— Linda, Kansas Most polyps in the bladder are actually bladder cancers. The majority of bladder cancers are noninvasive lesions that protrude into the hollow of the bladder on stalks, like a cauliflower. Bladder tumors are identified by cystoscopy, whereby a scope is passed up the urethra into the bladder to allow for visual inspection of the inside of the bladder. This is usually performed in the urologist’s office. Treatment involves “transurethral resection” — in simple terms, the doctor scrapes out the tumors with a cautery instrument for pathological examination. The procedure is usually an outpatient surgery, with possible limited hospitalization to obtain tissue for diagnosis and to attempt further treatment. In many cases, resection of the tumors will be the main surgical treatment of a bladder tumor. Additional treatments may involve installation of chemotherapy or immunotherapy agents in the bladder. A smaller subset of bladder cancers consists of tumors that are invasive. While they may have the appearance of polyps, they invade into the deep muscle of the bladder wall. In these instances, if biopsies confirm the invasive nature of the tumors, surgical removal of the bladder may be necessary. Noninvasive bladder cancers, if they are not removed, can progress to become invasive. Excellent treatments exist for all stages of bladder cancer, and thus timely evaluation and treatment are important. Q2. My doctor is testing me for flank pain. What is flank pain, what causes it, and what would prompt him to look for it? — Lonny, Florida Flank pain occurs in the kidney region in the middle to lower back, and typically it is felt in an area that stretches from the lower ribs in the mid back below the shoulder blade around to the front of the abdomen. Flank pain is often the result of a kidney abnormality, such as a stone, an obstruction, a tumor, or an infection. The first steps in evaluating flank pain are a physical examination and urinalysis. Other tests may be needed after this. Only rarely will the physical exam find signs of a kidney mass, for instance. If the urinalysis shows blood in the urine, this would be an indication that further radiographic studies are needed to evaluate the kidneys. Learn more in the Everyday Health Bladder Cancer Center.
