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.
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 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 noninvasive bladder cancer, which is the earliest form and the most common type. Tumors that grow into the muscle layer and bladder wall are considered invasive.
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 cells are less common and tend to be more aggressive.
The early symptoms of bladder cancer can be difficult to recognize, but some symptoms include:
- Blood in urine, which may appear orange, pink or rarely, dark red
- Change in bladder habits such as increased frequency or urgency
- Pain or burning sensation during urination
Blood in the urine is typically the first sign of bladder cancer. It may be present 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.
Diagnosing bladder cancer
If symptoms or lab results suggest 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.
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.
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 treatment plan based on a number of factors, including the type, grade and stage of cancer.