Bladder Cancer: Symptoms, Causes, Diagnosis & Treatment

Bladder cancer is a type of cancer that starts in the bladder lining, a small hollow organ tasked with storing and releasing urine. It is relatively rare, but when detected early there are various treatment options available, including surgery to remove the cancer.

Some symptoms of bladder cancer may include frequent urination, painful urination, and back pain. It is important to consult with a medical professional if you notice discolored urine or any other concerning symptoms.

The diagnosis of bladder cancer usually involves imaging tests such as a computerized tomography (CT) urogram or retrograde pyelogram, aiding doctors in scrutinizing the structures of the urinary tract.

The selection of treatment options may depend on the stage and aggressiveness of the cancer and could vary from surgery to chemotherapy. 

Prevention measures include leading a healthy lifestyle, avoiding exposure to harmful chemicals, and taking precautionary measures if you have a family history of the disease.

Key Bladder Cancer Information

Most bladder cancers begin in the urothelium, the bladder’s innermost lining, and can be treated if detected early.

Over time, changes in this cell layer can lead to abnormalities, eventually developing into tumors which may become invasive.

Diagnosis often involves imaging tests, while treatment depends on the stage of the cancer.

Prevention includes leading a healthy lifestyle and avoiding harmful chemical exposure.

Bladder cancer can occur in various forms and stages, with urothelial carcinoma being the most common type. 

The cancer can be either non-muscle-invasive or muscle-invasive, which ultimately impacts treatment options and prognosis. 

By understanding the risk factors, taking preventative measures, and staying vigilant for symptoms, individuals can increase their chances of early detection and effective treatment.

Bladder Cancer Types

There are various forms of bladder cancer, including transitional cell carcinoma, squamous cell carcinoma, adenocarcinoma, and small cell carcinoma.

Urothelial carcinoma, also termed as transitional cell carcinoma, is the predominant type, representing around 95% of bladder cancer cases.

Bladder cancer can be categorized into two main groups: non-muscle-invasive (superficial) and muscle-invasive (invasive). Superficial bladder cancer is confined to the interior lining of the bladder, whereas invasive bladder cancer has extended to the muscle layers or even further.

The prognosis and treatment options for these two groups differ significantly.

Causes and Risk Factors

Various factors increase the risk of developing bladder cancer. It’s important to note that having one or more risk factors does not necessarily mean someone will develop bladder cancer, but it does increase the chances of the cancer arising.


One of the major risk factors for bladder cancer is smoking. Tobacco use, including cigarettes and other forms of tobacco, exposes the body to harmful chemicals that can cause damage to the bladder lining.

Individuals who smoke cigarettes account for approximately half of all incidents of bladder cancer.

Chemical Exposure

Exposure to certain chemicals used in industries such as dyes, rubber, leather, and textiles may also increase the risk of bladder cancer. Workers who come into contact with these chemicals have a higher likelihood of developing the disease.

Arsenic is another chemical that can contribute to bladder cancer risk. Long-term exposure to arsenic in drinking water has been linked to an increased risk of bladder cancer.

Genetics and Family History

A family history of bladder cancer can also play a role in an individual’s risk.

If someone has a close relative who has been diagnosed with bladder cancer, their risk may be higher than someone without such a history.

Urinary Tract Infections

Urinary tract infections (UTIs) and bladder infections that cause chronic inflammation can also contribute to bladder cancer risk.

Conditions such as schistosomiasis, a parasitic infection causing long-term bladder inflammation, have been associated with a specific type of bladder cancer called squamous cell carcinoma.

Prostate Enlargement

An enlarged prostate is another factor that may increase the risk of bladder cancer.

Men with an enlarged prostate may experience urinary retention, which can lead to bladder infections and inflammation.

Gender and Age

Two demographic factors that affect the risk of bladder cancer are gender and age.

Bladder cancer is more common in men than women, and the chances of developing it increase as a person gets older. The majority of individuals diagnosed with bladder cancer are aged above 55.

Understanding these risk factors can help with prevention and early detection efforts.


Bladder cancer can present with a variety of symptoms that may initially seem unrelated. 

Blood in the Urine

Hematuria, the presence of blood in the urine, is one of the most common symptoms which can cause the urine to appear bright red or cola-colored.

However, there are times that the urine may look normal, and blood is only detected during lab tests.

Urge and Frequent Urination

Along with hematuria, individuals with bladder cancer may also experience frequent urination. This increased frequency is another key symptom which can be accompanied by a sense of urgency, sometimes even resulting in incontinence.

It is important to note that these symptoms can also be indicative of other conditions, such as urinary tract infections (UTIs), bladder stones, or an overactive bladder.

