Bladder cancer is a type of cancer that begins in the bladder and often starts in the cells that line the inside of your bladder.
What is bladder cancer?
Bladder cancer can be a concerning diagnosis, but understanding this disease is the first step toward managing it effectively. It’s a type of cancer that develops in the bladder, the organ that stores urine before it’s released from the body. While it can be frightening to face a cancer diagnosis, know that many individuals successfully navigate bladder cancer treatment and experience long-term recovery. Common symptoms can include blood in the urine (hematuria), frequent urination, or pelvic/back pain, but not everyone with these symptoms has bladder cancer. The American Cancer Society notes there are around 84,000 new diagnoses of bladder cancer every year in the U.S., and it is often a more common diagnosis in those assigned male at birth.
At the AHN Cancer Institute, our physicians have advanced degrees and training in the diagnosis and treatment of bladder cancer. This focused training allows us to get a precise diagnosis and to find the right treatment option for you. When you come to AHN, you can expect compassionate and comprehensive care.
AHN Urologic Oncology Center of Excellence
Our experts at the Urologic Oncology Center of Excellence focus exclusively on urologic cancers. This intensive approach gives us the expertise to quickly and precisely diagnose and treat bladder cancer. Our approach to care includes robust support services to help you feel your best during treatment.
We designed our comprehensive center to maximize your convenience. Shortly after diagnosis, you meet with several specialists, like a urologist and a radiation oncologist. We reduce your travel and wait time so you can get answers as quickly as possible.
Bladder cancer care at AHN: Why choose us?
Patients come to the AHN Cancer Institute for our exceptional care and the advanced, minimally invasive bladder cancer treatment options we offer. At the Cancer Institute, you can expect:
- Patient-centered care: We meet with you and your family to discuss the details of your treatment plan so you feel assured and informed. Our physicians invite you to audio record your visits, so you can refer to them when you need to. We pride ourselves on open communication with our patients.
- Quality treatment close to home: You don’t have to travel far to get the comprehensive bladder care you need. You can focus your energy on fighting the cancer, not on traveling.
- Endoscopically performed procedures: Most of our bladder cancer patients receive treatment without a surgical incision. We are able to pass a camera through the urethra to perform most interventions. These types of procedures often result in a quicker, more comfortable recovery.
- Advanced technology: Our surgeons use robotic surgical technology to perform intricate procedures with more precision and control than traditional techniques.
- Integrated team: You benefit from the combined experience of urologists (doctors who specialize in urinary tract disorders), radiation oncologists, medical oncologists, and researchers.
- Support services: Our robust support services include support groups, electronic medical records, urologic oncology nursing navigators, palliative care, and cancer genetics. These services help you live the best quality of life while you receive treatment. Learn more about our support services.
Bladder cancer symptoms and signs
The symptoms and signs of bladder cancer can vary, and some people may experience no symptoms at all, especially in the early stages. However, there are some symptoms and signs that, if present and out of the norm, should be brought up with a doctor or urologist. Those include:
- Hematuria: This is the most frequent symptom and refers to blood in the urine. It may be visible (gross hematuria), appearing red or pink, or microscopic, only detectable through a urine test.
- Frequent urination: A need to urinate more often than usual, even if only small amounts of urine are passed.
- Urinary urgency: A sudden, strong urge to urinate that is difficult to delay.
- Pain or burning during urination (dysuria): Discomfort or a burning sensation while urinating.
- Pelvic pain: Pain in the pelvic area, which may be constant or intermittent.
- Back pain: Pain in the lower back, particularly on one side.
- Changes in urination pattern: Changes in the stream of urine, if you feel or notice a stronger or weaker sensation when urinating.
- Urinary incontinence: Loss of bladder control, leading to unintentional leakage of urine.
Causes and risk factors
Bladder cancer develops when the cells in the bladder lining become abnormal and grow uncontrollably. The exact cause isn’t entirely known, but there are certain risk factors that can contribute to developing bladder cancer. There are also some environmental causes that have been attributed in bladder cancer cases.
