Carcinoma in situ bladder cancer is an early form of cancer that often appears at a flat patch on the lining of the bladder. Though it is early stage it is still aggressive, with a high likelihood of progression and recurrence. It is a type of non-muscle invasive disease, and accounts for around 10% of all non-muscle invasive cases.
Because it is an uncommon, high-grade disease, timely detection of bladder carcinoma in situ can be difficult but is crucial for preventing progression.
What does bladder carcinoma in situ look like?
Carcinoma in situ bladder cancer can be very hard to identify due to its appearance. Instead of a raised lump, carcinoma in situ is a flat tumor, which can be challenging to spot. While it may appear red or velvety, it can also be invisible on cystoscopy.
This type of bladder cancer is also likely to be multifocal, meaning it appears in two or more locations, or diffuse, meaning it is found throughout the bladder.
To further complicate matters, bladder carcinoma in situ only exists on its own in about 1% to 3% of all urothelial carcinoma cases. The vast majority of the time, it’s found alongside papillary, or raised, tumors in the bladder.
Symptoms to be aware of
While carcinoma in situ bladder cancer can be asymptomatic, some key symptoms include:
- Blood in the urine.
- Difficulty or irritation with urination.
- A strong urge to urinate.
Read more about bladder cancer types
Treating carcinoma in situ bladder cancer
The typical treatment for bladder carcinoma in situ is intravesical therapy via Bacillus Calmette-Guérin (BCG) immunotherapy. This treatment, which instructs the body’s immune system to target and destroy cancer cells, is inserted directly into the bladder.
Unfortunately, many individuals with non-muscle-invasive bladder cancer don’t respond to BCG therapy. On top of this, the long treatment course carries a risk of side effects, such as discomfort during urination and blood in the urine. Others might experience fever or flu-like symptoms.
Some of these side effects are very similar to those of the cancer itself, and it can be hard to disentangle them. However, if you notice your symptoms getting worse after treatment, you should set up an appointment with your provider to see if there’s anything that can be done to alleviate these issues.
Due to its shape and appearance, in situ bladder carcinoma usually can’t be completely removed via surgery. This is why following a set regimen of other forms of treatment — such as BCG therapy — is so important in fighting the disease.
Prognosis
Even though carcinoma in situ bladder cancer is aggressive, its five-year survival rate is very promising. For individuals who only have cancer cells in the bladder lining, the five-year survival rate is 97%.
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