Bladder Cancer

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What is bladder cancer?

Cancer occurs when abnormal cells reproduce in an uncontrolled fashion. In the urinary bladder, the cells that are most likely to become cancerous are the transitional cells, the stretchy cells that form the lining or inner layer of the organ. Of the 52,000 men and 18,000 women diagnosed with bladder cancer in the United States each year, more than 90% have transitional cell cancers (Source: NCI).

Bladder cancer is more common among older adults, males, and Caucasians. Although the specific cause is not known, various factors increase the risk of getting bladder cancer, including smoking and exposure to certain chemicals. Long-term inflammation, as can occur with chronic bladder infection, is associated with the more rare types of bladder cancer, such as squamous cell carcinoma and adenocarcinoma.

Symptoms of bladder cancer can be similar to those of a bladder infection, such as needing to go to the bathroom urgently or frequently, as well as blood in the urine. Abdominal pain and urinary incontinence can also occur. The presence of abdominal, flank, or pelvic pain suggests spread of bladder cancer or advanced tumor spread. Weight loss can be seen with later-stage cancers.

Bladder cancer that is caught early has an excellent prognosis and can often be treated with surgery alone or surgery plus intravesical therapy (therapeutic agents put directly into the bladder). More advanced cancers may be treated with chemotherapy and radiation therapy alone or in combination with surgery.

One symptom of bladder cancer is blood in the urine. Slow rates of bleeding can eventually result in anemia. Sometimes, the bleeding can be more profuse. Seek immediate medical care (call 911) for symptoms such as heavy bleeding, confusion, changes in level of consciousness, lethargy, sweating, pale or blue lips and fingernails, fast heart rate, difficulty breathing, or unusual anxiety.

Seek prompt medical care for blood in the urine.

What are the symptoms of bladder cancer?

Many symptoms of bladder cancer resemble those of a bladder infection. Other symptoms, such as weight loss, are often not seen with early-stage cancers.

Common symptoms of bladder cancer

Common symptoms of bladder cancer include:

Serious symptoms that might indicate a life-threatening condition

In some cases, the complications of bladder cancer can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bluish coloration of the lips or fingernails

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • Chest pain, chest tightness, chest pressure, palpitations

  • Heavy bleeding

  • Not producing any urine

  • Rapid heart rate (tachycardia)

  • Seizure

  • Severe abdominal pain

What causes bladder cancer?

The specific cause of bladder cancer is not known, although several factors that increase the risk of developing it have been identified.

What are the risk factors for bladder cancer?

A number of factors increase the risk of developing bladder cancer. Not all people with risk factors will get bladder cancer. Risk factors for bladder cancer include:

  • Caucasian race
  • Chronic bladder infections
  • Exposure to certain chemicals, typically in the workplace
  • Family history of bladder cancer
  • History of pelvic radiation
  • History of previous chemotherapy
  • Infection with the schistosomiasis parasite
  • Male gender
  • Smoking

Reducing your risk of bladder cancer

You may be able to lower your risk of bladder cancer by:

  • Quitting smoking
  • Taking precautions to limit exposure to chemicals

How is bladder cancer treated?

Goal of cancer treatment

The goal of bladder cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later.

Common treatments for bladder cancer

Common treatments for bladder cancer include:

  • Intravesical therapy (treatment placed directly in the bladder) to attack cancer cells or to stimulate the body's immune system to attack cancer cells
  • Radiation therapy to attack cancer cells
  • Surgery to evaluate nearby lymph nodes for possible spread of cancer
  • Surgery to remove the cancer
  • Systemic, or body-wide, chemotherapy to attack cancer cells
  • Targeted therapy in select cases with specific tumor mutations
  • Transurethral resection (TUR) (surgery through the urethra, the tube that drains the bladder) to remove smaller cancers

Transurethral tumor resections may need to be repeated, and intravesical therapies are often given multiple times.

Other treatments for bladder cancer

Other therapies may be added to help with your general state of health and any side effects of treatment including:

  • Antinausea medications if nausea occurs
  • Blood cell growth factors to increase the number of white blood cells if these are severely reduced during treatment
  • Blood transfusions to temporarily replace blood components (such as red blood cells) that have dropped to low levels as a result of treatment
  • Consultation with a wound, ostomy and continence nurse if the bladder needed to be removed and a new bladder was created surgically
  • Dietary counseling to help maintain strength and nutritional status
  • Pain medications as needed to increase comfort

Complementary treatments

Some complementary treatments may help some people to better deal with bladder cancer and its treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Acupuncture
  • Massage therapy
  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products
  • Yoga

Hospice care

In cases in which bladder cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift away from curing the disease and focus on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient’s family.

What are the potential complications of bladder cancer?

Left untreated, bladder cancer can spread to nearby and more distant organs. Also, bleeding can occur that can be serious and even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of bladder cancer include:

  • Adverse effects of chemotherapy
  • Adverse effects of radiation therapy
  • Anemia (low red blood cell count)
  • Changes in bowel movements
  • Hemorrhage
  • Recurrence of cancer after successful treatment
  • Spread of cancer
  • Ureteral obstruction (blockage of one of the tubes that carries urine from the kidneys to the bladder)
  • Urinary incontinence (inability to control urine flow)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 18
  1. Bladder Cancer—Patient Version. National Institutes of Health. National Cancer Institute. https://www.cancer.gov/types/bladder
  2. Bladder Cancer. PubMed. U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0021881/
  3. Moyer VA, U.S. Preventive Services Task Force. Screening for bladder cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2011; 155:246.
  4. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy.Philadelphia: Saunders, 2013.
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