Bladder cancer is a cancer that starts in the bladder. The bladder is the body part that holds and releases urine. It is in the center of the lower abdomen.
Transitional cell carcinoma of the bladder; Urothelial cancer
Bladder cancer often starts from the cells lining the bladder. These cells are called transitional cells.
These tumors are classified by the way they grow:
The exact cause of bladder cancer is not known. But several things that may make you more likely to develop it include:
Research has not shown clear evidence that using artificial sweeteners leads to bladder cancer.
Symptoms of bladder cancer can include:
Other diseases and conditions can cause similar symptoms. It is important to see your health care provider to rule out all other possible causes.
The provider will perform a physical examination, including a rectal and pelvic exam.
Tests that may be done include:
If tests confirm you have bladder cancer, additional tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future.
The TNM (tumor, nodes, metastasis) staging system is used to stage bladder cancer:
Tumors are also grouped based on how they appear under a microscope. This is called grading the tumor. A high-grade tumor is fast growing and more likely to spread. Bladder cancer can spread into nearby areas, including the:
Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health.
Stage 0 and I treatments:
Stage II and III treatments:
Most people with stage IV tumors cannot be cured and surgery is not appropriate. In these people, chemotherapy is often considered.
Chemotherapy may be given to people with stage II and III disease either before or after surgery to help prevent the tumor from returning.
For early disease (stages 0 and I), chemotherapy is usually given directly into the bladder.
Bladder cancers are often treated with immunotherapy. In this treatment, a medicine triggers your immune system to attack and kill the cancer cells. Immunotherapy for early stage bladder cancer is often performed using the Bacille Calmette-Guerin vaccine (commonly known as BCG). If the cancer returns after the use of BCG, newer agents may be used.
As with all treatments, side effects are possible. Ask your provider what side effects you might expect, and what to do if they occur.
Surgery for bladder cancer includes:
Surgery may also be done to help your body drain urine after the bladder is removed. This may include:
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
After treatment for bladder cancer, you will be closely monitored by a doctor. This may include:
How well a person with bladder cancer does depends on the initial stage and response to treatment of the bladder cancer.
The outlook for stage 0 or I cancers is fairly good. Although the risk for the cancer returning is high, most bladder cancers that return can be surgically removed and cured.
The cure rates for people with stage III tumors are less than 50%. People with stage IV bladder cancer are rarely cured.
Bladder cancers may spread into the nearby organs. They may also travel through the pelvic lymph nodes and spread to the liver, lungs, and bones. Additional complications of bladder cancer include:
Contact your provider if you have blood in your urine or other symptoms of bladder cancer, including:
If you smoke, quit. Smoking can increase your risk for bladder cancer. Avoid exposure to chemicals linked to bladder cancer.
Cumberbatch MGK, Jubber I, Black PC, et al. Epidemiology of bladder cancer: a systematic review and contemporary update of risk factors in 2018. Eur Urol.2018;74(6):784-795. PMID: 30268659 pubmed.ncbi.nlm.nih.gov/30268659/.
National Cancer Institute website. Bladder cancer treatment (PDQ) - health professional version. www.cancer.gov/types/bladder/hp/bladder-treatment-pdq. Updated February 4, 2022. Accessed June 26, 2022.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): Bladder cancer. Version 4.2021. www.nccn.org/patients/guidelines/content/PDF/bladder-patient.pdf. Updated July 27, 2021. Accessed June 24, 2022.
Smith AB, Balar AV, Milowsky MI, Chen RC. Carcinoma of the bladder. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 80.
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.