Learn About Bladder Cancer

What is Bladder Cancer?

Cancer is caused by malignant (cancerous) cells that grow and multiply without control. When cancer begins in the tissues of a bladder, it is called bladder cancer.

The bladder is a triangle-shaped, hollow organ located in the lower abdomen. Its walls relax and expand to store urine, and contract and flatten to empty urine through the urethra.

Types of bladder cancer include:

• Transitional cell (urothelial) carcinoma, which begins in the cells in the lining of the bladder, accounts for almost all bladder cancers
• Squamous cell carcinoma begins in squamous cells—thin, flat cells that may form if the bladder is irritated or infected (very rare)
• Adenocarcinoma begins in glandular (mucus-secreting) cells in the lining of the bladder (very rare)

The American Cancer Society (ACS) estimates that about 82,000 new cases of bladder cancer will be diagnosed in the United States in 2023, and that the disease would cause about 16,000 deaths. According to the ACS:

• About 9 out of 10 people who are diagnosed with bladder cancer are older than 55
• The disease is about 3 to 4 times more likely to strike men than women

The National Cancer Institute has more information on bladder cancer.

Bladder Cancer Symptoms

The signs of bladder cancer may look similar to those associated with other medical conditions. Talk to your doctor if you notice any of the following:

• Frequent urination
• Blood in the urine
• Painful urination
• Pelvic or lower back pain

Diagnosing Bladder Cancer

The first step in diagnosing any disease is to complete a medical history and physical examination. In order to diagnose bladder cancer, your doctor may also order tests and procedures including:

• Rectal or vaginal examination: The doctor checks for tumors (abnormal growths) that are large enough to be felt
• Cystoscopy: A cystoscope (a narrow, flexible tube) is inserted through the urethra to examine the bladder and urinary tract. The device has a lens and lighting to help the doctor detect tumors or stones
• Biopsy: During cystoscopy, samples of bladder tissue may be removed so that they can be put under a microscope to determine if cancer or other abnormal cells are present
• Laboratory tests: Various tests may be performed on urine to check for blood, chemicals, bacteria or cancer cells
• Imaging tests: Magnetic resonance imaging (MRI), computerized tomography (CT) and positron emission tomography (PET) scans are advanced imaging technologies used to look for tumors and other problems

Treating Bladder Cancer

Most people with bladder cancer have tumors that are superficial (on the surface) and have not spread. Long-term bladder cancer prognosis (outlook) in these cases is often excellent.

Less frequently with bladder cancer, a tumor has invaded deeply into the bladder wall and muscle. In these cases, there is a greater risk for metastasis (the cancer spreading elsewhere in the body).

If you are diagnosed with bladder cancer, your care team will work with you to develop a treatment plan that is right for you. This plan will depend on factors such as type and stage (extent) of bladder cancer, your general health, and your treatment preferences.

Several surgical procedures are used to treat bladder cancer, including:

• Transurethral resection: The surgeon inserts a cystoscope through the urethra into the bladder. Tissue containing cancer cells can be surgically removed or burned away with an electric current or laser
• Segmental cystectomy: The portion of the bladder containing a cancerous tumor is removed. This procedure is most effective when the cancer cells are confined to one small area of the bladder
• Radical cystectomy: The entire bladder is removed along with nearby lymph nodes and any nearby organs containing cancer cells. This procedure is usually used when there are multiple areas of cancerous cells in the bladder and the cancer has spread to other sites. Following bladder removal, a urostomy procedure is performed to create a new opening to allow urine to leave your body

Nonsurgical treatment options include:

• Chemotherapy kills cancer cells through the use of intravenous (IV) or oral drugs
• Biological therapy uses the body's own immune system to fight cancer. One example is Bacillus Calmette-Guérin (BCG) treatment, in which a solution is placed in the bladder to stimulate the immune system to kill the cancer cells
• Radiation therapy uses high-energy radiation beams to kill or shrink tumors while saving healthy tissue. The radiation source can come from outside the body (external radiation therapy) or from radioactive implants inside the body (internal radiation therapy)

Some hospitals also offer clinical trials that may provide access to new and promising therapies for bladder cancer.