What Is Bladder Cancer? A Guide

Medically Reviewed By Angelica Balingit, MD

Bladder cancer occurs when cells that make up the bladder, the organ that stores urine, begin to grow uncontrollably. People with bladder cancer may experience bloody urine, painful urination, and urinary incontinence. The exact cause of bladder cancer is unknown, but specific factors may increase your risk. These factors include:

  • smoking
  • exposure to workplace chemicals
  • family history of the condition

Read on to learn more about bladder cancer, including its risk factors, types, symptoms, and treatments.

Causes and risk factors

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All cancers result from DNA changes, or mutations, that affect how cells grow. According to the American Cancer Society Trusted Source American Cancer Society Highly respected international organization Go to source , bladder cancer is usually the result of acquired mutations, meaning a person will develop DNA changes throughout their life instead of inheriting them from their parents.

The exact mechanism behind these mutations isn’t fully understood. However, there are some known risk factors Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for bladder cancer, including exposure to tobacco smoke and workplace chemicals, such as those used in the production of rubber or dyes.

Tobacco smoke and workplace chemicals contain substances the body absorbs into the blood. These substances ultimately end up in the urine, which the bladder stores, and may begin to cause mutations in the cells of the bladder.

Other risk factors for bladder cancer include:

  • being older than 55
  • being male
  • a history of chronic bladder infections
  • a family history of bladder cancer
  • a history of chemotherapy or pelvic radiation

Types

There are a few types of bladder cancer, classified by where they start in the bladder.

The National Cancer Institute notes that many bladder cancer cases are urothelial carcinoma, also referred to as transitional cell carcinoma. Urothelial, or transitional, cells line the inside of the bladder and change shape to accommodate the amount of urine.

Less common types of bladder cancer include:

  • adenocarcinoma, which begins in the glandular cells in the lining of the bladder
  • sarcoma, which starts in the muscle fibers of the bladder walls. It is very rare
  • small cell carcinoma, which develops in nerve-like cells called neuroendocrine cells
  • squamous cell carcinoma, which begins in thin, flat cells known as squamous cells

Symptoms

The Centers for Disease Control and Prevention (CDC) Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source notes that bloody urine, or hematuria, is a common symptom of bladder cancer. Other possible symptoms include:

Learn more about early symptoms of bladder cancer.

Diagnosis

To diagnose bladder cancer, a doctor will ask about your symptoms and medical history and perform a physical exam. Testing may include:

  • Urine tests: These can help rule out other conditions, such as infections. A urine cytology can also find cancer cells.
  • Cystoscopy: This procedure involves inserting a thin, fiber-optic tube through the urethra into the bladder. It allows your doctor to view the bladder lining and take a biopsy if necessary.
  • Biopsy: This involves removing a small tissue sample for examination and testing. It is the only way to know for sure whether bladder cancer is present.
  • Imaging exams: These may include CT scans, MRI scans, or ultrasounds.

Learn more about how doctors diagnose bladder cancer.

Stages

Cancer staging tells doctors how widespread the cancer is. The stage will depend on the following:

  • how deep the tumor goes into the bladder wall
  • whether cancer cells are in lymph nodes
  • whether cancer has spread, or metastasized, to other areas and organs

There are five bladder cancer stages Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , with higher numbers indicating more advanced disease.

StageDescription
0The tumor is only in the bladder lining.
1The tumor has grown through the lining and is invading tissues underneath it.
2The cancer has spread deeper into the muscle layer of the bladder wall. It is still in the bladder and has not spread to lymph nodes or other sites.
3The cancer has penetrated through the bladder wall. It has spread to the reproductive organs and one or more lymph nodes but has not reached the abdominal wall or distant sites.
4This is the most advanced stage of bladder cancer. It has spread to the abdominal wall, lymph nodes, or distant body sites.

Treatments

The treatments for bladder cancer may vary depending on the stage of the disease.

For people with stage 0 or 1 bladder cancer, doctors may initially perform a transurethral resection (TUR) of the bladder. This procedure involves removing a tumor through the urethra, the tube that drains urine from of the bladder.

TUR procedures are often followed up with intravesical chemotherapy, which is chemotherapy administered directly into the bladder to destroy remaining cancer cells.

Other possible treatments include:

  • cystectomy, which is surgery to remove part or all of the bladder
  • radiation therapy, which uses intense energy beams to destroy cancer cells
  • systemic, or body-wide, chemotherapy to destroy cancer cells
  • immunotherapy, which stimulates the immune system to attack cancer cells
  • targeted therapy, which targets the proteins involved in cell growth in select cases with specific tumor mutations

Learn more about surgery for bladder cancer.

Complications

The main complication associated with bladder cancer is the possibility of metastasis Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source to nearby and distant parts of the body. Other possible complications of the condition and its treatments include:

  • adverse effects of chemotherapy
  • adverse effects of radiation therapy
  • anemia, or low red blood cell count
  • changes in bowel movements
  • bleeding
  • ureteral obstruction, or a blockage of the urethra

Learn more about side effects of bladder cancer treatment.

Outlook and survival rates

As with many cancers, the outlook for people with bladder cancer is improved when the disease is diagnosed and treated early.

According to the Surveillance, Epidemiology, and End Results (SEER) program Trusted Source National Cancer Institute Surveillance, Epidemiology, and End Results Program Governmental authority Go to source , the 5-year relative survival rate for bladder cancer averaged 77.9% for the years 2013–2019.

The relative survival rate suggests how long someone with a condition may live after their diagnosis compared to someone without the condition of the same race, sex, and age over a specific time. This is different from overall survival rate, which is a percentage of people still alive for a specific time after diagnosis of a condition.

The SEER database also provides statistics showing how the 5-year relative survival rate decreases as the cancer advances. Though people with the earliest stage of cancer may have a 5-year relative survival rate of 96.7%, that number drops to 8.3% for people with cancer that has metastasized to distant areas of the body.

Keep in mind that these numbers are only statistics. Experts arrive at them by looking at large groups of people with cancer several years ago.

Survival rates cannot tell you how long you will live. Your doctor can help you understand how your situation influences your outlook.

Summary

Bladder cancer develops when cells in the bladder change and begin to grow uncontrollably. This may lead to symptoms like bloody urine, frequent urination, and fatigue.

Treatment for bladder cancer may depend on how advanced the disease is. Your treatment plan may involve surgery to remove the tumor, chemotherapy, or other treatments like radiation therapy or immunotherapy.

If you have bladder cancer, talk with your care team about the outlook for your condition.

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Medical Reviewer: Angelica Balingit, MD
Last Review Date: 2024 Feb 20
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