Bladder Cancer


Bladder cancer is the 6th most common cancer in the US with over 74,000 new cases diagnosed in 2015. The most common sign of bladder cancer is blood in the urine. Rarely, urinary frequency or urgency may be a sign of a bladder cancer.



Bladder cancer is diagnosed by a cystoscopy, which is a procedure where a camera is placed in the urethra and into the bladder. A biopsy is then performed to get tissue and to remove the tumor and is called a transurethral resection of bladder tumor(TURBT). Depending on the pathology of the tumor, your physician may also order a CT scan or MRI for evaluation.


Pathology and Prognosis

The pathology and prognosis of bladder cancer varies. There are three major categories bladder cancer: those with cancer only affecting the lining of the bladder, those with bladder cancer that involves the muscle of the bladder, and those with cancer that has spread outside the bladder to other organs or lymph nodes.



The majority of patients are diagnosed with cancer only affecting the lining of the bladder, also called non-muscle invasive disease. These tumors tend to recur within the bladder and require frequent monitoring. They may be treated with additional resections or sometimes with medical treatments that are given within the bladder. Sometimes the recurrences of the tumor may progress to involving the muscle of the bladder so frequent monitoring with cystoscopies is required.


A smaller percentage of patients will be diagnosed with muscle-invasive bladder cancer. In this case, the tumor has grown through the lining of the bladder and into the muscle. In patients with this diagnosis, treatment beyond simple resection is required because the cancer will frequently spread to other locations. Your urologist may suggest removing the bladder, with or without chemotherapy prior to surgery. In some patients who cannot tolerate surgery, chemotherapy and radiation may be used.


In patients with metastatic disease at the time of diagnosis, the treatment of choice is generally systemic chemotherapy.



Other resources:


Bladder Cancer Advocacy Network


National Cancer Institute


Urology Care Foundation


Pathological stages of bladder cancer (primary lesion)