- Smoking: This is the single most significant risk factor for bladder cancer, accounting for at least half of all cases. Smoking damages the bladder lining, leading to cellular mutations. Even secondhand smoke exposure increases risk.
- Exposure to certain chemicals: Occupational exposure to certain chemicals is a major concern. These include aromatic amines, arsenic, and benzene.
- Age: The risk of bladder cancer increases significantly with age, with most diagnoses occurring after age 55.
- Gender: Those assigned male at birth are more likely to develop bladder cancer than those assigned female at birth.
- Race: Caucasians have a higher incidence rate than other racial groups.
- Family history: Having a close family member (parent, sibling) with bladder cancer increases your risk. This suggests a genetic component, although specific genes haven’t been fully identified in most cases.
- Certain medical conditions: Individuals with conditions like chronic bladder infections (cystitis), schistosomiasis, and bladder stones, or those who have received previous radiation therapy to the pelvis.
- Certain medications: Long-term use of certain medications, particularly some pain relievers (phenacetin, a now-banned analgesic), has been linked to an increased risk.
Bladder cancer screening and diagnosis
The majority of bladder cancers tend to be caught early. Our specialists work quickly to provide an accurate diagnosis, so you can begin treatment right away. Individuals with bladder cancer often detect it early by noticing blood in the urine. Our expert team confirms the presence of cancer as promptly as possible, so we can begin treatment. The earlier we diagnose bladder cancer and begin treatment, the higher the chances of a successful treatment.
At the AHN Cancer Institute, we use sophisticated technology to diagnose bladder cancer. You can expect the diagnosis process to be:
- Minimally invasive: Our diagnostic tests use advanced tools that do not require an incision and will keep you as comfortable as possible.
- Expert: Our bladder cancer specialists use the latest research, so you receive the most precise diagnosis. A specific diagnosis helps us create an effective treatment plan, tailored to your needs. We also offer robust support services to treat the whole person.
- Prompt: We get you the test results swiftly, so you can talk to your care team about your treatment options right away.
Diagnostic procedures for bladder cancer
In order to diagnose the cancer, a urologist (specialist in diseases of the urinary tract) will conduct a physical exam and discuss your symptoms. The most common symptom of bladder cancer is noticing blood in your urine. A physician may also detect bladder cancer with a routine urinalysis (test of the urine) during a physical.
Our diagnostic tests include:
- Cystoscopy: This minimally invasive exam usually takes place in a physician’s office. During the exam, you are made comfortable while a small, flexible tube is inserted through the urethra into the bladder. Sterile salt water is then flowed through the tube to expand the bladder so your doctor can examine the inner lining of the bladder.
- Bladder biopsy: If we suspect cancer after or during a cystoscopy, the physician performs a biopsy. This outpatient procedure is also minimally invasive. The scope (tube) collects cells from the bladder. A specially trained doctor called a pathologist examines the cells under a microscope to determine if cancer is present.
Staging procedures for bladder cancer
Our team uses leading-edge technology to detect bladder cancer and to determine its stage. The stage of the cancer refers to how advanced it is and if it has spread. We may perform these diagnostic tests to pinpoint the stage:
- Computed tomography (CT) scan: A combination of X-rays and computer technology produces detailed images of the abdomen and pelvis to help stage bladder cancer, so we can identify the exact locations of the cancer.
- MRI: An MRI may also be used in specific situations after a bladder cancer diagnosis (usually made by cystoscopy and biopsy) to stage the disease, determining how far it has spread and helping guide treatment decisions. It provides detailed images of the bladder wall, surrounding tissues, and lymph nodes to assess the extent of the tumor.
- PET scan: Your doctor may find a PET scan useful in detecting if bladder cancer has spread to other parts of the body (metastasis), helping to stage the disease and guide treatment decisions.
- Bone scan: We inject a small dose of radioactive material into a vein, where it travels through the bloodstream. This imaging test can detect if the cancer has spread to the bones.
You will meet with your entire care team shortly after receiving your diagnosis. Our treatment options include surgery, radiation therapy, chemotherapy, intravesical therapy (where we inject medication directly into the bladder), or combination therapy (a combination of two or more treatment methods).
