In one recent year, there were an estimated 72,570 new cases of bladder cancer reported in the U.S., and 15,210 deaths. Bladder cancer is the sixth leading type of cancer, with the majority of new cases (54,610) involving men. If diagnosed early enough, bladder cancer can be removed from the body and the survival rate is relatively high.
What is bladder cancer?
The bladder is a hollow organ in the lower abdomen that stores and releases urine produced by the kidneys. Comprised of four layers of tissue, the bladder is part of the urinary tract.
Bladder cancer usually starts in the cells lining the bladder (called transitional cells). Two other forms are squamous cell carcinoma, which begins in thin, flat cells, and adenocarcinoma (begins in cells that make and release mucous and other fluids). The cancer tumors are classified by the way they grow. Papillary tumors have a wart-like appearance and are attached to a stalk. Non-papillary tumors are flat. They are less common, more invasive, and usually have a worse outcome than papillary tumors.
The exact causes of bladder cancer are uncertain, although cigarette smoking is a high risk factor. Chemical exposure at work is another known high risk factor. Other risk factors include the chemotherapy drug cyclophosphamide, radiation treatment of women with cervical cancer, and chronic bladder infections or irritations.
How is bladder cancer diagnosed?
Symptoms of bladder cancer include:
- Abdominal pain
- Blood in the urine
- Bone pain or tenderness (if cancer has spread to the bone)
- Painful urination
- Urinary frequency
- Urinary urgency
- Incontinence (urinary leakage)
- Weight loss
Other diseases may cause similar symptoms. A definitive diagnosis is derived from various tests and medical procedures.
A physician will likely perform a physical examination, including a rectal and pelvic exam. Urine tests check for blood, cancer cells, and other signs of disease. A doctor may order an abdominal CT scan or MRI.
A bladder biopsy involves removing a small sample of tissue from the bladder for examination under a microscope. A biopsy is usually performed as part of cystoscopy, which is an examination of the inside of the bladder with a small video camera attached to a slender tube. Another testing procedure is a special X-ray examination of the kidneys, bladder, and ureters, known as an intravenous pyelogram (IVP).
If cancer is detected, further testing is done to determine if it has spread (known as staging), which guides treatment plans and follow-up procedures. Bladder cancer stages are:
- 0: cancer is in the bladder lining only
- 1: cancer has gone through the bladder lining, but has not reached the bladder muscle
- 2: cancer has spread to the bladder muscle
- 3: cancer has spread past the bladder into fatty tissue surrounding it
- 4: cancer has spread to nearby structures such as prostate gland, uterus, vagina, rectum, abdominal wall, or pelvic wall
A fast growing tumor can spread to the lymph nodes in the pelvic region, as well as bones, liver and lungs.
Delayed diagnosis or bladder cancer misdiagnosis
Bladder cancer is usually found when a person experiencing symptoms goes to the doctor. Early stages of bladder cancer usually cause blood in the urine absent any pain, more frequent urination, a feeling of urgency to urinate even if the bladder is empty, or pain or burning during urination (dysuria). Sometimes these symptoms are caused by benign conditions, such as an infection, benign tumor, bladder stones, or an enlarged prostate.
If bladder cancer is in a more advanced stage, it may cause lower back pain or an inability to urinate. Because bladder cancer can be fast growing, a delayed diagnosis can significantly increase the risk of death from the disease.
A missed or delayed diagnosis can result at any number of points during the medical examination process. For example, a urologist could downplay traces of blood in urine, perhaps attributing it to other causes, and fail to order a follow up exam to see if there is any improvement. Even if a urinalysis is conducted, a urologist could misread the test results. Or a biopsy may be improperly conducted such that it fails to detect the presence or extent of the cancer. Or a physician may initially diagnose a urinary tract infection and prescribe antibiotics, instead of ordering tests to determine if cancer is present.
Anyone with signs or symptoms of bladder cancer, especially white males over 55 or individuals with a family history of bladder cancer, should have a complete evaluation of the urinary tract system, including urine tests, cystoscopy and imaging tests. The failure to conduct tests at the first signs of potential bladder cancer can allow the cancer to grow and worsen. Treatments of later stage cancer may not be effective with fatal results. Earlier treatments have a much greater chance of removing the cancer.
Consequences of a missed or delayed diagnosis of bladder cancer
A delayed diagnosis can allow the cancer to spread deeper into the bladder muscle or beyond the bladder into other organs, the bones or lungs. Early detection of bladder cancer greatly enhances the prognosis of recovery.
In stages 0 and 1, treatment will often involve surgery to remove the tumor without removing the rest of the bladder. Other potential treatments are chemotherapy, or immunotherapy (medication placed directly into the bladder triggers the immune system to attack and kill the cancer cells). The prognosis of recovery is often good. The risk that the cancer may return is high, but with proper follow up testing most cancerous cells that return can be surgically removed.
Stages 2 and 3 may require surgery to remove the entire bladder and nearby lymph nodes, or partial removal followed by radiation and chemotherapy to help prevent the cancer from returning. If the bladder is removed, additional surgery is needed to help the body drain urine. The cure rate is less than 50 percent for Stage 3 patients.
If the cancer has advanced to Stage 4, surgery to remove the tumor is usually not an option, although chemotherapy is often considered. Stage 4 patients with bladder cancer are rarely cured.
Did a delayed diagnosis of bladder cancer increase my chance of dying?
The delayed cancer diagnosis attorneys at Powers & Santola, LLP, are dedicated to providing the very best legal representation to individuals who have been harmed by a needlessly delayed diagnosis of cancer. Legal excellence means more than knowledge and talent. It also means having the resources and a commitment to fundamentally changing the lives of our clients and their families for the better by helping them to find answers to difficult questions, and to obtain compensation for the harm caused by medical malpractice.
Founded in 1987, Powers & Santola, LLP, has built a reputation for excellence by devoting our full attention and resources to a limited number of very seriously injured clients in New York. When we agree to represent someone, we make a commitment that our services will be dedicated to helping that person improve his or her life for the better. To make that commitment meaningful, we have found that there is simply no substitute for focusing our skills, efforts and other resources on helping a select group of clients.
With our experience in delayed diagnosis cases, we can build clear, compelling evidence for recovery. Bladder cancer patients who would have had a near certain prognosis of cure and survival with an early diagnosis can recover for an “increased chance of death” or harsher treatment regimens they have to endure as a result of a delayed diagnosis of their cancer.
We can help you find the answers you need. To talk with us about a lawsuit involving a delayed diagnosis of bladder cancer, call us at 518.465.5995 or contact us online.
- Bladder Cancer, American Cancer Society
- Glossary of Terms, American Bladder Cancer Society
- Bladder Cancer, National Cancer Institute