A Guide to Bladder Cancer

Table of Contents

What is the bladder?

The bladder is a hollow, balloon-shaped organ in the pelvis that stores urine. Urine is made by the kidneys, stored in the bladder and then released through the urethra when you urinate.

The bladder is made up of smooth muscle tissue — which has no nerve endings — and connective tissue known as fascia, which connects muscles and other tissues together. The bladder wall contains layers of muscle with nerves running between them and through it from front to back. This allows for normal bladder function and sensation.

The bladder also has specialized nerve endings called proprioceptors. These receptors help the bladder tell your brain when it’s full so that you can urinate when you need to or want to — especially if you’re holding your urine for an extended period of time (for example, during pregnancy).

When these receptors are damaged or destroyed, it can cause overactive bladder syndrome (OAB), which causes urgency and frequency problems with urination.

What is bladder cancer?

Bladder cancer is a disease in which malignant (cancer) cells develop in the bladder. Bladder cancer can begin as a small, non-invasive group of cells (small cell carcinoma) or it can spread to other areas of the body and become more aggressive (non-small cell carcinoma).

The bladder is a hollow organ located between the pubic bone and tail bone. It collects urine from your kidneys, passes it through the ureters and empties it through the urethra. The muscle tissue that makes up the walls of your bladder acts as a barrier to keep urine from leaking out into your abdomen.

Bladder cancer can occur anywhere within your bladder, but most often occurs on one side or at one end of your bladder.

Cancerous tumors start when cells in your body begin to grow out of control. This growth can form a mass called a tumor. Tumors may remain small for many years without causing problems or symptoms until they start to interfere with normal body functions or cause discomfort.

What causes bladder cancer?

In the past, bladder cancer was most often associated with smoking. This is because tobacco smoke contains many substances that are known to cause cancer. Today, most people who develop bladder cancer are non-smokers or ex-smokers.

Although tobacco smoking is no longer the most common risk factor for bladder cancer, it still accounts for a significant proportion of cases. Smoking can increase your risk of developing bladder cancer by up to six times.

The chemicals in cigarette smoke damage the cells lining the bladder through a process called oxidative stress, which occurs when there’s an imbalance between free radicals (unstable molecules) and antioxidants (molecules that protect the body from free radicals). Oxidative stress can also lead to DNA damage.

How can I prevent bladder cancer?

The best way to prevent bladder cancer is to avoid things that can increase your risk for the disease. You may be able to lower your risk for bladder cancer by avoiding certain risk factors and making lifestyle changes, such as quitting smoking, reducing alcohol consumption and maintaining a healthy weight.

Here are some tips for preventing bladder cancer:

Quit smoking. Smoking doubles your risk of bladder cancer. If you currently smoke, talk with your doctor about ways to quit. If you have tried but failed in the past, consider enrolling in a smoking cessation program or therapy to help you stop.

Limit alcohol consumption. Drinking moderate amounts of alcohol — one drink a day for women and two drinks a day for men — may actually decrease your risk of dying from bladder cancer, according to NIH-funded research published in Annals of Internal Medicine in 2012. But drinking too much alcohol increases your risk of developing many types of cancer, including cancers of the mouth, throat and esophagus (throat), liver and breast as well as colorectal cancer (cancer that begins in the colon and rectum). Alcohol also increases levels of estrogen (female hormone) in men’s bodies, which raises their odds of developing certain types of prostate cancers.

What screening tests are used for bladder cancer?

Screening for bladder cancer is not recommended because there is not enough evidence that it can reduce the risk of dying from bladder cancer.

Bladder Cancer Screening Tests:

Urine analysis — Checks for blood in urine, infection, and kidney stones. It also looks for signs of malignancy. This test can be done at home using a cup or bag.

Digital rectal exam — Checks the size, shape, and feel of the prostate gland in men. This test may also look for lumps or nodules in the prostate. It is usually done by a doctor during an annual physical examination.

Cystoscopy — A scope is inserted into the urethra to examine the inside of your bladder (cystoscopy) and urethra (urethoscopy). This test can find polyps or other changes on the surface of your bladder, but it cannot detect if cancer has spread beyond these areas.

What are the signs of bladder cancer?

It’s important for people with bladder cancer to be aware of the signs and symptoms so they can get treatment as soon as possible.

The most common symptom of bladder cancer is blood or protein in your urine. Other symptoms include:

  • Pain or burning when you urinate (pee)
  • A feeling that you have to pee all the time
  • Blood in your urine or stool
  • Feeling like something is stuck in your bladder (often described as a “sinking” feeling)
  • If you have any of these symptoms, see your doctor right away.

How is bladder cancer diagnosed?

Bladder cancer is usually diagnosed with a combination of imaging tests and physical examination.

Imaging tests

Imaging tests use high-tech equipment to create pictures of the body’s internal organs and structures, including the bladder. These tests can be used to diagnose bladder cancer, determine its size and location, and evaluate its effects on surrounding tissue. Imaging tests include:

Urine cytology. A small sample of urine is collected from the bladder through the urethra (tube that carries urine out of the body). The sample is examined under a microscope for signs of tumor cells. Cytology can be used as a screening test for early detection or diagnosis of bladder cancer. It’s also used for monitoring treatment progress.

CT scan (computed tomography). CT scans use X-rays to produce detailed cross-sectional images of internal organs and tissues. CT scans are more detailed than plain X-rays, so they can show areas of concern more clearly than plain X-rays alone can. CT scans may be used to help diagnose bladder cancer in people who have blood in their urine but no other symptoms such as pain or burning with urination. CT scans are also sometimes done during surgery to help surgeons see what they’re doing inside the body when removing tumors.

How is bladder cancer treated?

Bladder cancer can be treated in many different ways depending on the type of cancer and how advanced it is. Treatment may include surgery, radiation therapy and chemotherapy.

Surgery

Surgery is usually the first treatment option for bladder cancer. It can remove the cancerous tissue, but it may not cure the disease. Most bladder cancers recur after surgery, even if all visible signs of cancer are removed during surgery.

Radiation therapy

Radiation therapy targets cancer cells with high-energy rays that damage the DNA in cells and stop them from dividing and multiplying. This can shrink tumors and relieve symptoms caused by advanced bladder cancer. Radiation therapy may be used before or after surgery, as well as alone if you’re unable to have surgery or if you’ve had previous radiation treatments that were unsuccessful at eliminating all signs of your disease.

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