Bladder Cancer - Summary, Symptoms & Treatments

What is bladder cancer?

Bladder cancer begins in the cells of the bladder, the organ responsible for storing urine. There are different types of bladder cancer, but the most common is urothelial carcinoma, which typically starts in the urothelial cells that line the inside of the bladder. It is sometimes known as transitional cell carcinoma.
 
Other types of bladder cancer include squamous cell carcinoma, which develops in the thin, flat cells lining the bladder and is often associated with chronic irritation and infection. Adenocarcinoma is a rare form that starts in the glandular cells of the bladder. The majority of bladder cancers are diagnosed in adults over age 55. In the U.S., men are three to four times more likely to develop bladder cancer than women.

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What are the signs and symptoms of bladder cancer?

There can be several warning signs of bladder cancer. The most common signs and symptoms include:
 

• Hematuria: Blood in the urine, which may cause the urine to appear bright red or cola-colored. Sometimes the blood is not visible and is only detected through a urine test.
• Frequent urination: An increased need to urinate more often than usual
• Painful urination: Discomfort or pain while urinating.
• Urgent need to urinate: A strong and sudden urge to urinate, even when the bladder is not full
• Pelvic pain: Discomfort or pain in the pelvic area
• Back pain: Pain in the lower back or sides
• Urinary incontinence: Loss of bladder control, leading to involuntary leakage of urine
• Unintended weight loss: Losing weight without trying
• Fatigue: Feeling unusually tired or weak

These symptoms can also indicate other non-cancerous conditions, such as urinary tract infections or bladder stones. See your medical doctor if you experience any of these symptoms.

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How is bladder cancer diagnosed?

Diagnosing bladder cancer begins with a physical examination so that your doctor can evaluate the symptoms you are experiencing and discuss your health history. Additional testing can include urine tests to check for blood, infection and other abnormalities. CT scans, ultrasound, MRI and other imagining tests can help also identify tumors or blockages.
 
A cystoscopy involves inserting a thin, lighted tube (cystoscope) through the urethra into the bladder to directly visualize the inside of the bladder. If any abnormal areas are seen, a small sample of tissue (known as a biopsy) can be taken during this procedure for examination under a microscope. A biopsy is the definitive test for diagnosing bladder cancer and determining its type and grade.

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What causes bladder cancer?

Several factors can increase the risk of developing bladder cancer:
 

• Smoking is the most significant risk factor. Tobacco contains harmful chemicals that, when excreted in urine, can damage the lining of the bladder.
• Exposure to certain industrial chemicals, such as those used in dye, rubber, leather, textiles and paint industries
• Chronic bladder conditions, such as infections and long-term use of urinary catheters
• Previous radiation treatments to the pelvis
• Certain chemotherapy drugs, such as cyclophosphamide
• Drinking water that contains high levels of arsenic
• A diet high in certain fats or lacking in fruits and vegetables
• Individuals who have had bladder cancer before are at a higher risk of recurrence.

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Is bladder cancer genetic?

A family history of bladder cancer can increase the risk, although inherited genetic mutations play a smaller role in bladder cancer compared to other cancers. It is best to talk with your doctor regarding any genetic predisposition.
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Is bladder cancer curable?

Bladder cancer can be treatable and potentially curable, especially if it is detected early. The prognosis and treatment options depend on several factors, including the stage and grade of the cancer, the patient’s overall health and how well the cancer responds to treatment. Regular follow-up is crucial as bladder cancer has a high recurrence rate, even after successful treatment.
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How is bladder cancer treated at FCS?

Each patient and each cancer is unique. At FCS, physicians develop a personalized treatment plan in partnership with patients. Treatment options for bladder cancer depend on a number of factors, including the specific type and stage of cancer, possible side effects, and the patient’s overall health and personal preference.
Common treatment options include:
 

• Surgery to remove the tumor from the bladder or to remove part or all of the bladder.
  Chemotherapy to deliver drugs directly in into the bladder or the bloodstream to shrink or kill cancerous tumors.

• A common form of immunotherapy, Bacillus Calmette-Guerin (BCG), which stimulates the body’s own immune system to attack cancer cells in the bladder.
• For patients with unresectable bladder cancer or in patients who are not surgical candidates, systemic chemotherapy, immunotherapy and antibody drug conjugates are the primary treatments used.
• Other treatments can include radiation therapy or the use of drugs that target specific mutations or proteins in cancer cells. Participation in clinical trials for new therapies or combinations of treatments can be an option, especially for advanced stages of cancer.

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What are common risk factors for bladder cancer?

The majority of bladder cancers are diagnosed in adults over age 55. In the U.S., men are three to four times more likely to develop bladder cancer than women.
 
Common risk factors for bladder cancer include:
 

• Smoking, which is the most significant risk factor. Chemicals in tobacco smoke are excreted in urine and can damage the lining of the bladder.
• Prolonged exposure to certain industrial chemicals used in dye, rubber, leather, textiles and paint products. People who work in these industries may be at higher risk.
• Long-term inflammation of the bladder, such as from infections or from long-term use of urinary catheters
• A personal history of bladder cancer or a family history of the disease
• Prior treatment with certain anticancer drugs (like cyclophosphamide) and radiation therapy to the pelvis
• Long-term exposure to drinking water containing arsenic
• A diet high in fried meats and fat
• These factors can vary in significance from person to person; having one or more risk factors does not mean an individual will definitely develop bladder cancer.

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Are there screening tests for bladder cancer?

There are routine screening tests for bladder cancer, especially for individuals at high risk. However, bladder cancer is not typically screened for in the general population without symptoms due to the lack of evidence showing it improves outcomes. For those at high risk, such as individuals with a history of smoking, occupational exposure to certain chemicals or a family history of bladder cancer, screening tests might be recommended by your doctor.
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What are the 5 warning signs of bladder cancer?

Bladder cancer can have various symptoms. Here are five common warning signs:
 

1. Blood in the urine (hematuria) may cause the urine to appear red or cola-colored, or it might be detectable only under a microscope.
2. Needing to urinate more often than usual
3. Experiencing pain or a burning sensation during urination
4. Feeling a strong need to urinate even when the bladder isn’t full
5. Pain in the pelvic area or lower back can occur, especially in advanced stages of bladder cancer.

If you or someone you know is experiencing these symptoms, it is important to consult a healthcare provider for a complete evaluation.

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Is bladder cancer hereditary?

Bladder cancer is generally not considered a hereditary disease, meaning it is not typically passed down from parent to child through genes. Most cases of bladder cancer are linked to environmental and lifestyle factors, such as smoking, exposure to certain chemicals and chronic bladder irritation. However, there are some rare genetic conditions that can increase the risk of bladder cancer. While having a family history of bladder cancer might slightly increase one’s risk, the majority of cases are not directly linked to inherited genetic mutations. It is always a good idea to discuss your family medical history with a healthcare provider, who can assess your individual risk factors and recommend appropriate screening and preventive measures.
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