Bladder cancer is a relatively rare form of cancer that starts in the lining of your bladder. There are many ways to treat bladder cancer, including surgery that removes bladder cancer. Bladder cancer may come back after treatment, so people with bladder cancer should be vigilant about following up with their healthcare providers.
Bladder cancer is a relatively rare form of cancer that starts in the lining of your bladder. Your bladder is a small hollow organ that holds your pee (urine). Healthcare providers have many ways to treat bladder cancer, including surgery to remove bladder cancer. Bladder cancer may come back after treatment, so people with bladder cancer should be vigilant about following up with their healthcare providers.
Healthcare providers can treat early-stage bladder cancer — cancer that’s found and treated before it can spread — but about 75% of early-stage bladder cancers come back.
Your bladder is a triangle-shaped organ that’s centered between your hip bones, above your urethra and below your kidneys. Pee from your kidneys drains into your bladder, which is lined with tissue called urothelium. Urothelium is made of cells that stretch when your bladder fills with pee and collapses when it’s empty. (Your bladder can hold about 2 cups of pee.)
Bladder cancer happens when certain cells in the tissue lining your bladder mutate or change, becoming abnormal cells that multiply and cause tumors in your bladder. Left untreated, bladder cancer may grow through your bladder walls to nearby lymph nodes and then other areas of your body, including your bones, lungs or liver.
There are three types of bladder cancer. Each type is named for the cells that line the wall of your bladder where the cancer started. Bladder cancer types include:
Healthcare providers may also categorize bladder cancer as being noninvasive, non-muscle-invasive or muscle-invasive.
Bladder cancer is the fourth most common cancer affecting men and people designated male at birth (DMAB). Men and people DMAB are four times more likely to develop bladder cancer than women and people designated female at birth (DFAB). But women and people DFAB who do have bladder cancer typically have advanced forms of the disease because they don’t know about bladder cancer symptoms. According to the Bladder Cancer Advocacy Network, women are less likely to pay attention to blood in their pee (hematuria), the first and most important bladder cancer symptom, because they associate blood in pee with common gynecological issues.
Bladder cancer typically affects people age 55 and older. On average, people are 73 when they’re diagnosed with bladder cancer. Men and people DMAB who are white are two times more likely to develop bladder cancer than men and people DMAB who are Black.
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Blood in your pee (urine) is the most common bladder cancer symptom. That said, simply having blood in your pee isn’t a sure sign of bladder cancer. Other conditions cause this issue, too. But you should contact a healthcare provider whenever you spot blood in your pee. Other bladder cancer symptoms include:
Healthcare providers and researchers don’t know exactly why certain bladder cells mutate and become cancerous cells. They’ve identified many different risk factors that may increase your chance of developing bladder cancer, including:
Healthcare providers do a series of tests to diagnose bladder cancer, including:
If urinalysis, cytology and cystoscopy results show you have bladder cancer, healthcare providers then do tests to learn more about the cancer, including:
Healthcare providers then use what they learn about the cancer to stage the disease. Staging cancer helps providers plan treatment and develop a potential prognosis or expected outcome.
Bladder cancer can be either early stage (confined to the lining of your bladder) or invasive (penetrating your bladder wall and possibly spreading to nearby organs or lymph nodes).
The stages range from TA (confined to the internal lining of your bladder) to IV (most invasive). In the earliest stages (TA, T1 or CIS), the cancer is confined to the lining of your bladder or in the connective tissue just below the lining, but hasn’t invaded the main muscle wall of your bladder.
Stages II to IV denote invasive cancer:
A more sophisticated and preferred staging system is TNM, which stands for tumor, node involvement and metastases. In this system:
There are four types of bladder cancer treatment. Providers may use any or all of these treatments and may combine treatments.
Surgery is a common bladder cancer treatment. Providers chose surgical options based on the cancer stage. For example, many times, TURBT, the procedure used to diagnose bladder cancer, can treat bladder cancer that hasn’t spread. Healthcare providers either remove the tumor or use high-energy electricity to burn it away with a process known as fulguration.
Radical cystectomy is another treatment option. This surgery removes your bladder and surrounding organs. It’s done when people have cancer that’s spread outside of their bladder or there are several early-stage tumors throughout their bladder.
In men and people DMAB, this surgery removes prostates and seminal vesicles. In women and people DFMB, providers may remove ovaries, their uterus and part of their vagina. Providers also do surgery known as urinary diversion so people can still pass pee.
Providers may follow surgery with chemotherapy or radiation therapy to kill any cancer cells surgery may have missed. This is adjuvant therapy.
These are cancer-killing drugs. Providers may use intravesical therapy to deliver chemotherapy drugs directly to your bladder via a tube inserted into your urethra. Intravesical therapy targets cancer without damaging healthy tissue.
Immunotherapy is a treatment that uses your immune system to attack cancer cells. There are different types of immunotherapy:
Radiation therapy may be an alternative to surgery. Healthcare providers may combine radiation therapy with TURBT and chemotherapy. This treatment is an alternative to bladder removal surgery. Healthcare providers consider factors such as tumor growth and tumor characteristics before recommending this treatment
Targeted therapy focuses on the genetic changes that turn healthy cells into cancer cells. For example, drugs called FGFR gene inhibitors target cells with gene changes that help cancer cells grow.
The most common warning sign is blood in your pee (urine). You should talk to a healthcare provider anytime you see blood in your pee.
You may not be able to prevent bladder cancer, but it may be helpful to know the risk factors that may increase the chance you’ll develop bladder cancer. Bladder cancer risk factors may include:
Left untreated, bladder cancer may spread to other parts of your body. Cancer that’s metastasized, or spread, may affect how long you’ll live with bladder cancer. Like many types of cancer, early detection and treatment increase the chance of living longer with bladder cancer. According to the National Cancer Institute, 96% of people who received treatment for early-stage cancer were alive five years after diagnosis. Overall, 77% of people with bladder cancer were alive five years after diagnosis.
About half of all people with bladder cancer have early-stage cancer that’s relatively easy to treat. But bladder cancer often comes back (recurs). People who’ve had bladder cancer will need regular checkups after treatment. Being vigilant about follow-up care is one thing you can do to take care of yourself. Here are some other suggestions from the Bladder Cancer Advocacy Network include:
Some people with bladder cancer need surgery that removes their bladder — and their bodies’ natural reservoir for pee. There are three types of urinary diversion surgeries. All three types involve surgically converting part of your intestine to become a passage tube for pee or a reservoir for storing pee.
Urinary diversion may be a challenging lifestyle change. If you’ll need urinary diversion surgery, ask your healthcare provider to explain each surgery type’s advantages and disadvantages. That way, you’ll know what to expect and how to take care of yourself.
If you’ve had bladder cancer treatment, you should contact your healthcare provider any time you have symptoms that could be signs that cancer has come back.
Bladder cancer is relatively rare, so you may not know as much as you’d like about the condition. Here are some questions that may be helpful:
A note from Cleveland Clinic
If you have bladder cancer, it may help to know about half of all people with the condition receive treatment when their tumors are limited to the inner layer of their bladder wall. For them, surgery to remove tumors means they’re cancer-free. But bladder cancer often comes back (recurs). If you’re worried about recurring cancer, talk to your healthcare provider. They’re your best resource for information on risk factors that increase the chance you’ll have another bout of bladder cancer. They’ll help you stay vigilant about symptoms that may be signs of recurring bladder cancer and be there for you if you need more bladder cancer treatment.
Last reviewed by a Cleveland Clinic medical professional on 08/26/2022.
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