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Cancer is the growth of abnormal cells in the body. These extra cells grow together and form masses, called tumors. In bladder cancer, these growths happen in the bladder.
The bladder is the part of your urinary tract that stores your urine until you are ready to let it out. See a picture of the female urinary system or male urinary system.
Bladder cancer can often be successfully treated if it is found and treated early. And most bladder cancer is found early.
This topic is about the most common type of bladder cancer, called transitional cell cancer. This is cancer that starts in the inner layer of the bladder. It happens most often in people who are in their 60s or older.
Experts don't know what causes bladder cancer. But smoking cigarettes or being exposed to certain chemicals raises your risk. And like other cancers, changes in the DNA of your cells seem to play a role.
Blood in the urine is the main symptom. Other symptoms may include having to urinate often or feeling pain when you urinate.
These symptoms can be caused by other problems, including a urinary tract infection. Always call your doctor if you see blood in your urine.
To diagnose bladder cancer, your doctor will:
Treatment choices for bladder cancer include:
The treatment depends a lot on how much the cancer has grown. Most bladder cancers are treated without having to remove the bladder.
Sometimes doctors do have to remove the bladder. For some people, this means having urine flow into a bag outside of the body. But in many cases, doctors can make a new bladder—using other body tissue—that works very much like the old one.
Bladder cancer often comes back. The new tumors can often be treated successfully if they are caught early. So it's very important to have regular checkups after your treatment is done.
Finding out that you have cancer can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counselor can really help. Ask your doctor about support groups. Or call the American Cancer Society (1-800-227-2345) or visit its website at www.cancer.org.
Anything that increases your chances of getting a disease is called a risk factor. The main risk factors for bladder cancer include:
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The cause of bladder cancer is not known. Changes in the genetic material (DNA) of bladder cells may play a role. Chemicals in the environment and cigarette smoking also may play a role. And when the lining of the bladder is irritated for a long time, cell changes that lead to cancer may occur. Some things that cause this are radiation treatment, having catheters in place for a long time, or having the parasite that causes schistosomiasis.
Bladder cancer is twice as likely to develop in smokers than in nonsmokers. Experts believe that smoking causes about half of all bladder cancers in men and women.footnote 1
Exposure to chemicals and other substances at work—including dyes, paints, leather dust, and others—may also cause bladder cancer.
The most common symptoms of bladder cancer include:
Symptoms that may indicate more advanced bladder cancer include:
Other symptoms that may develop when bladder cancer has spread include:
The symptoms of bladder cancer may be similar to symptoms of other bladder conditions.
Bladder cancer is the rapid, uncontrolled growth of abnormal cells in the bladder. Cancer usually begins in the lining of the bladder. The cancerous cells may spread through the lining into the muscular wall of the bladder.
Invasive bladder cancer may spread to lymph nodes, other organs in the pelvis (causing problems with kidney and bowel function), or other organs in the body, such as the liver and lungs.
Your treatment will depend on how far the cancer has spread.
Most bladder cancer is found early, before it has spread into the bladder wall. Surgery can usually remove these tumors. But bladder cancer often comes back, so you may also get other treatments, such as chemotherapy or immunotherapy, to lower the chances of that happening.
The main risk factors for bladder cancer include:
If you have been diagnosed with bladder cancer, be sure to follow your doctor's instructions about calling when you have problems, new symptoms, or symptoms that get worse.
Call your doctor if you:
If you are concerned about your symptoms or about your risk for bladder cancer, make an appointment with your doctor. Watchful waiting is not appropriate if you have symptoms that do not go away.
Health professionals who can evaluate your symptoms and your risk for bladder cancer include:
Doctors who can manage your cancer treatment include:
To find out whether bladder cancer may be the cause of your urinary symptoms, your doctor will:
You will have a cystoscopy, a test that allows your doctor to look at your bladder with a thin, lighted tube. The doctor can use the same tube to take small tissue samples (biopsies) of any abnormal areas. The samples will be looked at under a microscope to find out whether cancer cells are present and what the cells look like.
Bladder cancer is classified by stage and grade. The stage is determined by the cancer growth in the bladder wall and how far it has spread to nearby tissues and other organs, such as the lungs, the liver, or the bones. The grade of bladder cancer is determined by how the cancer cells look in comparison with normal bladder cells.
Your doctor finds out the stage and grade of your bladder cancer by gathering information from several tests, including:
Knowing the stage and grade of your cancer is important in choosing the right treatments.
Other diagnostic tests that may be done include:
Bladder cancer often comes back, so it's important to have regular checkups. Then, if the cancer does come back, you have a better chance of finding it early enough for successful treatment.
The choice of treatment and the long-term outcome (prognosis) for people who have bladder cancer depend on the stage and grade of cancer. When deciding about your treatment, your doctor also considers your age, overall health, and quality of life.
Bladder cancer has a better chance of being treated successfully if it is found early.
Treatment choices for bladder cancer may include:
There are five stages of bladder cancer, stages 0 to IV:footnote 2
The grade of bladder cancer is usually either low-grade (LG) or high-grade (HG). High-grade tumors tend to grow faster. They are also more likely to spread than low-grade tumors. When your doctor knows the grade of your cancer, this information will help him or her choose the best treatment plan for you.
