The urologist and the patient then discuss the pathology findings from the transurethral resection of the bladder tumor taking into account the stage and grade of the tumor. These discussions may lead to decisions regarding further treatment of the disease. As mentioned above, low grade, superficial tumors are relatively innocuous. These tumors are usually cured by simple removal with the cystoscope and they often do not require further treatment. However, they have a very high rate of recurrence, so the patient must be monitored closely by the urologist for several years.
Monitoring is accomplished in several different ways.
The urologist usually recommends checking the bladder every 3 or 4 months with the cystoscope in an effort to diagnose tumors even before they cause symptoms such as bleeding. Also, urine may be sent off to the laboratory to check for abnormal cells. Finally, the patient who smokes should be encouraged to stop. Smoking is a well known risk factor in causing bladder cancer because the carcinogens in cigarette smoke pass from the lungs into the blood stream, and are concentrated by the kidneys into the urine. Thus the interior of the bladder is constantly exposed to these carcinogens at high concentration.