How Common Is Bladder Cancer
The American Cancer Societys estimates for bladder cancer in the United States for 2022 are:
- About 81,180 new cases of bladder cancer
- About 17,100 deaths from bladder cancer
The rates of new bladder cancers and deaths linked to bladder cancer and have been dropping slightly in women in recent years. In men, incidence rates have been decreasing, but death rates have been stable.
Bladder cancer is the fourth most common cancer in men, but it’s less common in women.
Other Causes Of Blood In The Urine
Blood in the urine is common. At any one time, between 1% and 18% of the population will have asymptomatic microscopic hematuria, but only 1.3% of patients with this symptom have bladder cancer. Other causes of hematuria include:
- Some medications , Rifadin , certain blood thinners, laxatives. and chemotherapy drugs
- Bladder and/or kidney infections
Non Muscle Invasive Bladder Cancer
This means the cancer is only in the lining of the bladder. It has not grown into the deeper layers of the bladder wall. There are different types:
Papillary bladder cancer
Non muscle invasive bladder cancer usually appears as small growths, shaped like mushrooms. These grow out of the bladder lining. This is called papillary bladder cancer. Your surgeon can remove these growths and they may never come back.
Carcinoma in situ
Unlike other non muscle invasive bladder cancers, areas of CIS are flat. They do not grow out of the bladder wall. In CIS the cancer cells look very abnormal and are likely to grow quickly. This is called high grade. It is more likely to come back than other types of non muscle invasive bladder cancer.
High grade T1 tumours
T1 tumours are early cancers that have grown from the bladder lining into a layer underneath. This layer is called the lamina propria. High grade T1 tumours are early cancers, but they can grow very quickly.
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Bladder Cancer Risk Factors
A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. You can change some risk factors, like smoking or weight others, like your age or family history, you cant.
But having a risk factor, or even many, does not mean that you will get the disease. Many people with risk factors never get bladder cancer, while others with this disease may have few or no known risk factors.
Still, its important to know about the risk factors for bladder cancer because there may be things you can do that might lower your risk of getting it. If you’re at higher risk because of certain factors, you might be helped by tests that could find it early, when treatment is most likely to be effective.
Many risk factors make a person more likely to develop bladder cancer.
Changes In Bladder Habits Or Symptoms Of Irritation
Bladder cancer can sometimes cause changes in urination, such as:
- Having to urinate more often than usual
- Pain or burning during urination
- Feeling as if you need to go right away, even when your bladder isnât full
- Having trouble urinating or having a weak urine stream
- Having to get up to urinate many times during the night
These symptoms are more likely to be caused by a urinary tract infection , bladder stones, an overactive bladder, or an enlarged prostate . Still, its important to have them checked by a doctor so that the cause can be found and treated, if needed.
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What Is The Most Aggressive Form Of Bladder Cancer
In general, bladder cancers that are muscle invasive and/or have high-grade cells are the most serious and aggressive. The less common types of bladder cancer such as squamous cell carcinoma, adenocarcinoma, and small cell carcinoma have a greater tendency to be muscle invasive compared to urothelial carcinoma. However, if left untreated, initially low-grade, non-muscle invasive urothelial carcinoma can progress into the bladder wall and spread to other parts of the body.
The prognosis for bladder cancer is very favorable when the disease is detected early, so it is important to see your doctor if you are experiencing symptoms that could be due to bladder cancer. The most common early sign of bladder cancer is the presence of blood in the urine . Other symptoms that may be experienced include urinary irritation and changes in bladder habits. For further information regarding the signs and symptoms of bladder cancer, see Bladder Cancer Symptoms.
Risk Of Bladder Cancer
Bladder cancer occurs mainly in older people. About 9 out of 10 people with this cancer are over the age of 55. The average age of people when they are diagnosed is 73.
Overall, the chance men will develop this cancer during their life is about 1 in 27. For women, the chance is about 1 in 89.
Whites are more likely to be diagnosed with bladder cancer than African Americans or Hispanic Americans.
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How Can I Prevent Bladder Cancer
You may not be able to prevent bladder cancer, but it may be helpful to know the risk factors that may increase the chance youll develop bladder cancer. Bladder cancer risk factors may include:
- Smoking cigarettes: Cigarette smoking more than doubles the risk of developing bladder cancer. Smoking pipes and cigars or being exposed to second-hand smoke also increases that risk.
- Cancer treatments: Radiation therapy is the second-most common risk factor. People who have certain chemotherapy drugs may also develop an increased risk of bladder cancer.
- Exposure to certain chemicals: People who work with chemicals, such as aromatic amines , are at an increased risk. Extensive exposure to rubber, leather, some textiles, paint and hairdressing supplies, typically related to occupational exposure, also appears to increase the risk.
- Infections: People who have frequent bladder infections, bladder stones or other urinary tract diseases may have an increased risk of developing bladder cancer.
- Past bladder cancer: People with a previous bladder cancer are at increased risk to form new or recurrent bladder tumors.
Treatment Of Stage Iv Bladder Cancer
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stage IV bladder cancer that has not spread to other parts of the body may include the following:
- Urinary diversion or cystectomy as palliative therapy to relieve symptoms and improve quality of life.
Treatment of stage IV bladder cancer that has spread to other parts of the body, such as the lung, bone, or liver, may include the following:
- External radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
- Urinary diversion or cystectomy as palliative therapy to relieve symptoms and improve quality of life.
- Aclinical trial of new anticancer drugs.
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.
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What Causes Bladder Cancer
Bladder cancer is the tenth most common form of cancer. Each year, it affects over 70,000 Americans and many more worldwide. But what causes bladder cancer, and who is at risk?
The bladder is a muscular, balloon-like organ located in the pelvis. It connects to the kidneys via two long tubes called ureters, which deliver urine to the bladder for storage. When the bladder is full, it releases this urine through another tube called the urethra.
The bladder, ureters, urethra and some other pelvic organs are lined with cells called urothelial cells. Also known as transitional cells, they play a role in immunity and cell-to-cell communication. These cells are the most common site for bladder cancer to develop.
Urothelial carcinomas make up the vast majority of bladder cancer cases. Less common types include squamous-cell carcinomas and adenocarcinomas. Small-cell carcinomas and sarcomas are rare.
Now, lets take a look at some causes of bladder cancer.
What Does Your Bladder Do
Your bladder is part of your urinary system. The job of the urinary system is to filter waste products from your blood and transport the waste products or urine, out of your body. The diagram below shows the organs of the urinary system.
Most of the urinary tract is lined with a special layer of cells called transitional cells. The primary machines in the human filtering system are the two kidneys located close to the backbone and protected by the ribs. The kidneys work independently. They have the significant task of filtering approximately 20% of total blood volume each minute and removing the by-products of digestion and of other body functions.
Once produced, the urine is stored in the central part of the kidney called the renal pelvis. At regular intervals, the renal pelvis contracts and propels the urine through the ureters. These narrow, thin-walled tubes extend from inside the renal pelvis to the bladder. The bladder is a thick-walled structure, consisting of a relatively thin inner layer with a thick muscle covering.
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There Are Different Types Of Treatment For Patients With Bladder Cancer
Different types of treatment are available for patients with bladder cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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.
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Chronic Bladder Irritation And Infections
Urinary infections, kidney and bladder stones, bladder catheters left in place a long time, and other causes of chronic bladder irritation have been linked to bladder cancer . But its not clear if they actually cause bladder cancer.
Schistosomiasis , an infection with a parasitic worm that can get into the bladder, is also a risk factor for bladder cancer. In countries where this parasite is common , squamous cell cancers of the bladder are much more common. This is an extremely rare cause of bladder cancer in the United States.
Other Squamous Cell Carcinoma Risk Factors
Having bladder diverticula may increase an individuals chance of developing SCC. Rarely, bacillus Calmette-Guerin treatment for CIS has been reported to lead to development of SCC. Development of bladder cancer at a younger age has been associated with bladder exstrophy. SCC has also been described in urachal remnants.