Types and stages of bladder cancer
Bladder cancer is classified into several types based on the cells where the cancer originates and how it appears under a microscope. Staging describes how far the cancer has spread. The vast majority of bladder cancers are urothelial carcinomas. These cancers originate in the urothelium, the specialized lining of the urinary tract that includes the bladder. Less common types of bladder cancer include:
- Squamous cell carcinoma: These arise from squamous cells, which are flat cells found in some parts of the bladder, often associated with chronic inflammation or schistosomiasis.
- Adenocarcinoma: This type develops from glandular cells in the bladder, which is rare.
- Small cell carcinoma: A very aggressive type, similar to small cell lung cancer. It’s relatively rare.
- Neuroendocrine tumors: These are rare tumors that originate from neuroendocrine cells in the bladder.
Once the bladder cancer type is confirmed, your AHN oncologist will determine the staging. Bladder cancer staging uses the TNM (Tumor, Nodes, Metastasis) system to classify the tumor’s size and extent, any potential nodules, and if the cancer has metastasized (spread).
Bladder cancer treatment
At the AHN Cancer Institute, a team including experts in urology, radiation therapy, and oncology uses the latest techniques and technology to provide a comprehensive treatment plan. We work to destroy the cancer while saving as much of the bladder function as possible. We offer robust support services to keep you living the best quality of life during treatment.
Our team is experienced in treating patients who have early-stage or late-stage bladder cancer:
- Early-stage bladder cancer: More than 80% of our bladder cancer patients have early-stage cancer that can be fully treated by a urologist (a doctor who specializes in diseases of the urinary tract) with one minimally invasive procedure.
- Late-stage bladder cancer: If the bladder cancer is further along, our highly skilled team of experts will work together to determine the best course of treatment for you. Our options include surgery, radiation therapy, chemotherapy, and clinical trials.
In most instances, a urologist treats bladder cancer by performing a minimally invasive surgery. Other times, we may use a combination of surgery, chemotherapy, and radiation therapy.
Bladder cancer surgery
At AHN, our experienced, skilled surgeons use the precise procedure for the patient. Some procedures are minimally invasive that require no incision at all or robotic surgery that uses tiny cuts instead of large incisions. These advanced techniques help you recover more quickly. Before your procedure, we will discuss pain management options with you. Bladder surgery treatment options include:
- Transurethral resection of bladder tumor (TURBT): In this noninvasive endoscopic procedure, a physician inserts a scope into the urethra. The scope (tube) has a thin, wire loop at the end to remove any small tumors or cancerous cells from the bladder.
- Cystectomy: When bladder cancer is in a more advanced stage, we may need to remove the bladder. We use robotic-assisted surgery, which is the most minimally invasive way possible to perform bladder cancer surgery. This type of surgery reduces pain and allows you to return to normal activities faster. After a cystectomy, you will need bladder reconstruction or a urostomy bag (an external bag that helps your body eliminate urine).
- Partial cystectomy: If the cancer is contained to one small area of the bladder, we may remove a portion of the bladder. The rest of the bladder remains intact. You will be able to urinate normally, but since the bladder is smaller than before, you may have to urinate more frequently.
- Bladder reconstruction: After removing the bladder, a surgeon creates a new way for the body to expel urine.
- Ileal conduit: The surgeon connects a piece of the intestine to the kidneys and creates an opening, called a stoma, at the front of the abdomen. Urine exits the stoma into a urostomy bag.
- Neobladder: In certain patients, the surgeon may be able to create a new bladder made out of a piece of intestine. With this type of surgery, you will not need a urostomy bag and will be able to urinate more normally.
Bladder sparing procedure for bladder cancer
We use this advanced therapy to save the bladder and stop cancer from coming back (recurrence). This therapy combines three elements: TURBT surgery, followed by radiation, chemotherapy, or both.
Radiation therapy for bladder cancer
Radiation therapy (high-dose radiation beams directed at the tumor) may be used as a part of a bladder sparing treatment for advanced bladder for patients who may not qualify for having their bladder removed. We use advanced radiation treatments for bladder cancer that target the tumor while sparing the surrounding healthy tissue.
