What Is the Main Cause of Bladder Cancer?

Reviewed on 11/3/2020

What Is Bladder Cancer?

Causes of bladder cancer are often genetic, and risk factors include smoking, chemical exposure, race, age and other factors.
Causes of bladder cancer are often genetic, and risk factors include smoking, chemical exposure, race, age and other variables.

Bladder cancer is a type of cancer that occurs when cells in the bladder become abnormal and grow out of control. 

Types of bladder cancers include: 

  • Urothelial carcinoma, also known as transitional cell carcinoma (TCC): the most common type of bladder cancer 
  • Squamous cell carcinoma: only about 1% to 2% of bladder cancers are squamous cell carcinomas
  • Adenocarcinoma: only about 1% of bladder cancers are adenocarcinomas
  • Small cell carcinoma: less than 1% of bladder cancers 
  • Sarcoma: very rare

What Are Symptoms of Bladder Cancer?

Bladder cancer is often discovered early because it causes blood in the urine or other urinary symptoms that cause a person to see a doctor. Many of the symptoms are more likely to be caused by something other than bladder cancer, but it’s important to have them checked.

Symptoms of bladder cancer include: 

  • Blood in the urine (hematuria)
  • Usually the first sign of bladder cancer
  • Urine may appear orange, pink, or, less often, dark red
  • Changes in bladder habits 
    • Bladder irritation
    • Urinary frequency
    • Pain or burning during urination
    • Feeling as if you need to go right away, even when the bladder isn't full
    • Difficulty urinating or having a weak urine stream
    • Urinating multiple times during the night (nocturia)

Symptoms of advanced bladder cancers that have grown large or have spread to other parts of the body may include:

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What Causes Bladder Cancer?

The cause of most bladder cancers is unknown but genetic changes may play a role. 

Risk factors for developing bladder cancer include:

  • Smoking is the main risk factor for bladder cancer, and is responsible for about half of all bladder cancers in both men and women
  • Workplace exposures to certain chemicals
    • Aromatic amines, such as benzidine and beta-naphthylamine, sometimes used in the dye industry
    • Makers of rubber, leather, textiles, paint products, and printing companies
    • Painters, machinists, printers, hairdressers (exposure to hair dyes), and truck drivers (exposure to diesel fumes)
  • Certain medicines or herbal supplements
  • Arsenic in drinking water
    • Not a major problem in the U.S. but may be in other parts of the world
  • Not drinking enough fluids
  • Race and ethnicity
    • People of European descent are two times more likely to develop bladder cancer than African Americans and Hispanics
    • Asian Americans and native American Indians have slightly lower rates 
  • Age
  • About 90% of people who develop bladder cancer are over 55 years
  • Gender
    • More common in men than in women
  • Chronic bladder irritation and infections
    • Urinary infections (UTIs), kidney and bladder stones, bladder catheters left in place a long time, and other causes of chronic bladder irritation 
    • Schistosomiasis (bilharziasis), parasitic worm infection that can get into the bladder
      • More common in Africa and the Middle East; rare in the U.S.
  • Personal history of bladder or other urothelial cancer
  • Bladder birth defects
  • Genetics and family history
  • Chemotherapy or radiation therapy

How Is Bladder Cancer Diagnosed?

Bladder cancer is diagnosed with a physical exam which may involve a digital rectal exam (DRE) and in women, a pelvic exam. 

Tests used to diagnose bladder cancer include: 

What Is the Treatment for Bladder Cancer?

Treatment for bladder cancer may involve one or more of the following:

  • Bladder cancer surgery
    • Transurethral resection of bladder tumor (TURBT) or a transurethral resection (TUR): most common treatment for early-stage or superficial (non-muscle invasive) bladder cancers
    • Surgical removal of all or part of the bladder (radical or partial cystectomy): for invasive bladder cancer
    • Reconstructive surgery after radical cystectomy: if the entire bladder is removed, patients need another way to store urine and pass it out of the body
  • Intravesical therapy: liquid drug administered into the bladder 
  • Chemotherapy 
  • Radiation therapy 
  • Immunotherapy 
    • Immune checkpoint inhibitors: atezolizumab (Tecentriq), durvalumab (Imfinzi), avelumab (Bavencio), nivolumab (Opdivo), and pembrolizumab (Keytruda) 
  • Monoclonal antibodies
    • Enfortumab vedotin (Padcev) 
  • Targeted therapy drugs 
    • Erdafitinib (Balversa)

What Is the Life Expectancy for Bladder Cancer?

Life expectancy for bladder cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis. 

Bladder cancer 5-year survival rates:

  • In situ (cancer is still confined to the cells in which it initially started and has not spread into any nearby tissue): 96%
  • Localized (no sign the cancer has spread outside the bladder): 70%
  • Regional (cancer has spread outside the bladder to nearby structures or lymph nodes): 36%
  • Distant (cancer has spread to distant parts of the body, such as the lung, liver, or distant lymph nodes): 5%

How Do You Prevent Bladder Cancer?

There is no definite way to prevent bladder cancer but some factors can be controlled to lower the risk of developing it, such as:

  • Don’t smoke
    • Smoking is believed to cause about half of all bladder cancers
  • Limit exposure to certain chemicals in the workplace
    • Follow proper work safety practices in workplaces with chemical exposure risks
  • Drink adequate amounts of liquids
  • Eat plenty of fruits and vegetables

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Reviewed on 11/3/2020
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