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Bladder cancer Q&As

Published by Bupa's health information team, April 2009.

Answers to questions about bladder cancer

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Can bladder cancer be detected with a urine test?

The best way to diagnose bladder cancer is for your surgeon to look inside your bladder using a cystoscope (a thin, flexible, tube-like telescope with a camera at the end) and take a biopsy (a small sample of cells) from your bladder wall.

It would be simpler if bladder cancer could be diagnosed by testing your urine. A number of tests are under development but aren't yet available in the UK.

Explanation

Urine tests that are currently under development are:

  • BTA (Bladder Tumour-Associated Antigen)
  • NMP22 (Nuclear Matrix Protein 22)
  • Mcm5 (minichromosome maintenance 5)

The BTA test uses two monoclonal antibodies (proteins made in a laboratory) to look for particular cancer proteins in your urine. BTA is a protein that is usually found at higher levels in the urine of people with bladder cancer than people with a healthy bladder. At the moment, this test is only suitable for monitoring people who have had treatment for bladder cancer. If these proteins are found in your urine it could mean that cancer cells have come back in your bladder.

The NMP22 test looks for levels of the protein NMP22 in your urine. Some NMPs have been found in the cells of certain types of bladder cancer including the most common type, transitional cell cancer (TCC). NMP22 is often found at higher levels in the urine of people with TCC than people with a healthy bladder. This test is thought to be most useful for monitoring people who have had treatment for bladder cancer.

The Mcm5 test looks for levels of the protein Mcm5 in your urine. This protein is made by some types of cancer cells including TCC. Mcm5 is often found in higher levels in the urine of people with TCC than people with a healthy bladder.

Even if these tests do become available, they won't be used alone to diagnose bladder cancer - a cystoscopy and biopsy will still be needed to confirm the result.

Further information

Sources

  • What's new in bladder cancer? Cancer Research UK. www.cancerhelp.org.uk, accessed 18 June 2008
  • I've heard about the Mcm5 test for bladder cancer. Can you tell me more? Macmillan Cancer Support. www.macmillan.org.uk, accessed 16 July 2008
  • What is the BTA test for bladder cancer? Macmillan Cancer Support. www.macmillan.org.uk, accessed 2 December 2008
  • What is a NMP22 test? Macmillan Cancer Support. www.macmillan.org.uk, accessed 2 December 2008
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Will treatment for invasive bladder cancer affect my sex life?

Treatment for invasive bladder cancer may result in physical changes that could affect your sex life. If you're a man, the operation to remove the cancer may damage the nerves that control erection, making it difficult to get an erection after the operation. If you're a woman, an operation to remove your urethra may shorten or narrow your vagina.

Explanation

Although great care will be taken, it may not be possible for your surgeon to avoid damaging the nerves in your pelvis during the operation.

If you're a man and have problems getting an erection after surgery for invasive bladder cancer there are several options that may help.

Medicines in tablet form

Your doctor may prescribe a medicine that helps give you an erection by increasing the blood flow to your penis. Examples include sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). The tablets are taken at various times before sex (eg for sildenafil, about one hour beforehand).

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Medicines in injection or pellet form

Your doctor may prescribe medicines that you need to inject directly into your penis, or pellets that you insert into the tip of your penis, to cause an erection.

Vacuum pumps

These devices draw blood into your penis to create an erection. The erection is maintained by placing a rubber ring around the base of your penis. After sex, you remove the ring and your blood flows normally again.

Penile prostheses

Mechanical devices can be used to create an erection. Flexible rods or thin inflatable cylinders are inserted into your penis under general anaesthetic.

If you're a woman, and surgery has shorted or narrowed your vagina, it may help to use a dilator to stretch your vagina. Dilators are metal or plastic objects shaped like a tampon. You insert them into your vagina for a few minutes every day. Over a few weeks you gradually use larger sizes and this slowly stretches your vagina. Having regular gentle sex will also have the same effect.

Ask your doctor if you have any concerns about sex after treatment for bladder cancer.

You may feel differently about yourself after surgery for bladder cancer and this can also affect how you feel about sex. Contacting other people who have invasive bladder cancer through charities and patient groups can be a good source of support and advice.

Further information

Sources

  • How surgery for invasive bladder cancer may affect your sex life. Macmillan Cancer Support. www.macmillan.org.uk, accessed 24 June 2008
  • Your sex life and bladder cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 24 June 2008
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How will having a urostomy affect my every day life?

It may take some time and practice to learn to look after your urostomy, but most people are able to get back to their jobs, every day activities, and hobbies. Most hospitals have specialist stoma care nurses who can help and advise you.

Explanation

A urostomy is the commonest operation for invasive bladder cancer.

During the operation, your surgeon will remove your bladder and then remove a small piece of your small bowel (rejoining the two cut ends). He or she will join one end of the piece of bowel to your ureters (the tubes that carry your urine from your kidneys) and the other end to a small hole cut into the surface of your abdomen (tummy). The hole is called a stoma. The position of the stoma is usually to the right of your umbilicus (tummy button). However, before your operation your surgeon or nurse will help you plan the position of the stoma that best suits you.

After the operation urine will pass down your ureters, but instead of going into the bladder it will run through the piece of bowel and out onto the surface of your abdomen. A waterproof bag (a urostomy bag) is placed over the stoma to collect your urine. The bag stays in place with glue. You will need to empty the bag as often as you would normally go to toilet to pass urine.

Your nurse will show you how to clean the stoma and change the bags.

Modern urostomy bags are very well designed. They are flat and unnoticeable under clothing and shouldn't leak. Talk to your nurse if you have problems with your bag.

You should be able to carry on with every day activities and hobbies. You can exercise and swim. You can wear a smaller bag for exercising or a waterproof dressing for swimming.

Talk to your stoma care nurse if you have any worries or problems. Contacting other people who have had invasive bladder cancer, through charities and patient groups, can be a good source of support and advice.

Further information

Sources

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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: April 2009

 

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