Bladder cancer is the fourth most common cancer in men and eighth most common cancer in women, affecting about 80,000 people in the United States every year.
When detected and diagnosed early, bladder cancer is highly treatable. Because there are no recommended screenings for bladder cancer, catching it early means heeding its warning signs.
We sat down with a urologic oncologist, Paul Crispen, MD, to learn more about bladder cancer.
Warning signs of bladder cancer
Early bladder cancer symptoms can be difficult to recognize, but some common symptoms include:
- Blood in urine, which may appear orange, pink or rarely, dark red
- Change in bladder habits such as increased frequency or urgency of urination
- Pain or burning sensation during urination
Blood in the urine is typically the one of the first bladder cancer signs. The blood may be present in the urine on a regular basis or disappear and reappear over the course of days or weeks. Those noting blood in urine should seek medical attention, so an evaluation can be completed.
What is bladder cancer?
The bladder is a hollow, muscular organ that collects and stores urine to be released into the urethra, the tube urine passes through.
Most bladder cancers — about 90% — arise from cancer cells that line the inside of the bladder, a type of cancer known as urothelial carcinoma.
Urothelial carcinoma that hasn’t spread to the tissue or muscle that makes up the organ’s walls is known as non-muscle invasive bladder cancer, which is the earliest form and the most common type. Tumors that grow into the muscle layer and bladder wall are considered muscle invasive bladder cancer.
Urothelial cells also can line the upper urinary tract, which contains tubes that attach and carry urine from the kidneys to the bladder.
Bladder cancers involving other types of cancer cells are less common and tend to be more aggressive.
Diagnosing bladder cancer
If symptoms or lab results suggest signs of bladder cancer, further tests and procedures are needed to make a diagnosis.
The evaluation should include a urinalysis, CT scan or MRI and a cystoscopy. A cystoscopy is performed by the urologist who places a small camera in the bladder through the urethra — the tube that carries urine out of the body — to check for abnormal areas. The test takes less than a minute and is done under local anesthesia. A biopsy or sample of tissue may be taken at that time if abnormalities are discovered during the cystoscopy.
Further urine testing for cancer cells in the urine may be performed if abnormal areas are indicated.
Patients with bladder tumors will undergo a biopsy and resection, known as trans urethral resection of bladder tumor, or TURBT, to reach a diagnosis and treat the cancer’s early stages. This TURBT will also determine what stage the bladder cancer is in.
In a biopsy, a doctor takes a tissue sample from an area where cancer may exist. During the procedure, the doctor will try to remove the cancerous growth. This is known as resectioning.
Risks and prevention
One of the leading risk factors for bladder cancer is tobacco abuse. Smokers are 4 to 7 times more likely to develop bladder cancer than non-smokers, and smokers are strongly encouraged to quit. Visit tobaccofree.ufl.edu for help.
Environmental and occupational exposures also have been linked to bladder cancer. For example, some chemicals used in the rubber, leather, paint and dye industries can increase the risk of bladder cancer.
The occurrence of bladder cancer is higher in men, especially those who are older. Men are four times more likely to develop bladder cancer than women and the average age at diagnosis is 73. However, women should be wary of warning signs too as they tend to be diagnosed later than men.
Hereditary forms of bladder cancer are rare but should be considered when patients have multiple forms of cancer in their family.
Treating bladder cancer
Results from a bladder cancer diagnosis evaluation can help a urologist devise a bladder cancer treatment plan based on a number of factors, including the type, grade and stage of cancer. In addition to various treatment plans, clinical trials are often suggested in efforts to offer patients latest advances in care, gain insight for future patients and to provide close monitoring.
UF Health’s nationally recognized multidisciplinary team of specialists are dedicated to determine the proper prevention, diagnosis and treatment of bladder cancer.
Read more stories on how UF Health treats bladder cancer.
FAQs
What are the different types of bladder cancer?
The two different types of bladder cancer include:
Non-muscle invasive bladder cancer is the earliest stage of bladder cancer. This means that the cancer cells are only located in the inner lining of the bladder, or the bladder wall.
The five year-survival for patients with non-muscle invasive bladder cancer is more than 92%, with the proper treatment.
Muscle invasive bladder cancer occurs when tumors grow into the deep muscle layer and bladder wall. For muscle invasive bladder cancer, where the bladder cancer is confined to the bladder and treated with surgery, the five-year survival is 85%. However, the survival rate decreases as the stage of the disease advances.
Knowing the two different types of bladder cancer is important to determine the necessary treatment options.
What are the standard bladder cancer treatments?
The diagnosis of the bladder cancer and the stage that it is in determines the proper treatment plan.
Non-muscle invasive bladder cancer treatment options include:
- Transurethral resection of the bladder tumor, or TURBT. TURBT is a procedure that uses a cystoscope to remove as much, if not all of the bladder tumor. The biopsy specimen from the TURBT is then sent to the pathologist to determine the stage of the cancer.
- Intravesical drug therapy is a medical therapy where drugs are administered into the bladder through a ureteral catheter in efforts to minimize the risk of tumor recurrence and progression.
Muscle invasive bladder cancer treatment options include:
- Radical Cystectomy with urinary diversion, which means removing the bladder and pelvic lymph nodes. This means a new method of urination is created. In men, the prostate is removed, while in women the fallopian tubes, ovaries and anterior portion of the vagin* are also removed.
- Chemotherapy is also used to treat muscle invasive bladder cancer. Chemotherapy is a systemic treatment, usually administered through the vein, that is designed to kill cancer cells. For patients with non-invasive bladder cancer, chemotherapy may be infused in the urethra using intravesical chemotherapy.
- Radiation therapy with chemotherapy pairs high-energy X-rays with systemic chemotherapy to destroy cancer cells.