The AHN Cancer Institute is the only radiation oncology network accredited in western Pennsylvania by both the American Society for Radiation Oncology and American College of Radiology. These designations mean that the Cancer Institute meets specific guidelines for patient safety, quality control, and efficiency of equipment.
Medical oncology for bladder cancer
Our expert medical oncologists choose specific chemotherapy medications depending on the results of surgery. We may give the drugs before surgery to shrink the tumor and make it easier to remove or give the drugs after the surgery to kill any remaining cancer cells. We may give you these medications through:
- Your vein (intravenous)
- Your mouth (oral)
Our advanced medical oncology therapies include:
- Chemotherapy: These medications slow the growth of cancer. Because these strong drugs can also affect healthy cells, you may experience side effects. Our team monitors you to ease any side effects and to ensure the drugs are as effective as possible.
- Targeted therapy: These drugs specifically target the genes and protein changes in cancer cells to stop the growth and spread of cancer. They often cause less severe side effects than chemotherapy.
- Immunotherapy: Another type of drug treatment, immunotherapy prompts the body’s own immune system to fight the cancer.
Rehabilitation after bladder cancer treatment
We offer a comprehensive recovery program. At the Cancer Institute, we help you manage any pain after surgery. If you need a urostomy bag or are adapting to using a neobladder, we will help you adjust to the changes and return to a full life. Visit one of our 10 convenient locations.
Palliative care for bladder cancer focuses on improving the quality of life for individuals living with the disease, regardless of the stage or prognosis. Palliative care is not limited to end-of-life situations. It can be integrated at any stage of bladder cancer to enhance quality of life, complement curative treatments, and provide holistic support for patients and their loved ones.
We also have radiation oncologists that can help you treat any pain.
You can also request a home visit from a rehabilitation therapist through our Healthcare@Home service. Learn more about our rehabilitation program.
Bladder cancer FAQ
A bladder cancer diagnosis can bring on a whole host of questions. Your AHN Care Team is here to help and these FAQs are a good place to get some basic information that you can use when talking with your team. AHN is here to help you navigate your diagnosis and get the answers and care you need.
Is bladder cancer usually curable?
While early detection and treatment significantly improve the chances of a cure, bladder cancer's curability is not a simple yes or no answer. It’s highly dependent on the stage at diagnosis and the individual’s overall health. Many people are successfully cured, particularly those diagnosed early. However, advanced cases present a greater challenge. It’s crucial to consult with an oncologist for a personalized assessment and prognosis.
I am getting my bladder removed and will need a urostomy bag. What will that change in my life?
Bladder removal is a significant surgery and lifestyle change. With education, support, and time, those who have their bladder removed and have a urostomy bag can lead full and fulfilling lives. Some of these changes in lifestyle include urostomy bag management and care and diet adjustments. The physical adjustments and changes vary for each person and are best discussed with your health care provider and support team.
What is usually the first symptom or early indicator of bladder cancer?
The most common symptom — and often the first symptom — of bladder cancer is blood in the urine (hematuria). This can range from a noticeable reddish or pink color to a more subtle discoloration, sometimes only detectable through a urine test. It’s important to note that hematuria isn’t always caused by bladder cancer; many other conditions can cause it. However, it’s a crucial sign that warrants medical attention and investigation.
What can be mistaken for bladder cancer?
There are a number of conditions that can mimic symptoms of bladder cancer. Some of those conditions include urinary tract infections, kidney stones, bladder stones, prostatitis (inflammation of the prostate gland), painful bladder syndrome, certain medications, and trauma to the urinary tract.
What is the life expectancy of a person with bladder cancer?
There are many variables that will determine life expectancy for someone who has bladder cancer. These include the stage, gravity, and type of bladder cancer, along with the patient’s overall health, treatment response, and age. For stage I, there is 98% five-year survival rate. For stage II, the five-year survival rate is 88%. Speaking with your doctor and understanding your diagnosis will help give you a more accurate life expectancy.
Contact us
Call the Hope Line at (412) 578-HOPE (412) 578-4673 to connect with a Nurse Navigator or schedule an appointment.