What is bladder cancer?
Bladder cancer develops when cells inside the bladder grow out of control. The most common type of bladder cancer is urothelial carcinoma (also known as transitional cell carcinoma), which starts in the lining of the bladder. Rare types of bladder cancer include squamous cell carcinoma, adenocarcinoma and small cell carcinoma.
Who gets bladder cancer?
Around 81,200 people will be diagnosed with bladder cancer and about 17,200 people will die from it this year in the United States, according to the American Cancer Society.
Men are three to four times more likely to develop bladder cancer than women. Overall, about 1 in 26 men will develop bladder cancer in their lifetimes, with risk increasing with age. About 90 percent of people who develop bladder cancer are over 55. Whites have a higher risk for this cancer than African Americans or Hispanics.
What are the risk factors for bladder cancer?
Certain environmental exposures are linked to greater risk of bladder cancer, with tobacco smoking being a leading cause. Smokers are two to six times more likely to develop this cancer than nonsmokers.
People exposed to certain types of pollutants have an increased risk of bladder cancer, such as diesel exhaust, petroleum products, arsenic and dyes and solvents. Certain medical conditions are also associated with an increased risk, including a history of radiation therapy to the pelvis, chronic or frequent urinary infections or inflammation (cystitis), long-term catheter use and schistosomiasis, a disease caused by a parasitic worm.
What are the symptoms of bladder cancer?
The bladder is a hollow muscular organ that stores urine collected from the kidneys before it is disposed of by urination.
Symptoms of bladder cancer in early stages may include:
- Blood in the urine (hematuria)
- Need to urinate frequently
- An intense feeling of needing to urinate (urinary urgency)
- Pain or a burning sensation when urinating
Symptoms of bladder cancer in later stages may include:
- Loss of appetite
- Weight loss
- Pain in the rectum, anus or side of the body
- A lump in the pelvis
- Swelling in the legs, scrotum (men) or vulva (women)
How is bladder cancer diagnosed?
Early detection and treatment of cancer increases the likelihood of long-term survival. But bladder cancer sometimes takes a while to diagnose because other medical conditions can cause similar symptoms. The process of diagnosis starts with a physical exam and health history. A doctor may do a pelvic exam, which is a manual internal exam of the vagina or rectum, to feel for lumps or thickening of the bladder wall. A urine sample may show the presence of blood, unusual bacteria or abnormal cells.
Further evaluation may include cystoscopy, an exam using a type of endoscope (a thin, tube-like instrument with a light and a lens) that is inserted to look at the inside of the bladder, and a biopsy, or small tissue sample, might be removed to examine in the laboratory. A pyelogram, a type of imaging test, may be done to get a better look at the bladder and surrounding structures.
How is bladder cancer treated?
Treatment for bladder cancer depends on how advanced the disease is when it is detected, including how large it is and whether it has spread to nearby lymph nodes or other parts of the body.
Surgery: Most people with bladder cancer will undergo surgery to remove tumors. The type of surgery and how extensive it is depends on the type of tumor and how advanced it is. Surgical removal of a tumor is known as resection.
Ablation: Some bladder tumors that are not deep in the tissue may be ablated, or destroyed using a laser.
Radiation: Radiation may be used to kill any cancer cells that remain after surgery or to shrink tumors that cannot be surgically removed. It is often used in conjunction with other forms of treatment.
Chemotherapy: Traditional chemotherapy works by killing fast-growing cells, including cancer cells. It can also destroy rapidly dividing healthy cells, such as those in the gut or hair follicles, leading to side effects including nausea and hair loss.
Targeted therapy: Targeted drugs work against cancers with specific characteristics. For example, they may interfere with signaling pathways that regulate cell growth. Targeted treatment is often better tolerated than chemotherapy, but cancer may develop resistance over time.
Immunotherapy: The newest type of treatment helps the immune system fight cancer. For example, some tumors can turn off immune responses against them, and drugs known as checkpoint inhibitors can restore T cells’ ability to recognize and destroy cancer cells. Some checkpoint blockers are approved for bladder cancer, but these work for only a subset of patients and it is hard to predict who will benefit. An older immunotherapy uses BCG bacteria to attract immune cells to attack bladder cancer.
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Last Reviewed: June 20, 2018