Coffee consumption does not increase the risk of developing bladder cancer. Early studies of rodents and a minority of human studies suggested a weak connection between artificial sweeteners and bladder cancer however, most recent studies show no significant correlation.
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Whats Usually The First Symptom Of Bladder Cancer
Blood in your pee is the most common bladder cancer symptom. That said, simply having blood in your pee isnt a sure sign of bladder cancer. Other conditions cause this issue, too. But you should contact a healthcare provider whenever you spot blood in your pee. Other bladder cancer symptoms include:
- Visible blood in your pee : Healthcare providers can also spot microscopic amounts of blood in pee when they do a urinalysis.
- Pain when you pee : This is a burning or stinging sensation that you may feel when you start to pee or after you pee. Men and DMAB may have pain in their penises before or after peeing.
- Needing to pee a lot: Frequent urination means youre peeing many times during a 24-hour period.
- Having trouble peeing: The flow of your pee may start and stop or the flow may not be as strong as usual.
- Persistent bladder infections: Bladder infections and bladder cancer symptoms have common symptoms. Contact your healthcare provider if you have a bladder infection that doesnt go away after treatment with antibiotics.
Symptoms Of Advanced Bladder Cancer In Women
Undiagnosed and untreated bladder cancer may advance, causing additional symptoms. Many of these result from the original tumor getting larger.
As bladder cancer progresses, it penetrates the bladder lining and the surrounding layers of muscle and tissue. If the cancer continues to metastasize , it may also cause symptoms in nearby or faraway organs and tissues.
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Patients May Want To Think About Taking Part In A Clinical Trial
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today’s standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
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.
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Bladder Reconstructions And Stomas
If you have had your bladder removed, the way you pass urine will change. There are several options that your treatment team will talk to you about:
- Urostomy is where doctors create a new hole in your abdomen called a stoma. Urine drains from the stoma to the outside of your abdomen into a special bag.
- Neobladder is where a new bladder made from your small bowel forms a pouch inside your body to store urine. You will pass urine by squeezing your abdominal muscles. You will also pass a small tube into the neobladder each day to help drain the urine.
- Continent urinary diversion is a pouch made from your small bowel inside your body to store urine. The urine empties through a hole called a stoma to the outside of your abdomen into a special bag.
A bladder reconstruction is a big change in your life. You can speak with a continence or stomal therapy nurse for help, support and information. You can also call Cancer Council . You may be able to speak with a trained Cancer Council volunteer who has had cancer for tips and support.
If you find it difficult to adjust after your bladder reconstruction, it may help to be referred to a psychologist or counsellor.
Note: If you have a stoma, you can join a stoma association for support and free supplies. For more information about stoma associations, visit the Australian Council of Stoma Associations.
About The Bladder Renal Pelvis Ureter And Urethra
The bladder is a hollow organ in the pelvis that stores urine before it leaves the body during urination. This function makes the bladder an important part of the urinary tract. The urinary tract is also made up of the kidneys, ureters, and urethra. The renal pelvis is a funnel-like part of the kidney that collects urine and sends it into the ureter. The ureter is a tube that runs from each kidney into the bladder. The urethra is the tube that carries urine out of the body. The prostate gland is also part of the urinary tract.
The bladder, like other parts of the urinary tract, is lined with a layer of cells called the urothelium. This layer of cells is separated from the bladder wall muscles, called the muscularis propria, by a thin, fibrous band called the lamina propria.
Bladder cancer begins when healthy cells in the bladder liningmost commonly urothelial cellschange and grow out of control, forming a mass called a tumor. Urothelial cells also line the renal pelvis and ureters and urethra. Cancer that develops in the renal pelvis and ureters is also considered a type of urothelial cancer and is often called upper tract urothelial cancer. In most cases, it is treated in much the same way as bladder cancer and is described in this guide. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. Benign bladder tumors are very rare.
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