What Is Bladder Cancer?
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:
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
- About 90% of people who develop bladder cancer are over 55 years
- More common in men than in women
- Chronic bladder irritation and infections
- 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:
- Urine tests
- Biopsy using transurethral resection of bladder tumor (TURBT)
- Imaging tests
- Intravenous pyelogram (IVP)
- Retrograde pyelogram
- Computed tomography (CT) scans
- CT urogram
- CT-guided needle biopsy
- Magnetic resonance imaging (MRI) scans
- MRI urogram
- Chest X-ray
- Bone scan
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
- Radiation therapy
- 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