What is Bladder Cancer? Types, Symptoms, and Treatment

Bladder cancer occurs when cells in the bladder begin to grow uncontrollably. The bladder is a hollow, balloon-like organ located in the lower abdomen. It sits between the hip bones, just above the urethra and beneath the kidneys, and its main job is to store urine.

Urine from the kidneys flows into the bladder, which is lined with a special tissue called urothelium. This lining is made of stretchy cells that expand as the bladder fills and shrink back when it’s empty. On average, the bladder can hold about two cups of urine.

Bladder cancer develops when some of the cells in the lining of the bladder change or mutate, becoming abnormal and growing uncontrollably. These cells can form tumors inside the bladder. If not treated, the cancer can spread beyond the bladder wall to nearby lymph nodes and eventually to other parts of the body, like the bones, lungs, or liver.

Types of Bladder Cancer

Bladder cancer comes in several types, each named after the specific cell type in the bladder wall where the cancer originates. The main types include:

• Transitional cell carcinoma (also known as urothelial carcinoma): This is the most common form, making up about 90% of all bladder cancers. It begins in the transitional cells that line the inside of the bladder. As it progresses, the cancer can grow into deeper layers of the bladder wall and even spread into the surrounding fatty tissue.
• Squamous cell carcinoma: This type of cancer originates in the thin, flat squamous cells that line the bladder. It accounts for around 5% of bladder cancers and usually develops in people who’ve experienced long-term bladder irritation or inflammation.
• Adenocarcinoma: This rare type of bladder cancer begins in the glandular cells of the bladder and makes up about 1% to 2% of all bladder cancer cases.
• Small cell carcinoma: An extremely rare form, this cancer affects approximately 1,000 people in the U.S. It originates in neuroendocrine cells, which release hormones into the bloodstream in response to signals from the nervous system.
• Sarcoma: Also rare, sarcoma starts in the muscle or connective tissue of the bladder wall.

Healthcare providers also classify bladder cancer based on how deeply it invades the bladder:

• Noninvasive bladder cancer remains on or near the surface and hasn’t grown into deeper layers.
• Non-muscle-invasive bladder cancer spreads below the surface but hasn’t reached the muscle layer.
• Muscle-invasive bladder cancer grows into the muscle wall and may extend into surrounding fat or nearby organs.

Symptoms of Bladder Cancer

Some changes you may encounter in your body are symptoms. Signs are changes in a measurable aspect, such as your blood pressure or the results of a lab test. The symptoms and signs that a person experiences can help diagnose a medical problem. Sometimes, people with bladder cancer don’t have any symptoms or signs.

• Blood or blood clots in the urine.
• Pain or burning during urination.
• Frequent urination.
• Not being able to urinate when you feel/want to.
• Low back pain on one side of the body.

Causes of Bladder Cancer

Bladder cancer begins when the cells in the bladder develop changes (mutations) in their DNA. DNA contains the instructions required for a cell to carry out its functions. The differences signal the cell to multiply rapidly and continue living, whereas healthy cells would normally die. Instead, the abnormal cells form a tumor that can invade and damage normal body tissue. Over time, the abnormal cells may break away and spread, or metastasize, throughout the body.

Risk Factors of Bladder Cancer

• Smoking: Cigarettes, cigars, or pipes may increase the risk of bladder cancer by causing harmful chemicals to accumulate in the urine. This can lead to cancer development. In addition, smoking produces chemicals in the smoke that your body processes and then eliminates through your urine. These harmful chemicals may damage the bladder lining, increasing cancer risk.
• Exposed to certain chemicals: Your kidneys help filter harmful chemicals from your bloodstream and move them into your bladder. As a result, some people believe that being around certain chemicals may increase the risk of bladder cancer. Chemicals linked to an increased risk of bladder cancer include arsenic and those used in the production of dyes, rubber, leather, textiles, and paint products.
• Chronic Bladder Inflammation: Chronic or repeated urinary infections or inflammations (cystitis), which might be caused by long-term use of a urinary catheter, may increase the risk of squamous cell bladder cancer. In some parts of the world, squamous cell carcinoma is often linked to chronic bladder inflammation caused by Schistosoma infection.
• Previous treatment for cancer: Treatment with the anticancer drug cyclophosphamide increases the risk of bladder cancer. In addition, people who have received radiation therapy directed to the pelvis for previous cancer have a higher risk of developing bladder cancer.
• Family history with cancer: If you’ve had bladder cancer, you’re more likely to get it again. If one of your blood relatives, such as a parent, sibling, or child, has a history of bladder cancer, you may be at an increased risk of the disease, although bladder cancer rarely runs in families.

Prevention of Bladder Cancer

Although there is no guaranteed way to prevent bladder cancer, there are some steps you can take to reduce your risk. Don’t smoke cigarettes. If you smoke, talk to your doctor about a plan to help you quit smoking. Support groups, medications, and other methods may help you successfully quit smoking. Second, take care when handling chemicals. If you work with them, follow all safety instructions to avoid exposure. Third, add various fruits and vegetables to get a healthy and balanced diet. Choose a diet that includes a variety of colorful fruits and vegetables. The antioxidants found in fruits and vegetables may help reduce your cancer risk.

Treatment for Bladder Cancer

There are many different treatment options for bladder cancer, depending on the type of cancer, the tumour’s grade, and the cancer stage. Treatment options may also depend on your overall health and your preferences.

• Surgery to remove the cancer cells
• Chemotherapy in the bladder (intravesical chemotherapy) is used to treat cancers that are limited to the lining of the bladder but have a high risk of coming back or progressing to a later stage
• Radiation therapy destroys cancer cells and is a treatment procedure used when surgery is not desired.
• Immunotherapy can help the body boost its immune system to fight cancer cells.
• Targeted therapy treats advanced cancer when other treatments haven’t worked.

Frequently Asked Questions