Bladder cancer is a type of cancer that occurs when cells in the bladder become abnormal and grow out of control.
Warning signs of bladder cancer include:
- Blood in the urine (hematuria)
- Bladder irritation
- Urinary frequency
- Changes in bladder habits
- Pain or burning during urination
- Feeling as if you need to urinate immediately, even when the bladder isn't full
- Difficulty urinating or having a weak urine stream
- Urinating multiple times during the night (nocturia)
Many of the symptoms above are more likely to be caused by something other than bladder cancer, but it’s important to see a doctor for a proper diagnosis.
When bladder cancer is advanced and has grown large or spread (metastasized) to other parts of the body, symptoms may include:
- Inability to urinate
- Lower back pain on one side
- Loss of appetite
- Tiredness
- Weakness
- Swelling in the feet
- Weight loss
- Bone pain
What Causes Bladder Cancer?
It is unknown what causes most cases of bladder cancer, but genetic changes are thought to play a role.
Risk factors for developing bladder cancer include:
- Smoking
- The main risk factor for bladder cancer
- Accounts for about half of all bladder cancers in both men and women
- Certain medicines or herbal supplements
- Pioglitazone (Actos), used to treat diabetes
- Dietary supplements containing aristolochic acid (mainly in herbs from the Aristolochia family)
- Workplace exposures to certain chemicals
- Painters, machinists, printers, hairdressers (exposure to hair dyes), and truck drivers (exposure to diesel fumes)
- Makers of rubber, leather, textiles, paint products, and printing companies
- Aromatic amines, such as benzidine and beta-naphthylamine, sometimes used in the dye industry
- Not drinking enough fluids
- Gender
- More common in men than in women
- Age
- About 90% of people who develop bladder cancer are over 55 years
- Race and ethnicity
- Whites are two times more likely to develop bladder cancer than African Americans and Hispanics
- Chronic bladder irritation and infections
- Urinary infections (UTIs), kidney and bladder stones, bladder catheters left in place a long time, and other causes of chronic bladder irritation
- Schistosomiasis (bilharziasis), parasitic worm infection that can get into the bladder
- More common in Africa and the Middle East; rare in the U.S.
- Personal history of bladder or other urothelial cancer
- Bladder birth defects
- Genetics and family history
- Chemotherapy or radiation therapy
- Chemotherapy drug cyclophosphamide (Cytoxan)
- Radiation to the pelvis
- Arsenic in drinking water
- Not a significant problem in the U.S. but may be in other parts of the world
How Is Bladder Cancer Diagnosed?
Bladder cancer is diagnosed with a physical examination which may involve a digital rectal exam (DRE) and in women, a pelvic exam.
Tests used to diagnose or rule out bladder cancer include:
- Urine tests
- Urinalysis
- Urine cytology
- Urine culture
- Urine tumor marker tests
- Cystoscopy
- Biopsy using transurethral resection of bladder tumor (TURBT)
- Imaging tests
- Intravenous pyelogram (IVP)
- Retrograde pyelogram
- Computed tomography (CT) scans
- Magnetic resonance imaging (MRI) scans
- Ultrasound
- Chest X-ray
- Bone scan
What Is the Treatment for Bladder Cancer?
Treatment for bladder cancer may involve one or more of the following:
- Bladder cancer surgery
- Transurethral resection of bladder tumor (TURBT) or a transurethral resection (TUR) is the most common treatment for early-stage or superficial (non-muscle invasive) bladder cancers
- Surgical removal of all or part of the bladder (radical or partial cystectomy) is used for invasive bladder cancer
- Reconstructive surgery after radical cystectomy
- If the entire bladder is removed, patients need another way to store urine and pass it out of the body
- Intravesical therapy in which a liquid drug is administered into the bladder
- Chemotherapy
- Radiation therapy
- Immunotherapy
- Monoclonal antibodies
- Targeted therapy drugs