Pain and Discomfort

Pain is another symptom associated with bladder cancer. Patients might notice painful urination or discomfort in the pelvic area.

In some cases, people with bladder cancer can also experience back pain, although this symptom is not exclusive to bladder cancer and can result from various other health issues.

It’s important to consult a healthcare professional if you experience any of these symptoms, as they can evaluate the issue and determine the appropriate course of action.


To diagnose bladder cancer, doctors use a combination of tests, examinations, and imaging studies. 


One of the most common diagnostic procedures is a cystoscopy, which involves inserting a thin, flexible tube with a light and camera (cystoscope) through the urethra to examine the bladder’s interior. 

This examination allows the doctor to see any abnormalities or growths within the bladder.


If the cystoscopy reveals suspicious areas, the doctor may perform a biopsy. During this procedure, a small tissue sample is collected from the abnormal area and sent to a laboratory for further analysis.

The lab results can confirm the presence of cancerous cells and determine the cancer’s type and stage.

Cancer Staging and Grading

To better understand the extent and aggressiveness of bladder cancer, doctors use a staging and grading system. Staging measures how far cancer has spread, while grading refers to how abnormal the cancer cells look under a microscope.

A higher stage or grade usually indicates a more aggressive cancer.

Urinalysis and Urine Cytology

In addition to cystoscopy and biopsy, urine tests play a significant role in the diagnosis of bladder cancer. A urinalysis and urine cytology may be conducted to check for the presence of blood, bacteria, or cancerous cells.

These tests can provide valuable information and help rule out other medical conditions with similar symptoms.

Imaging Tests

Imaging tests are also often used in the diagnostic process to visualize the urinary tract and the surrounding organs. A computed tomography (CT) scan or an intravenous pyelogram can provide detailed images of the bladder, ureters, and kidneys.

These tests can help doctors identify tumors, assess the cancer’s extent, and determine the best course of treatment.

Consultation and Examination

Lastly, a physical exam plays a crucial role in the overall diagnostic process. The doctor will carefully evaluate the patient’s medical history, symptoms, and risk factors.

Information gathered during a physical exam can help guide further testing and treatment options. Early detection of bladder cancer is critical, as it improves the chances of successful treatment.

Treatment Options

There are several treatment options available for bladder cancer, depending on the stage, type, and aggressiveness of the cancer.

Some common treatment options include surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy.

Surgical Intervention

Surgery is often the first line of treatment for bladder cancer.

There are different types of surgical procedures used, such as transurethral resection of bladder tumor (TURBT) and cystectomy.

Tumor Removal

In a TURBT procedure, the tumor is excised from the bladder without affecting the remainder of the organ. 

Removal of Affected Organs

In contrast, a cystectomy involves the removal of the entire bladder, along with nearby organs and lymph nodes if necessary. For men, this may include the prostate gland, while for women, the uterus, vagina, and part of the reproductive system may be removed during the surgery. 

After a cystectomy, a urinary diversion is typically created to help the body expel urine.


Chemotherapy is another common treatment option for bladder cancer, which utilizes powerful drugs to destroy cancer cells.

Chemotherapy drugs can be administered systemically (through the bloodstream) or directly into the bladder (intravesical chemotherapy), depending on the stage and type of cancer. This treatment is often used in conjunction with surgery or radiation therapy.

Radiation Therapy

Radiation therapy utilizes high-energy x-rays with the purpose of eliminating cancer cells and reducing tumors.

This treatment can be given externally (external beam radiation therapy) or internally (brachytherapy), and is sometimes used alongside chemotherapy or surgery, particularly when the cancer has spread to the lymph nodes or pelvis.

Immune System Therapy

Immunotherapy is a relatively recent treatment option that uses the body’s immunity system to combat cancer cells. 

One of the most commonly used immunotherapies for bladder cancer is Bacillus Calmette-Guérin (BCG), a live bacterium that is introduced into the bladder through a catheter. This stimulates the immune system to attack cancer cells.

Other immunotherapies, such as checkpoint inhibitors, can also be used for advanced or metastatic bladder cancer.

Targeted Therapy

Targeted therapy is another newer treatment option that focuses on specific proteins, enzymes, or other molecules on the surface of cancer cells.

These targeted therapies can hamper or halt the growth of cancer by interacting with certain molecules that contribute to the proliferation rate and spread of the tumor. This treatment is usually reserved for advanced or metastatic bladder cancer.


When it comes to prevention, some risk factors, such as age, gender, and family history, cannot be changed.

However, there are modifiable factors we need to be mindful of to reduce the risk of developing this disease.

Quitting Smoking

One of the most effective ways to prevent bladder cancer is smoking cessation. Cigarette smoke contains harmful chemicals that can increase your risk of developing this type of cancer.

If you’re a smoker, quitting smoking can significantly lower your chances of getting cancer. Numerous resources are available to help you quit, including counseling, nicotine replacement therapies, and prescription medications.

Limiting Chemical Exposure

Another important aspect of prevention is to avoid exposure to harmful chemicals. Occupational exposure to certain chemicals, particularly those found in the dye, rubber, leather, and textile industries, can increase the risk of bladder cancer.

Limiting contact with these chemicals through protective gear and using proper ventilation can help protect your health. If you work in an environment where you’re exposed to these substances, it’s essential to follow safety precautions and discuss concerns with your employer.

Healthy Diet and Exercise

Maintaining a healthy lifestyle can also play a significant role in preventing bladder cancer. A balanced diet, rich in fruits, vegetables, and whole grains, can provide essential nutrients and antioxidants that aid in cancer prevention.

Additionally, regular physical activity can help lower your overall risk for various types of cancer.

By staying vigilant about your health and making positive lifestyle choices, you can work towards a lower likelihood of developing bladder cancer.

Living with Bladder Cancer

Living with bladder cancer can present various challenges, both physically and emotionally, but with the right support and management, one can maintain a good quality of life.

Understanding the prognosis, treatment options, and coping strategies for different stages of the cancer is essential.

Lifestyle Modification

Adapting to lifestyle changes is important during the cancer journey. Some tips for living with bladder cancer include:

Healthy Diet and Physical Activity

Maintaining a healthy diet and staying physically active are crucial components of living with bladder cancer.

Nutritious foods aid in bolstering the immune system and supporting recovery, while physical activity can improve overall wellbeing and strength.

Adequate Fluid Intake

Staying well-hydrated is of primary importance when living with bladder cancer.

Adequate hydration keeps the urinary system functioning properly and reduces the risk of urinary tract infections by flushing out bacteria.

Managing Complications

Managing side effects and complications is integral to living with bladder cancer.

For example, urinary incontinence can be managed through pelvic floor exercises and incontinence products.

Emotional Support Group

Emotional support is paramount when living with bladder cancer. It is crucial to forward feelings of fear, anxiety, and depression that can accompany a cancer diagnosis. Reaching out to friends, family, or mental health professionals is essential.

Various resources, such as support groups and counseling services, are available to help manage the emotional impact of the disease. 

Stress Management and Relaxation

A comprehensive approach to live with bladder cancer involves stress management and relaxation practices.

Learning relaxation techniques such as deep breathing, guided imagery, and progressive muscle relaxation can help manage stress and promote mental well-being.

Open Communication

Of course, each person’s experience with bladder cancer is unique, and their coping strategies and support needs can differ.

It is essential to keep the lines of communication open with the healthcare team and loved ones, and take each day as it comes. 

Frequently Asked Questions

What are the early warning signs of bladder cancer?

The most common initial symptom of bladder cancer is the presence of blood in the urine (hematuria), which may give the urine a pink, orange, or dark red appearance.

Other possible symptoms include increased urgency, frequency, and pain during urination or incontinence.

How is bladder cancer typically diagnosed?

Bladder cancer is usually diagnosed by performing a cystoscopy, which involves examining the inside of the bladder using a small, narrow tube called a cystoscope. 

It’s inserted through the urethra to check for any abnormalities or tumors in the bladder lining.

What factors contribute to the development of bladder cancer?

Some risk factors for developing bladder cancer include smoking, exposure to certain chemicals, a history of chronic bladder inflammation or urinary tract infections, and a family history of cancer.

Age, ethnicity, and gender may also play a role in the development of bladder cancer.

What are the different stages of bladder cancer?

The stages of bladder cancer are determined by factors such as the size and reach of the tumor, and by examining any spread to adjacent lymph nodes or to other areas of the body. 

The stages range from stage 0 (non-invasive and confined to the lining of the bladder) to stage IV (cancer has spread to distant parts of the body).

What treatments are available for bladder cancer?

The treatment for bladder cancer can vary based on the stage, degree of the cancer, and the overall wellbeing of the patient. Possible treatment selections could involve surgery, chemotherapy, radiation therapy, immunotherapy, or a mix of these options. 

Early-stage cancers are often treated with surgery, while more advanced cases may require a combination of treatments.

How can one reduce the risk of developing bladder cancer?

To reduce the risk of bladder cancer, consider adopting habits such as quitting smoking, maintaining a healthy diet, limiting exposure to certain chemicals, staying well-hydrated, and promptly treating urinary tract infections.

Regular check-ups and discussing any concerns with your healthcare provider can also help in early detection and prevention of the disease.