Accessed July 13, 2009.
VALSTAR is a liquid medicine put into the bladder with flexible tubing (a catheter) and is used for patients whose bladder cancer (CIS) did not respond to BCG therapy and for those that cannot have surgery right away to take out the bladder. This type of treatment is called intravesical therapy, which means "within the bladder."
Important Safety Information
Tell your doctor if you have had a reaction or a close family member has had a reaction to any of the ingredients in VALSTAR and if a doctor has ever said you have a hole in your bladder or a weak bladder wall. Tell your doctor if you have a urinary tract infection or if you go to the bathroom a lot because of a small bladder. VALSTAR should not be used if you have any of these conditions.
VALSTAR treatment may result in full remission of bladder cancer (CIS) in about 1 in 5 patients (about 18%) whose cancer did not respond to BCG therapy. Waiting to have all or part of your bladder taken out could lead to the spread of bladder cancer (CIS) and even death. You should talk with your doctor about the risks of waiting for surgery.
If your bladder cancer (CIS) does not respond to the medicine after 3 months or if your bladder cancer (CIS) comes back, you should talk with your doctor again about having the surgery to take out your bladder.
You may have pain or irritation of your bladder during or shortly after getting the medicine. You may not be able to hold the medicine in the whole time or it may leak out. For the first day after getting the medicine, your urine may have a red color. This is normal. Tell your doctor right away if you have pain or if you have red-colored urine after the first day of getting the medicine.
If you plan to be sexually active, talk with your doctor about possible risks and use the birth control method recommended by your doctor.
During or after getting the medicine, you may experience some common side effects reported by other patients. These side effects may include going to the bathroom a lot, not going to the bathroom enough, not making it to the bathroom in time, or pain when urinating. The side effects most reported by other patients included urinary tract infections, stomach pain, nausea, weakness, headache, a general feeling of being sick, and not going to the bathroom enough.
Safety and effectiveness in children have not been established.
You are asked to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For more information, ask your doctor or call 1-800-462-3636.
Risk factors of bladder cancer
A risk factor is anything that changes your chance of developing a disease. Having one or more risk factors does not mean that you will develop the disease, but people with certain risk factors are more likely to develop bladder cancer. However, it is important to know about risk factors so that a person can take appropriate actions such as changing a health behavior or being monitored closely for a potential cancer.
Because the bladder is the final exit from the body for many chemicals, these are the major risk factors for bladder cancer:
- Smoking is the greatest risk factor for bladder cancer. Some cancer-causing chemicals in tobacco smoke are absorbed from the lungs and get into the blood. From the blood they are filtered by the kidneys and concentrated in urine. These chemicals in urine damage the cells that line the inside of the bladder
- Workplace exposures. Certain industrial chemicals have been linked with bladder cancer
- Race. Whites are about twice as likely to develop bladder cancer as African Americans and Hispanics
- Age. The risk of bladder cancer increases with age.
Over 70% of people with bladder cancer are older than 65 years old - Gender. Men get bladder cancer at a rate 4 times greater than women
- Chronic bladder irritation, such as urinary infections, kidney and bladder stones have been linked with bladder cancer; however, they do not necessarily cause bladder cancer
- Family or personal history increases your risk of developing bladder cancer or a second tumor
- Bladder birth defects
- Arsenic in drinking water has been associated with an increased risk of bladder cancer
- Low fluid consumption increases the risk of bladder cancer. People who drink a lot of fluids each day have a lower rate of bladder cancer because they empty their bladders often
VALSTARTM (valrubicin) is a liquid medicine put into the bladder with flexible tubing (a catheter) and is used for patients whose bladder cancer (CIS) did not respond to BCG therapy and for those that cannot have surgery right away to take out the bladder. This type of treatment is called intravesical therapy, which means "within the bladder."
Important Safety Information
Tell your doctor if you have had a reaction or a close family member has had a reaction to any of the ingredients in VALSTAR and if a doctor has ever said you have a hole in your bladder or a weak bladder wall. Tell your doctor if you have a urinary tract infection or if you go to the bathroom a lot because of a small bladder. VALSTAR should not be used if you have any of these conditions.
VALSTAR treatment may result in full remission of bladder cancer (CIS) in about 1 in 5 patients (about 18%) whose cancer did not respond to BCG therapy. Waiting to have all or part of your bladder taken out could lead to the spread of bladder cancer (CIS) and even death. You should talk with your doctor about the risks of waiting for surgery.
If your bladder cancer (CIS) does not respond to the medicine after 3 months or if your bladder cancer (CIS) comes back, you should talk with your doctor again about having the surgery to take out your bladder.
You may have pain or irritation of your bladder during or shortly after getting the medicine. You may not be able to hold the medicine in the whole time or it may leak out. For the first day after getting the medicine, your urine may have a red color. This is normal. Tell your doctor right away if you have pain or if you have red-colored urine after the first day of getting the medicine.
