This page was reviewed under our medical and editorial policy by Maurie Markman, MD, President, Medicine & Science
This page was updated on July 20, 2022.
Bladder cancer is the sixth most common cancer in the United States, with more than 80,000 new cases diagnosed each year. It’s more prevalent among men than women—men are four times more likely to develop bladder cancer—and mainly develops in adults older than age 55, according to the American Cancer Society (ACS). Most people are diagnosed around age 73.
At City of Hope, our cancer experts have extensive experience in diagnosing, staging and treating bladder cancer. You may undergo tests such as a cystoscopy, advanced genomic testing, biopsy and/or X-ray to determine the type and extent of the disease. Then, a multidisciplinary team of doctors and other clinicians will work with you to develop a comprehensive treatment plan tailored to your needs and diagnosis, including techniques and strategies designed to help you manage the side effects of the disease and its treatment.
This overview will cover the basic facts about bladder cancer, including:
If you believe you may be experiencing symptoms of bladder cancer and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for bladder cancer, call us or chat online with a member of our team.
The bladder is the organ that collects urine after it’s made in the kidneys. During urination, the bladder tightens, and the urine leaves the bladder through a tube (the urethra) and exits the body. The lining of the bladder (the urothelium) is made of urothelial cells. Ninety percent of bladder cancers develop in urothelial cells. This type of bladder cancer is called transitional cell carcinoma (TCC).
Bladder cancer forms when cells in the bladder start multiplying uncontrollably. These abnormal cells typically develop within the tissue layer lining the inside of the bladder. There are many layers of muscle and tissue that make up the bladder wall, which surrounds the bladder’s inner chamber.
Over time, as these cancerous cells multiply, they grow deeper into the bladder wall. Once they reach the outermost layer of bladder tissue, they may spread to nearby organs or tissues and, eventually, to faraway organs or parts of the body (metastasis).
For roughly half of all bladder cancer patients, a diagnosis is made before the cancer extends beyond the bladder wall’s inner layer, when it’s easier to treat. These are called noninvasive bladder cancers.
Invasive bladder cancers, which have invaded farther into the bladder wall, account for about a third of cases diagnosed. About 4 percent of bladder cancers have reached distant organs by the time they’re diagnosed, according to the ACS.
Genetic changes, or mutations, alter the process by which healthy cells grow, divide and die. When specific mutations occur in genes that control these processes, cells start dividing too fast or surviving longer than intended, and the cells become cancerous.
People may inherit mutations from their parents (inherited mutations) or acquire them over their lifetime (acquired mutations). Some inherited gene changes are known to raise the odds of getting bladder cancer, but most of the gene changes associated with bladder cancer are acquired, not inherited.
While the exact causes of bladder cancer are not always known, the most common risk factors are age and gender. Other risk factors include:
"The most unexpected outcome from this experience is that I like myself better after going through cancer treatment. I am more patient and more caring. I was attentive to the needs of others before, but now I have so much more awareness. Having gone through a time of such need, now I want to be there for others even more. It is strange to say that I’m a better person for having had cancer, but it’s true.
"
Early-stage bladder cancer may not produce symptoms. But as the disease progresses, many symptoms are related to urination. It’s important for patients to make a doctor’s appointment if they experience:
These symptoms may be caused by a problem other than bladder cancer, such as a urinary tract infection, bladder stones or an enlarged prostate.
The most common type of bladder cancer is called urothelial carcinoma, or transitional cell carcinoma. Urothelial carcinoma begins in the inner lining of the bladder, in bladder cells called urothelial cells. Urothelial cells may be found in the bladder’s inner lining and the kidneys, ureters and urethra. Almost all people with bladder cancer have this type. The other, much rarer types of bladder cancer include:
If a patient is experiencing symptoms associated with bladder cancer, and other causes are ruled out, the doctor may recommend other tests. These diagnostic tests may include:
Bladder cancers are split into stages ranging from stage 1 to stage 4 based on how far the cancer has spread. Doctors determine the stage of bladder cancer through various procedures. Many of these tests may be done during the diagnosis process, but additional tests may be necessary.
The treatment for bladder cancer depends largely on its stage. Doctors need to know whether the cancer has spread and, if so, where.
The stage plays a significant role in predicting how well a cancer may respond to treatment. Besides the cancer stage, other factors that play a role in the severity of bladder cancer and how it’s treated include:
Multiple treatment options are used for bladder cancer, and which are appropriate for you depends on the stage and location of the disease. The approach to treating bladder cancer also depends on a patient’s age and healthy history. A multidisciplinary team of cancer experts will recommend treatment options based on each patient’s unique diagnosis, as well as any concerns about side effects and personal preferences. Common treatments for bladder cancer include:
In addition to these treatment options, new therapies are always being studied in clinical trials. Before proceeding with treatment, patients may want to ask their doctor whether enrolling in a clinical trial would be the right approach.
We understand that bladder cancer and other malignancies of the genitourinary tract create unique challenges for patients, and that treatment options are very specific to each disease. That’s why we developed the Genitourinary Cancer Program, led by a multidisciplinary team of board-certified medical, urologic, surgical and radiation oncologists, along with gastroenterologists and interventional radiologists, who collaborate to deliver quality clinical care to bladder cancer patients. Because they all work together under one roof, our team of experts and specialists develop a treatment plan tailored to the unique needs of each patient, communicating regularly and adjusting the treatment plan as necessary.
Many bladder patients experience sexual side effects and urinary incontinence related to their treatment, which may require difficult decisions and conversations. Our Genitourinary Cancer Program team includes specialists who are fellowship-trained in urologic reconstruction, including in the use of prosthetics (i.e., penile prosthesis and artificial urinary sphincters).
As a patient at the Genitourinary Cancer Program, you will also have a range of supportive care providers on your care team to help manage disease- and treatment-related side effects, such as nausea, vomiting, pain and sex and intimacy challenges.
Supportive care therapies that may be recommended to help patients with bladder cancer stay strong and maintain their quality of life include:
