What is bladder cancer?

The bladder is an organ that stores urine prior to urination. The bladder has four main layers of tissue. The type of bladder cancer someone is diagnosed with depends on the tissue in which the cancerous cells originate.

What are the types of bladder cancer?

There are three main types: transitional cell carcinoma (90% of bladder cancers), squamous cell carcinoma (4%), and adenocarcinoma (2%). Transitional cell carcinoma (also known as urothelial carcinoma) is the most common type. It originates in the urothelial cells found in the bladder and other parts of the urinary tract. Squamous cell carcinoma originates in the squamous cells, which are thin flat cells in the lining of the bladder. Adenocarcinoma originates in cells that produce mucus in the bladder called glandular cells.

How common is bladder cancer?

Approximately 80,000 people are diagnosed with bladder cancer in the U.S. each year, making it the sixth most common type of cancer. Overall, 1 in 27 men and 1 in 89 women develop bladder cancer in their lifetime. Nine out of ten people are diagnosed over the age of 55, with an average age at diagnosis of 73-years-old.

What are the risk factors?

Smoking is one of the biggest risk factors for bladder cancer, with people who smoke being at least three times as likely to develop bladder cancer as non-smokers. Chemical exposure in the workplace is also linked to increased bladder cancer risk. These include aromatic amines (e.g., the dye industry) and certain organic chemicals (e.g., makers of rubber leather, textiles, paint products, as well as printing processes). Certain medications (e.g., high doses of pioglitazone, a diabetes medicine) and supplements (e.g., those containing aristolochic acid) may also increase risk, as can arsenic exposure in drinking water. Lastly, not drinking enough fluids, as well as chronic bladder irritation and infections, can increase risk.

What are the symptoms?

Blood in the urine and pain during urination are the most common signs of bladder cancer. Other signs include frequent urination, lower back pain, and feeling the need to urinate but not being able to. Advanced bladder cancer may cause additional symptoms such as unexplained appetite and weight loss.

How do people get diagnosed?

A physical exam with health history review is a typical place to start. Next, different tests and procedures are used to help diagnose bladder cancer. Urinalysis tests urine by examining the color and levels of sugar, protein, red blood cells, and white blood cells. Urine can also be tested in the lab for abnormal cells in a process known as urine cytology. Cystoscopy is a procedure in which a cystoscope, a thin tube with a camera, enters the urethra and then the bladder to view the bladder. This instrument may also have a tool to collect a tissue sample for testing.

What is the prognosis?

The prognosis, or the chance a condition will improve or worsen (and how quickly), depends on multiple factors, including the type and stage of the cancer. Has it grown into the bladder wall, reached nearby organs, or spread to lymph nodes or distant organs? Bladder cancer is most often detected in early stages and therefore easier to treat. About 75-80% of people who develop bladder cancer survive five years or more.

What are the treatment options?

Surgery may be used alone to treat bladder cancer or in combination with other types of treatment. Other treatments include radiation therapy, chemotherapy, and biologic therapy. A list of cancer drugs approved by the Food and Drug Administration (FDA) for bladder cancer can be found here.

What can I do to reduce my risks of bladder cancer?

There is no proven way to prevent bladder cancer, but there are measures you can take to reduce your risk. Limiting or stopping tobacco use is one of the best ways to reduce your risk. Avoiding exposure to the chemicals described above and drinking plenty of liquids may lower your risk as well.

Additional resources:

About Bladder Cancer (American Cancer Society)
Cancer Stat Facts: Bladder Cancer (National Cancer Institute)
Guide to Bladder Cancer (Cancer.Net)
Bladder Cancer – Patient Version (National Cancer Institute)
Bladder Cancer (MedlinePlus)