If you plan to be sexually active, talk with your doctor about possible risks and use the birth control method recommended by your doctor.
During or after getting the medicine, you may experience some common side effects reported by other patients. These side effects may include going to the bathroom a lot, not going to the bathroom enough, not making it to the bathroom in time, or pain when urinating. The side effects most reported by other patients included urinary tract infections, stomach pain, nausea, weakness, headache, a general feeling of being sick, and not going to the bathroom enough.
Safety and effectiveness in children have not been established.
You are asked to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For more information, ask your doctor or call 1-800-462-3636.
Signs and symptoms of bladder cancer
You should always report any of the following problems to your doctor right away:
- Blood in the urine is the first warning signal of bladder cancer. However, it does not mean you have bladder cancer
- Change in bladder habits or irritative symptoms, such as frequent urination, burning during urination, and urgency can also be symptoms of bladder cancer
VALSTARTM (valrubicin) is a liquid medicine put into the bladder with flexible tubing (a catheter) and is used for patients whose bladder cancer (CIS) did not respond to BCG therapy and for those that cannot have surgery right away to take out the bladder. This type of treatment is called intravesical therapy, which means "within the bladder."
Important Safety Information
Tell your doctor if you have had a reaction or a close family member has had a reaction to any of the ingredients in VALSTAR and if a doctor has ever said you have a hole in your bladder or a weak bladder wall. Tell your doctor if you have a urinary tract infection or if you go to the bathroom a lot because of a small bladder. VALSTAR should not be used if you have any of these conditions.
VALSTAR treatment may result in full remission of bladder cancer (CIS) in about 1 in 5 patients (about 18%) whose cancer did not respond to BCG therapy. Waiting to have all or part of your bladder taken out could lead to the spread of bladder cancer (CIS) and even death. You should talk with your doctor about the risks of waiting for surgery.
If your bladder cancer (CIS) does not respond to the medicine after 3 months or if your bladder cancer (CIS) comes back, you should talk with your doctor again about having the surgery to take out your bladder.
You may have pain or irritation of your bladder during or shortly after getting the medicine. You may not be able to hold the medicine in the whole time or it may leak out. For the first day after getting the medicine, your urine may have a red color. This is normal. Tell your doctor right away if you have pain or if you have red-colored urine after the first day of getting the medicine.
If you plan to be sexually active, talk with your doctor about possible risks and use the birth control method recommended by your doctor.
During or after getting the medicine, you may experience some common side effects reported by other patients. These side effects may include going to the bathroom a lot, not going to the bathroom enough, not making it to the bathroom in time, or pain when urinating. The side effects most reported by other patients included urinary tract infections, stomach pain, nausea, weakness, headache, a general feeling of being sick, and not going to the bathroom enough.
Safety and effectiveness in children have not been established.
You are asked to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For more information, ask your doctor or call 1-800-462-3636.
What is carcinoma in situ (CIS)?
CIS looks like a flat patch of red velvet lying on top of the bladder lining. Although CIS begins on the surface of the bladder lining, it is a high-grade cancer, which means that without treatment it may grow into the bladder wall and spread to other parts of the body.
VALSTARTM (valrubicin) is a liquid medicine put into the bladder with flexible tubing (a catheter) and is used for patients whose bladder cancer (CIS) did not respond to BCG therapy and for those that cannot have surgery right away to take out the bladder. This type of treatment is called intravesical therapy, which means "within the bladder."
Important Safety Information
Tell your doctor if you have had a reaction or a close family member has had a reaction to any of the ingredients in VALSTAR and if a doctor has ever said you have a hole in your bladder or a weak bladder wall. Tell your doctor if you have a urinary tract infection or if you go to the bathroom a lot because of a small bladder. VALSTAR should not be used if you have any of these conditions.
VALSTAR treatment may result in full remission of bladder cancer (CIS) in about 1 in 5 patients (about 18%) whose cancer did not respond to BCG therapy. Waiting to have all or part of your bladder taken out could lead to the spread of bladder cancer (CIS) and even death. You should talk with your doctor about the risks of waiting for surgery.
If your bladder cancer (CIS) does not respond to the medicine after 3 months or if your bladder cancer (CIS) comes back, you should talk with your doctor again about having the surgery to take out your bladder.
You may have pain or irritation of your bladder during or shortly after getting the medicine. You may not be able to hold the medicine in the whole time or it may leak out. For the first day after getting the medicine, your urine may have a red color. This is normal. Tell your doctor right away if you have pain or if you have red-colored urine after the first day of getting the medicine.
If you plan to be sexually active, talk with your doctor about possible risks and use the birth control method recommended by your doctor.
During or after getting the medicine, you may experience some common side effects reported by other patients. These side effects may include going to the bathroom a lot, not going to the bathroom enough, not making it to the bathroom in time, or pain when urinating. The side effects most reported by other patients included urinary tract infections, stomach pain, nausea, weakness, headache, a general feeling of being sick, and not going to the bathroom enough.
