What Are The Types Of Bladder Cancer

What Are The Types Of Bladder Cancer

About 90 percent of bladder cancers begin in the cells on the surface of the bladders inner lining. This type of cancer is called urothelial carcinoma . Most urothelial carcinoma is non-muscle invasive. That means the cancer stays within the bladders inner lining. Less common types of bladder cancer include squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. These types can develop in the inner lining as a result of chronic irritation and inflammation. They usually grow into the muscle of the bladder over time.

Other Terms Often Used To Describe Bladder Cancer

Although bladder cancer types are assigned based on the cells that the cancer originates from, several other terms may be used to describe the disease.

• Advanced bladder cancer is another term that may be used to describe metastatic bladder cancer. It means that the cancer has spread to distant parts of the body such as the lungs, bones, liver, or lymph nodes outside the pelvis.
• Locally advanced bladder cancer refers to cancer that has grown through the bladder wall, and possibly into nearby lymph nodes or organs, but has not spread to distant sites in the body.
• Bladder cancer stage describes where the cancer is located within the bladder and any sites of spread. As described above, the TNM staging system assigns a patients bladder cancer to a tumor , lymph node and metastasis category. These categories may also be combined to give an overall stage number: an overall stage of 0 or 1 describes early disease, while stage 4 is the most advanced. For further information regarding staging, see Bladder Cancer Stages.
• Bladder cancer grade is based on the microscopic appearance of cancer cells and suggests how fast a cancer might grow. Low-grade cancer cells appear similar to normal cells and usually grow slowly, whereas high-grade cancer cells have a very abnormal appearance and tend to grow quickly. High-grade cancers are more likely than low-grade cancers to spread.

The Camp Lejeune Justice Act & Bladder Cancer Lawsuits

The Biden Administration recently passed a law called the Camp Lejeune Justice Act of 2022, which offers protections and benefits to veterans affected by Camp Lejeune water.

This act is part of a larger act called the Honoring our Promise to Address Comprehensive Toxics Act .

It is because of these acts that veterans and their family members are now able to file Camp Lejeune claims and lawsuits for bladder cancer and other illnesses, even though the toxic exposure occurred many years ago.

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How Do Healthcare Providers Diagnose Bladder Cancer

Healthcare providers do a series of tests to diagnose bladder cancer, including:

• Urinalysis: Providers use a variety of tests to analyze your pee. In this case, they may do urinalysis to rule out infection.
• Cytology: Providers examine cells under a microscope for signs of cancer.
• Cystoscopy: This is the primary test to identify and diagnose bladder cancer. For this test, providers use a pencil-sized lighted tube called a cystoscope to view the inside of your bladder and urethra. They may use a fluorescent dye and a special blue light that makes it easier to see cancer in your bladder. Providers may also take tissue samples while doing cystoscopies.

If urinalysis, cytology and cystoscopy results show you have bladder cancer, healthcare providers then do tests to learn more about the cancer, including:

Healthcare providers then use what they learn about the cancer to stage the disease. Staging cancer helps providers plan treatment and develop a potential prognosis or expected outcome.

Bladder cancer can be either early stage or invasive .

The stages range from TA to IV . In the earliest stages , the cancer is confined to the lining of your bladder or in the connective tissue just below the lining, but hasnt invaded the main muscle wall of your bladder.

Stages II to IV denote invasive cancer:

A more sophisticated and preferred staging system is TNM, which stands for tumor, node involvement and metastases. In this system:

Squamous Cell Bladder Cancer

About 5 out of every 100 bladder cancers are squamous cell cancers. It is usually invasive.

Squamous cells are flat cells that make up the moist, skin-like tissues that line your body organs. This type of bladder cancer develops from these cells.

It is more common in some parts of the world, including Africa and Asia. This is because an infection called bilharzia increases the risk of squamous cell bladder cancer. Bilharzia is caused by a parasitic worm that lives in fresh water in some parts of the world. But this parasitic infection is extremely rare in the UK.

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Five Types Of Standard Treatment Are Used:

Surgery

One of the following types of surgery may be done:

• Transurethral resection with fulguration: Surgery in which a cystoscope is inserted into the bladder through the urethra.A tool with a small wire loop on the end is then used to remove thecancer or to burn the tumor away with high-energy electricity. This is known as fulguration.
• Radical cystectomy: Surgery to remove the bladder and anylymph nodes and nearby organs that contain cancer. This surgery may bedone when the bladder cancer invades the muscle wall, or when superficialcancer involves a large part of the bladder. In men, the nearby organs that areremoved are the prostate and the seminal vesicles. In women, the uterus, theovaries, and part of the are removed. Sometimes, when the cancer hasspread outside the bladder and cannot be completely removed, surgery to removeonly the bladder may be done to reduce urinarysymptoms caused by the cancer.When the bladder must be removed, the surgeon creates another way for urine toleave the body.
• Partial cystectomy: Surgery to remove part of thebladder. This surgery may be done for patients who have a low-grade tumor thathas invaded the wall of the bladder but is limited to one area of the bladder.Because only a part of the bladder is removed, patients are able to urinate normally afterrecovering from this surgery. This is also called segmental cystectomy.
• Urinary diversion: Surgery to make a new way forthe body to store and pass urine.