More information about bladder cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/types/bladder.
After initial treatment for bladder cancer, it is important to receive follow-up care, because bladder cancer often comes back (recurs). Your doctor will set up a regular schedule of checkups and tests.
Bladder cancer may recur in the bladder, or it may spread (metastasize) to other parts of the body. Recurrent bladder cancer may be treated with surgery or chemotherapy to slow cancer growth and relieve symptoms.
Participation in a clinical trial may be recommended if you have been diagnosed with recurrent bladder cancer.
Sexual problems can be caused by physical or psychological factors related to the cancer or its treatment. You may experience less sexual pleasure or lose your desire to be sexually intimate.
Your feelings about your body may change after treatment for cancer. Managing your feelings about your body may involve talking openly about your concerns with your partner and discussing your feelings with your doctor. Your doctor may also be able to refer you to groups that can offer support and information.
Palliative care is a kind of care for people who have a serious illness. It's different from care to cure your illness. Its goal is to improve your quality of life—not just in your body but also in your mind and spirit. You can have this care along with treatment to cure your illness.
Palliative care providers will work to help control pain or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
If you're interested in palliative care, talk to your doctor.
For more information, see the topic Palliative Care.
For some people who have advanced cancer, a time comes when treatment to cure the cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But you can still get treatment to make you as comfortable as possible during the time you have left. You and your doctor can decide when you may be ready for hospice care.
For more information, see the topics:
Bladder cancer cannot be prevented, but you may be able to reduce some of your risk for getting it.
The side effects of bladder cancer treatment can be serious. Healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms. Your doctor may also give you medicines to help you with certain side effects.
You can try home treatments:
Other issues that can be treated at home include:
Having cancer can be very stressful, and it may feel overwhelming to face the challenges in front of you. Finding new ways of coping with the symptoms of stress may improve your overall quality of life.
These ideas may help:
Having cancer can change your life in many ways. For support in managing these changes, see the topic Getting Support When You Have Cancer.
Medicines may be used to control the growth of bladder cancer cells and to relieve symptoms. These medicines may be taken by mouth, injected into a vein (intravenous, or IV), or delivered directly into the bladder using a catheter.
Examples of chemotherapy medicines used for bladder cancer include gemcitabine, mitomycin, and cisplatin.
Side effects of chemotherapy may include:
Some people may need medicines to control nausea and vomiting.
Examples of immunotherapy medicines used for bladder cancer include Bacillus Calmette-Guerin (BCG), nivolumab, and atezolizumab.
Side effects of immunotherapy medicines may include:
Surgery is used to treat most stages of bladder cancer.
The side effects of surgery may include:
Radiation treatment for bladder cancer uses high-energy X-rays to kill cancer cells and shrink tumors. It may be given after surgery. It may be used along with chemotherapy. Sometimes it is used instead of surgery or chemotherapy.
Which treatment you receive will depend on the type and stage of your cancer.
Side effects of radiation may include:
Your doctor may talk to you about joining a research study called a clinical trial if one is available in your area. Clinical trials are research studies to look for ways to improve treatments for bladder cancer. Experts are doing studies on:
For some people with bladder cancer, clinical trials may offer the best treatment available.
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
These mind-body treatments may help you feel better. They can make it easier to cope with treatment. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. They are not meant to take the place of standard medical treatment.
American Cancer Society (2012). Cancer Facts and Figures 2012. Atlanta: American Cancer Society. Available online: http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2012.
National Cancer Institute (2010). What You Need To Know About Bladder Cancer (NIH Publication No. 10-1559). Available online: http://www.cancer.gov/cancertopics/wyntk/bladder.
Other Works Consulted
American Cancer Society (2011). Lasers in cancer treatment. Available online: http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/lasers-in-cancer-treatment.
American Cancer Society (2012). Bladder cancer. Available online: http://www.cancer.org/cancer/bladdercancer/detailedguide/index.
American Joint Committee on Cancer (2010). Urinary bladder. In AJCC Cancer Staging Manual, 7th ed., pp. 497–505. New York: Springer-Verlag.
National Cancer Institute (2012). Bladder Cancer Treatment (PDQ)—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/bladder/healthprofessional.
National Cancer Institute (2012). Bladder Cancer Treatment (PDQ)—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/bladder/patient.
National Cancer Institute (2012). SEER Fact Sheets: Bladder. Bethesda, MD: National Cancer Institute. Available online: http://seer.cancer.gov/statfacts/html/urinb.html.
National Comprehensive Cancer Network (2013). Bladder Cancer. NCCN Clinical Practice Guidelines in Oncology, version 1.2013. Available online: http://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf.
U.S. Preventive Services Task Force (2011). Screening for bladder cancer: Recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf11/bladdercancer/bladcanrs.htm.
Current as ofDecember 19, 2018
Author: Healthwise StaffMedical Review: E. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineChristopher G. Wood, MD, FACS - Urology
Current as of:
December 19, 2018
E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Christopher G. Wood, MD, FACS - Urology
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