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Cancer is the growth of
abnormal cells in the body. These extra cells grow together and form masses,
called tumors. In bladder cancer, these growths happen in the bladder.
The bladder is the part of your
urinary tract that stores your urine until you are
ready to let it out. See a picture of the
female urinary system or
male urinary system.
Bladder cancer can often be successfully treated if it
is found and treated early. And most bladder cancer is found early.
This topic is about the most common type of bladder cancer, called transitional cell cancer. This is cancer that starts in the inner layer of the bladder. It happens most often in people who are in their 60s or older.
Experts don't know what
causes bladder cancer. But smoking cigarettes or being exposed to certain chemicals raises your risk. And like other cancers, changes in the DNA of your
cells seem to play a role.
Blood in the urine is the
main symptom. Other symptoms may include having to urinate often or feeling
pain when you urinate.
These symptoms can be caused by other
problems, including a
urinary tract infection. Always call your doctor if
you see blood in your urine.
bladder cancer, your doctor will:
Treatment choices for bladder
The treatment depends a lot on how much the cancer has
grown. Most bladder cancers are treated without having to remove the
Sometimes doctors do have to remove the bladder. For some
people, this means having urine flow into a bag outside of the body. But in
many cases, doctors can make a new bladder—using other body tissue—that works
very much like the old one.
Bladder cancer often comes back. The
new tumors can often be treated successfully if they are caught early. So it's very
important to have regular checkups after your treatment is done.
Finding out that you have cancer can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counselor can really help. Ask your doctor about support groups. Or call the American Cancer Society (1-800-227-2345) or visit its website at www.cancer.org.
Anything that increases your chances of getting a disease is called a
risk factor. The main risk factors for bladder cancer include:
Learning about bladder cancer:
Living with bladder cancer:
Health Tools help you make wise health decisions or take action to improve your health.
The cause of
bladder cancer is not known. Changes in the genetic
material (DNA) of bladder cells may play a role. Chemicals in
the environment and cigarette smoking also may play a role. And when the lining
of the bladder is irritated for a long time, cell changes that lead to cancer
may occur. Some things that cause this are radiation treatment, having
catheters in place for a long time, or having the parasite that causes
Bladder cancer is twice as likely to develop in
smokers than in nonsmokers. Experts believe that smoking causes about half of
all bladder cancers in men and women.1
Exposure to chemicals and other
substances at work—including dyes, paints, leather dust, and others—may also
cause bladder cancer.
The most common symptoms of
bladder cancer include:
Symptoms that may indicate more advanced bladder cancer
Other symptoms that may develop when bladder cancer has
The symptoms of bladder cancer may be similar to symptoms
of other bladder conditions.
is the rapid, uncontrolled growth of abnormal cells in the bladder. Cancer
usually begins in the lining of the bladder. The cancerous cells may spread
through the lining into the muscular wall of the bladder.
cancer may spread to
lymph nodes, other organs in the pelvis (causing
problems with kidney and bowel function), or other organs in the body, such as
the liver and lungs.
Your treatment will depend on how far the cancer has spread.
Most bladder cancer is found early, before it has spread into the bladder wall. Surgery can usually remove these tumors. But bladder cancer often comes back, so you may also get other treatments, such as chemotherapy or immunotherapy, to lower the chances of that happening.
The main risk factors for
bladder cancer include:
If you have been diagnosed with
bladder cancer, be sure to follow your doctor's
instructions about calling when you have problems, new symptoms, or symptoms
that get worse.
Call your doctor if you:
If you are concerned about your symptoms or about your risk for bladder cancer, make an appointment with your
Watchful waiting is not appropriate if you have
symptoms that do not go away.
Health professionals who can evaluate your symptoms and your risk
for bladder cancer include:
Doctors who can manage your
cancer treatment include:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
To find out whether
bladder cancer may be the cause of your urinary
symptoms, your doctor will:
You will have a cystoscopy, a test that allows your doctor to look at your bladder with a thin, lighted tube. The doctor can use the same tube to take small tissue samples (biopsies) of any abnormal areas. The samples will be looked at under a microscope to find out whether cancer cells are present and what the cells look like.
Bladder cancer is classified by
stage and grade. The stage is determined by the
cancer growth in the bladder wall and how far it has spread to nearby tissues
and other organs, such as the lungs, the liver, or the bones. The grade of
bladder cancer is determined by how the cancer cells look in comparison with
normal bladder cells.
Your doctor finds out the stage and grade of
your bladder cancer by gathering information from several tests, including:
Knowing the stage and grade of your cancer is important in choosing the right treatments.
Other diagnostic tests that may be done include:
Bladder cancer often comes back, so it's important to have regular checkups. Then, if the cancer does come back, you have a better chance of finding it early enough for successful treatment.
The choice of treatment and the
long-term outcome (prognosis) for people who have
bladder cancer depend on the
stage and grade of cancer. When deciding about your treatment, your doctor also considers your age, overall
health, and quality of life.
Bladder cancer has a better chance of being treated successfully if it is found early.
Treatment choices for bladder cancer may include:
There are five stages of bladder cancer, stages 0 to IV:2
The grade of bladder cancer is usually either low-grade (LG) or high-grade (HG). High-grade tumors tend to grow faster. They are also more likely to spread than low-grade tumors. When your doctor knows the grade of your cancer, this information will help him or her choose the best treatment plan for you.
More information about bladder cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/types/bladder.
After initial treatment for
bladder cancer, it is important to receive follow-up
care, because bladder cancer often comes back (recurs). Your doctor will set up a regular schedule of checkups and tests.
Bladder cancer may recur in the bladder, or it may spread (metastasize) to other parts of
the body. Recurrent bladder cancer may be treated with surgery or
chemotherapy to slow cancer growth and relieve
Participation in a
clinical trial may be recommended if you have been
diagnosed with recurrent bladder cancer.
