Minimally invasive surgery for bladder cancer? This safer approach is now a reality, thanks to a new method pioneered by surgeons at Keck Medicine of USC.

A bladder cancer diagnosis often comes with a double dose of worry that goes beyond a successful treatment. Patients worry: Will I have normal bathroom function? If I have a urostomy (external bag), how will it affect my quality of life?

Fortunately, urologists at Keck Medicine of USC are America’s leading specialists in surgical and cancer treatments for bladder cancer. Using a robotic arm, they are effectively treating patients with innovative robotic bladder cancer surgery.

We asked Andre K. Berger, MD, assistant professor of clinical urology at the USC Institute of Urology of Keck Medicine of USC, to explain robotic bladder surgery and discuss its benefits.

First, how is bladder cancer diagnosed?

The major symptom is painless gross hematuria, which is blood in the urine. Even if it’s only one occurrence and a tinge of blood, you need to get checked out — especially if you are over the age of 50.

The presence of blood doesn’t always mean bladder cancer. It could be kidney stones or an enlarged prostate. Even so, these are also conditions that should not be overlooked. Follow this rule: If you see blood in your urine, see a doctor.

What causes bladder cancer?

Major risk factors include:

  • Smoking (increases the risk 5x)
  • Exposure to second-hand smoke
  • Exposure to certain chemicals like aromatic amines, such as benzidine and beta-naphthylamine, which are sometimes used in the dye industry
  • Chronic bladder infections and bladder stones
  • Hx of pelvic radiation and chemotherapy with cyclophosphamide (Cytoxan)
  • Family history of bladder cancer

Bladder cancer is four times more common in men than women. Age also matters. People 50 to 70 years old are at higher risk of developing bladder cancer.

What ways can bladder cancer be treated?

In non-invasive or early stages, bladder cancer can be treated endoscopically by removing the tumor piece-by-piece through the urethra. For more aggressive tumors, surgery, radiation, chemotherapy can be used.

Advanced bladder cancer requires more complex treatment. Traditionally, invasive open surgery has been the only option, but now robotic bladder surgery is proving to be very successful.

How does robotic bladder surgery work and why is it a Keck Medicine specialty?

Surgery is the only way to remove a tumor when it has invaded deeper layers of the bladder. Instead of making a large abdominal incision, we can use a surgical robot and small tools to remove the bladder, remove the lymph nodes and reconstruct the urinary tract through tiny cuts.

The benefits are worth it: it’s safe, has smaller incisions, less blood loss, and fewer blood transfusions.

Urologists at the USC Institute of Urology have more than 45 years of experience in treating patients for bladder cancer. We have pioneered many of the methods used today. So we not only have the expertise, but we also have access to detailed patient data that helps us determine optimal treatment and care.

Are there alternatives to a urostomy (external bag)?

Once the tumor is removed, our experts can reconstruct the urinary tract so that the ureters (channels that connect the kidneys to the bladder), are attached to asegment of bowel so the urine gets out of the patient’s body in its usual manner. Another option is creating a neobladder by reshaping part of the bowel into a sphere and connecting it to the patient’s urethra. This way the patient can urinate near normally.

If you have any of the symptoms described or want a second opinion, don’t hesitate to see a urologist.

The expert urologists at the Keck Medicine of USC Institute of Urology are some of the country’s leading care specialists for bladder patients. If you are in the Los Angeles area, be sure to schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting http://urology.keckmedicine.org/request-an-appointment/.

By Heidi Tyline King