Does bladder cancer spread to kidney and lungs?

Question

Hello doctor,

My uncle, aged 61, was diagnosed with bladder cancer last year and underwent TURBT. His latest cystoscopy showed a new small growth near the bladder neck, and urine cytology was suspicious for malignancy again. He also had mild blood in his urine last week. Does this mean his cancer is recurring despite treatment?

Should we ask about intravesical BCG this time, or go directly for radical surgery? Also, is it possible for bladder cancer to spread quickly to the kidneys or lungs, and how often should he do CT scans to make sure it hasn’t already progressed?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I hope you are doing well.

I truly understand how much fear you are going through, especially since your husband’s bladder cancer has recurred. First of all, I would like to reassure you this situation is not dangerous in itself. What we need to do now is to evaluate whether the tumor has returned to the bladder again.

We need to perform a TURBT (transurethral resection of bladder tumour) and determine whether the disease is still localized or if it has extended to the surrounding lymph nodes. If the cancer is still localized and non–muscle invasive, meaning it has not invaded the bladder muscle, we can repeat BCG (Bacillus Calmette–Guérin) therapy without any problem.

However, if the cancer has invaded the bladder muscle, then we prefer a bladder-preserving strategy. This involves performing an extensive TURBT, combined with chemotherapy and localized radiotherapy to the pelvis. With this approach, we can achieve good overall tumor control, and it is often a better option than surgery, as surgery can have difficult side effects and negatively affect quality of life, including urinary control and intimate relationships.

Therefore, our priority is to accurately determine the stage of the disease and then choose the most appropriate and best treatment option for his condition. I hope my explanation has clarified things for you. If you have any questions at any time, please do not hesitate to ask.