Safety and effectiveness in children have not been established.
You are asked to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For more information, ask your doctor or call 1-800-462-3636.
What treatments are available for CIS?
Transurethral resection of the bladder tumor (TURBT)
Transurethral resection (tranz-yoo-REE-thral ree-SEK-shun) of the bladder tumor is usually the first treatment that healthcare professionals recommend for cancer tumors growing on the bladder lining.
In TURBT, the healthcare professional gently threads a resectoscope, a slender tube with a wire loop on the end, through the urethra (urine tube) and into the bladder. The wire loop is used to remove tumors from the bladder lining. The tumor can then be examined to determine its type and progression. The healthcare professional can send an electrical current through the same tube to burn away the base of the tumor. (This procedure is called fulguration [ful-gyuh-RAY-shun]).
Laser therapy may also be used in TURBT. Laser therapy damages cancer cells, which means that there are no intact cells left to be examined later. To get a good sample of the cancer cells, the healthcare professional will remove a few cells from the tumor before TURBT (called biopsy).
Intravesical therapy
Intravesical (in-truh-VES-ih-kul) therapy is a liquid medicine placed inside the bladder through a flexible tube called a catheter. It may be used after TURBT to help make TURBT more effective. For a CIS tumor, the healthcare professional might first use a liquid medication called BCG.
BCG
BCG is an intravesical therapy that works by boosting the body’s natural immune system to kill cancer cells. BCG is short for Bacillus Calmette-Guérin (buh-SIH-lus KAL-met GAY-ran). It is the most common intravesical therapy used in bladder cancer and is also considered the most effective intravesical immunotherapy for treating low-stage bladder cancer.
It is an effective treatment for patients with CIS, although its effects are not always permanent. If BCG cannot control the cancer, the healthcare professional might need to consider other treatment options.
What options are available when BCG no longer works for you?
When BCG fails, your healthcare professional will talk to you about other ways to treat your bladder cancer. The decision will take into account your particular situation, including your age, health, and whether you’re a candidate for surgery.
If you’re in good health and can tolerate major surgery, a cystectomy is usually recommended.
What is a cystectomy?
A cystectomy is surgery to remove part or all of the bladder and the tissue surrounding it. After removing the bladder, the surgeon will create another way for urine to leave the body.
Delaying surgical removal of all or part of the bladder could lead to the spread of bladder cancer, which can be deadly. The risk of bladder cancer spreading to other parts of the body from the delay of needed surgery may be difficult to determine, but the risk may increase the longer it is delayed.
What if a cystectomy is not right for you?
A cystectomy may not be appropriate for some patients. If your CIS did not respond to BCG therapy, and if you cannot have surgery right away to take out the bladder, you may have a treatment option called VALSTARTM (valrubicin). Only you and your healthcare professional can decide what treatment is right for you.
VALSTAR is a liquid medicine put into the bladder with flexible tubing (a catheter) and is used for patients whose bladder cancer (CIS) did not respond to BCG therapy and for those that cannot have surgery right away to take out the bladder. This type of treatment is called intravesical therapy, which means "within the bladder."
Important Safety Information
Tell your doctor if you have had a reaction or a close family member has had a reaction to any of the ingredients in VALSTAR and if a doctor has ever said you have a hole in your bladder or a weak bladder wall. Tell your doctor if you have a urinary tract infection or if you go to the bathroom a lot because of a small bladder. VALSTAR should not be used if you have any of these conditions.
VALSTAR treatment may result in full remission of bladder cancer (CIS) in about 1 in 5 patients (about 18%) whose cancer did not respond to BCG therapy. Waiting to have all or part of your bladder taken out could lead to the spread of bladder cancer (CIS) and even death. You should talk with your doctor about the risks of waiting for surgery.
If your bladder cancer (CIS) does not respond to the medicine after 3 months or if your bladder cancer (CIS) comes back, you should talk with your doctor again about having the surgery to take out your bladder.
You may have pain or irritation of your bladder during or shortly after getting the medicine. You may not be able to hold the medicine in the whole time or it may leak out. For the first day after getting the medicine, your urine may have a red color. This is normal. Tell your doctor right away if you have pain or if you have red-colored urine after the first day of getting the medicine.
If you plan to be sexually active, talk with your doctor about possible risks and use the birth control method recommended by your doctor.
During or after getting the medicine, you may experience some common side effects reported by other patients. These side effects may include going to the bathroom a lot, not going to the bathroom enough, not making it to the bathroom in time, or pain when urinating. The side effects most reported by other patients included urinary tract infections, stomach pain, nausea, weakness, headache, a general feeling of being sick, and not going to the bathroom enough.
Safety and effectiveness in children have not been established.
You are asked to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For more information, ask your doctor or call 1-800-462-3636.