Radiation therapy

Chemotherapy

What Is My Bladder Tumors Grade

Malignant tumors are classified as either low grade or high grade.

• Low-grade tumors grow slowly, and rarely invade other tissues or spread to other parts of the body.
• High-grade tumors are more likely to recur and may become invasive. These tumors contain cells that grow abnormally, and can invade other tissues and spread to other parts of the body.

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Treatment Of Stages Ii And Iii Bladder Cancer

For information about the treatments listed below, see the Treatment Option Overview section.

• Transurethral resection with fulguration.
• A clinical trial of a new treatment.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

What Is My Bladder Tumors Shape

The shape of your tumor and whether or not it is invasive can tell your doctor how serious your bladder cancer is and the best way to remove it.

• Flat tumors are flat, superficial, spreading tumors. These tumors are often more difficult to treat.
• Papillary tumors have long, finger-like projections that stretch out from the bladder wall toward your bladders interior.

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What Other Types Of Bladder Cancer Are There

Several less common types of bladder cancer make up the remaining approximately 10% of bladder cancers. Some examples of the uncommon types include:

• Squamous cell carcinoma: Squamous cells develop in the lining of the bladder as a result of irritation or inflammation. These cells may eventually become cancerous. Although squamous cell carcinoma is uncommon, making up around 4% of all bladder cancers,2 it has a high likelihood of progression.
• Adenocarcinoma: This type of bladder cancer consists of glandular-type cells and is usually invasive. Overall, around 2% of bladder cancers are adenocarcinomas.2
• Small cell carcinoma: Small cell carcinomas of the bladder start in nerve-like cells. This bladder cancer type is rare, accounting for less than 1% of bladder cancers,4 but can grow rapidly and spread to other parts of the body.
• Sarcoma: A sarcoma is a type of cancer that begins in the bodys supporting tissues, such as bone, muscle, fibrous tissues, and fat. Very rarely, sarcomas may arise from the muscle or fat layers of the bladder.

Although the treatment for most bladder cancer types is similar for early-stage tumors, different drugs may be used if chemotherapy is undertaken.

Smoking Can Affect The Risk Of Bladder Cancer

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk to your doctor if you think you may be at risk for bladder cancer.

Risk factors for bladder cancer include the following:

• Using tobacco, especially smoking cigarettes.
• Having a family history of bladder cancer.
• Having certain changes in the genes that are linked to bladder cancer.
• Being exposed to paints, dyes, metals, or petroleum products in the workplace.
• Past treatment with radiation therapy to the pelvis or with certain anticancer drugs, such as cyclophosphamide or ifosfamide.
• Taking Aristolochia fangchi, a Chinese herb.
• Drinking water from a well that has high levels of arsenic.
• Drinking water that has been treated with chlorine.
• Having a history of bladder infections, including bladder infections caused by Schistosoma haematobium.
• Using urinarycatheters for a long time.

Older age is a risk factor for most cancers. The chance of getting cancer increases as you get older.

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What Are The Risk Factors For Bladder Cancer

Tobacco use is by far the biggest risk factor for developing bladder cancer. People who smoke cigarettes are up to four times more likely than nonsmokers to develop the disease. Studies have shown that smoking is responsible for approximately 50 percent of bladder cancers.

People who work in the textile, dye, rubber, leather, paint, or printing industries may also be at an increased risk of bladder cancer.

Damages In Camp Lejeune Cancer Claims

Camp Lejeune cases can be incredibly complex, and those who got sick may receive several different types of damages .

Types of Camp Lejeune bladder cancer damages may include:

• Loss of current or future income
• Medical expenses
• Pain and suffering

Bladder cancer is more treatable than some other types of cancer, so wrongful death claims are less common with this type of cancer.

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How Is Bladder Cancer Diagnosed

Doctors use several tests to diagnose bladder cancer. One common method is a cystoscopy. In this procedure, a small tube with a camera is inserted into the urethra and slowly moved into the bladder.A doctor can then examine the lining and take a sample, called a biopsy.Another method is a urine cytology. This test analyzes a urine sample to see if it contains tumor cells. Doctors also use a variety of imaging tests to examine the urinary tract.

Occurrence In The United States

The American Cancer Society estimates that 81,180 new cases of bladder cancer will be diagnosed in the United States in 2022 and that 17,100 people will die of the disease. The incidence of bladder cancer increases with age, with the median age at diagnosis being 73 years bladder cancer is rarely diagnosed before age 40 years.

Bladder cancer is about 4 times more common in men than in women. The male predominance in bladder cancer in the United States reflects the prevalence of transitional cell carcinoma . With small cell carcinomain contrast to TCCthe male-to-female incidence ratio is 1:2.

Bladder cancer is the fourth most common cancer in men in the United States, after prostate, lung, and colorectal cancer, but it is not among the top 10 cancers in women. Accordingly, more men than women are expected to die of bladder cancer in 2022, with 12,120 deaths in men versus 4980 in women. Nevertheless, women generally have a worse prognosis than men.

