Minimally Invasive Urology Institute
Delivering Excellence in Urologic Patient Care, Education & Research

Bladder and Ureter Cancer

Cancer of the urinary bladder is the fifth most common cancer in Rhode Island, and the sixth most common cancer in the United States. Early detection of bladder cancer increases the chances of successful treatment.

Blue-Light Cystoscopy at The Miriam Hospital

The Miriam Hospital is one of three New England hospitals to use blue-light cystoscopy to diagnose and treat bladder cancer.

Watch the video.

For bladder cancer, our treatment therapies include:

Cystoscopy 
During a cystoscopy, the patient is sedated and the physician inserts a long thin tube into the bladder without making any incision and uses a bright light to inspect the lining closely for any abnormal growths or suspicious areas that may indicate bladder cancer.

Blue-light cystoscopy
The Miriam Hospital is the only hospital in the state, and one of three in New England, to offer blue-light cystoscopy to diagnose and treat tumors in the bladder. Blue-light cystoscopy is a minimally invasive, leading-edge technology that improves bladder cancer detection. 

Fulguration 
Destruction of diseased tissue by burning with electrical current

Transurethral resection of bladder tumor (TUR BT)
Often the first step in diagnosing, staging and treating visible tumors. The endoscope used to remove the tumor is inserted into the bladder through the urethra. At the end of the scope is a small, electrified loop of wire that is used to cut and remove diseased tissue.

Intravesical installation
Insertion of chemotherapy drug immediately after the TUR procedure to prevent recurrence of cancer

Nephroureterectomy
Nephroureterectomy is a surgical procedure to remove the kidney, ureter and connection between the ureter and bladder. Nearby lymph nodes may also be removed.

Robot-assisted laparoscopic radical cystectomy
The entire bladder, nearby lymph nodes, part of the urethra, and nearby organs such as the prostate in men and the uterus, ovaries and fallopian tubes in women are removed to eliminate cancer cells.

After this procedure, our surgeon will create a way to eliminate urine:

  • A neobladder may be created using piece of the bowel that is attached to the urethra and ureters, allowing the patient to pass urine as prior to surgery.
  • A piece of the small intestine is used to make a passageway (ileal conduit) that connects the ureters (the two tubes that carry urine from the kidneys to the bladder) to a small opening in the abdomen. After surgery, the urine passes from the ureters through the conduit into a urostomy or ostomy appliance.
  • A urinary pouch with a stoma that can be catheterized may be created using part of the large and/or small bowel. The pouch is connected to the exterior of the body with the stoma, through which urine may be removed three to four times daily using a urinary catheter.

Extended robot-assisted laparoscopic pelvic lymph node dissection
Pelvic lymph nodes are removed and sent for pathology analysis

Cancer Center Research for Physicians

Diagnosis and Treatment

We work in collaboration with oncologists at the Lifespan Cancer Institute, with the goal of precisely diagnosing and treating prostate, kidney and bladder cancers as soon as possible. 

Diagnostic modalities include: 

• PET scans
• MRI scans
• High-resolution CT scans
• Ultrasound

Bladder Cancer Facts

The most common risk factors for bladder cancer include:

  • Cigarette smoking: Smoking is the number one cause of bladder cancer. About 60 percent of men and 50 percent of women who are diagnosed have a history of smoking.
  • Chemical exposure: Those who have been exposed to certain chemicals, especially in jobs where chemicals made from arylamines are used, are at increased risk for bladder cancer. These jobs include working with dyes, textiles, tires, rubber, leather, and petroleum. Those who work as painters and hairdressers are also at increased risk.
  • Age: The risk for bladder cancer increases with age. Approximately nine out of 10 people with bladder cancer are over age 55.

The most common symptom of possible bladder cancer is blood in the urine. If you experience this symptom, please contact your doctor immediately. 

In The News

Read the WPRI story by reporter Alexandra Leslie about the new registry recently created to find out why Rhode Island has such a high incidence rate of bladder cancer.

Watch WJAR-TV 10 Health Check story by reporter Barbara Morse Silva's about one of our grateful bladder cancer patients.