Sexual problems can be caused by physical or psychological factors related to the cancer or its treatment. You may experience less sexual pleasure or lose your desire to be sexually intimate.
Your feelings about your body may change after
treatment for cancer. Managing your feelings about your body may involve talking openly
about your concerns with your partner and discussing your feelings with your
doctor. Your doctor may also be able to refer you to groups that can offer
support and information.
Cancer treatment has two main goals: curing cancer and making your quality of life as good as possible. Palliative care can improve your quality of life by helping you manage your symptoms. It can also help you with other concerns that you may have when you are living with a serious illness.
For some people who have advanced cancer, a time comes when treatment to cure cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief.
But this isn't the end of treatment. It can be hard to decide when to stop treatment aimed at prolonging your life and shift the focus to end-of-life care. You and your doctor can decide when you may be ready for hospice care.
For more information, see:
Bladder cancer cannot be prevented, but you may be
able to reduce some of your risk for getting it.
The side effects of bladder cancer treatment can be serious. Healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms. Your doctor may also give you medicines to help you with certain side effects.
You can try home treatments:
Other issues that can be treated at home include:
Having cancer can be very stressful, and it may feel overwhelming to face the challenges in front of you. Finding new ways of coping with the symptoms of stress may improve your overall quality of life.
These ideas may help:
Having cancer can change your life in many ways. For support in managing these changes, see the topic
Getting Support When You Have Cancer.
Medicines may be used to control the growth
bladder cancer cells and to relieve symptoms.
These medicines may be taken by mouth, injected
into a vein (intravenous, or IV), or delivered directly into the bladder using a catheter.
Side effects of chemotherapy may
Some people may need
medicines to control nausea and vomiting.
Side effects of immunotherapy vary
depending on the medicine.
Bacillus Calmette-Guerin (BCG) is a type of bacteria related to the bacteria that cause tuberculosis (TB). BCG is used in TB vaccines. Also, BCG is placed into the bladder to treat bladder cancer. With BCG, the side effects
Surgery is used to treat most
The side effects of surgery may include:
Radiation treatment for
bladder cancer uses high-energy X-rays to kill cancer
cells and shrink tumors. It may be given after surgery. It may be used along with chemotherapy. Sometimes it is used instead of surgery or chemotherapy.
treatment you receive will depend on the type and stage of your cancer.
Side effects of radiation may include:
Your doctor may talk to you about joining a research study called
a clinical trial if one is available in your area. Clinical trials are research studies to look for ways
to improve treatments for bladder cancer. Experts are doing studies on:
For some people with bladder cancer, clinical trials may offer the best treatment available.
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
These mind-body treatments may help you feel better. They can make it easier to cope with treatment. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. They are not meant to take the place of standard medical treatment.
The American Cancer Society (ACS) conducts educational
programs and offers many services to people with cancer and to their families.
Staff at the toll-free number have information about services and activities
in local areas and can provide referrals to local ACS divisions.
The National Cancer Institute (NCI) is a U.S. government
agency that provides up-to-date information about the prevention, detection,
and treatment of cancer. NCI also offers supportive care to people who have cancer
and to their families. NCI information is also available to doctors, nurses,
and other health professionals. NCI provides the latest information about
clinical trials. The Cancer Information Service, a service of NCI, has trained
staff members available to answer questions and send free publications.
Spanish-speaking staff members are also available.
The National Kidney and Urologic Diseases Information
Clearinghouse (NKUDIC) provides information about diseases of the
kidneys and urologic system to people with these problems and to
their families, to health professionals, and to the public. NKUDIC answers
inquiries; develops, reviews, and distributes publications; and works closely
with professional and patient groups and government agencies to
coordinate resources about kidney and urologic diseases.
NKUDIC, a federal agency, is a service of the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part
of the National Institutes of Health under the U.S. Department of Health and
UrologyHealth.org is a website written by urologists
for patients. Visitors can find specific topics by using the "search"
The website provides information about adult and
pediatric urologic topics, including kidney, bladder, and prostate conditions.
You can find a urologist, sign up for a free quarterly newsletter, or click on
the Urology A–Z page to find information about urologic problems.
American Cancer Society (2012). Cancer Facts and Figures 2012. Atlanta: American Cancer Society. Available online.
National Cancer Institute (2010). What You Need To Know About Bladder Cancer (NIH Publication No. 10-1559). Available online: http://www.cancer.gov/cancertopics/wyntk/bladder.
Other Works Consulted
American Cancer Society (2011). Lasers in cancer treatment. Available online: http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/lasers-in-cancer-treatment.
American Cancer Society (2012). Bladder cancer. Available online: http://www.cancer.org/cancer/bladdercancer/detailedguide/index.
American Joint Committee on Cancer (2010). Urinary bladder. In AJCC Cancer Staging Manual, 7th ed., pp. 497–505. New York: Springer-Verlag.
National Cancer Institute (2012). Bladder Cancer Treatment (PDQ)—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/bladder/healthprofessional.
National Cancer Institute (2012). Bladder Cancer Treatment (PDQ)—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/bladder/patient.
National Cancer Institute (2012). SEER Fact Sheets: Bladder. Bethesda, MD: National Cancer Institute. Available online: http://seer.cancer.gov/statfacts/html/urinb.html.
National Comprehensive Cancer Network (2013). Bladder Cancer. NCCN Clinical Practice Guidelines in Oncology, version 1.2013. Available online: http://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf.
U.S. Preventive Services Task Force (2011). Screening for bladder cancer: Recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf11/bladdercancer/bladcanrs.htm.
April 30, 2013
E. Gregory Thompson, MD - Internal Medicine & Christopher G. Wood, MD, FACS - Urology, Oncology
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