The incidence of bladder cancer is twice as high in White men as in Black men in the United States. However, Blacks have a worse prognosis than Whites.

Limited data indicate that small cell carcinoma of the urinary bladder probably has the same epidemiologic characteristics as urothelial carcinoma. Patients are more likely to be male and older than 50 years.

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Rare Forms Of Bladder Cancer

Adenocarcinomas account for less than 2% of primary bladder tumors. These lesions are observed most commonly in exstrophic bladders and are often associated with malignant degeneration of a persistent urachal remnant.

Other rare forms of bladder cancer include leiomyosarcoma, rhabdosarcoma, carcinosarcoma, lymphoma, and small cell carcinoma. Leiomyosarcoma is the most common sarcoma of the bladder. Rhabdomyosarcomas most commonly occur in children. Carcinosarcomas are highly malignant tumors that contain a combination of mesenchymal and epithelial elements. Primary bladder lymphomas arise in the submucosa of the bladder. Except for lymphomas, all these rare bladder cancers carry a poor prognosis.

Small cell carcinoma of the urinary bladder is a poorly differentiated, malignant neoplasm that originates from urothelial stem cells and has variable expression of neuroendocrine markers. Morphologically, it shares features of small cell carcinoma of other organs, including the lung.

Cancer That Has Spread To The Bladder

Sometimes cancer that has started elsewhere in the body can spread to the bladder. This can happen with prostate, rectum, ovary, cervix and womb cancer for example.

Cancers that have spread from somewhere else in the body are called secondary cancers. The cancer cells are the same type as the first cancer. So is the treatment.

If you have cancer that has spread to the bladder, you need to go to the section about your primary cancer.

• Cancer and Its Management J Tobias and D HochhauserWiley Blackwell, 2015

• A M Kamat and othersThe Lancet, 2016. Volume 388, Pages 276 -2810

• AJCC Cancer Staging Manuel American Joint Committee on CancerSpringer, 2017

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Other Ways Of Describing Bladder Cancer

In addition to its cell type, bladder cancer may be described as noninvasive, non-muscle-invasive, or muscle-invasive.

• Noninvasive. Noninvasive bladder cancer includes noninvasive papillary carcinoma and carcinoma in situ . Noninvasive papillary carcinoma is a growth found on a small section of tissue that is easily removed. This is called stage Ta. CIS is cancer that is found only on or near the surface of the bladder, which is called stage Tis. See Stages and Grades for more information.

• Non-muscle-invasive. Non-muscle-invasive bladder cancer typically has only grown into the lamina propria and not into muscle, also called stage I. Non-muscle-invasive cancer may also be called superficial cancer, although this term is being used less often because it may incorrectly suggest that the cancer is not serious.

• Muscle-invasive. Muscle-invasive bladder cancer has grown into the muscle of the bladder wall and sometimes into the fatty layers or surrounding tissues or organs outside the bladder.

It is important to note that non-muscle-invasive bladder cancer has the potential of spreading into the bladder muscle or to other parts of the body. Additionally, all cell types of bladder cancer can spread beyond the bladder to other areas of the body through a process known as metastasis.

Patient Stories & Blog

We are very grateful to everyone who has shared their story with us on this website. We know that many people find reading the story of other patients very helpful when trying to make sense of their diagnosis or cancer journey. We also know that these stories can be very powerful in helping to raise awareness of bladder cancer and highlight the urgent need for new treatments, research and support for those with bladder cancer.

If you would like to tell your story please do get in touch with us by email at

We can arrange for one of our Patient Support Officers to get in touch to help you tell your story, if that would be helpful, and we also have a hints and tips sheet to give you more ideas about what to write.

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Treating Stage I Bladder Cancer

Stage I bladder cancers have grown into the connective tissue layer of the bladder wall , but have not reached the muscle layer.

Transurethral resection with fulguration is usually the first treatment for these cancers. But it’s done to help determine the extent of the cancer rather than to try to cure it. If no other treatment is given, many people will later get a new bladder cancer, which often will be more advanced. This is more likely to happen if the first cancer is high-grade .

Even if the cancer is found to be low grade , a second TURBT is often recommended several weeks later. If the doctor then feels that all of the cancer has been removed, intravesical BCG or intravesical chemo is usually given. If all of the cancer wasn’t removed, options are intravesical BCG or cystectomy .

If the cancer is high grade, if many tumors are present, or if the tumor is very large when it’s first found, radical cystectomy may be recommended.

For people who arent healthy enough for a cystectomy, radiation therapy might be an option, but the chances for cure are not as good.

Stage Iv Bladder Cancer

Stage IV cancer is the most advanced form of bladder cancer. It is called metastatic. This means the cancer has spread to distant lymph nodes or organs. Cancers that have spread beyond the bladder into the wall of the abdomen or pelvis are also considered Stage IV. Stage IV cancer is usually treated with chemotherapy and, more recently, with immunotherapy as well.

People with bladder cancer of all stages may be able to participate in a clinical trial. Clinical trials are research studies that test new treatments to see how well they work.

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