Bladder Cancer

What it is

Overview

Bladder cancer is the sixth most common cancer in the US. It begins in the urothelial cells lining the bladder. The most common type, transitional cell carcinoma (urothelial carcinoma), has one of the highest recurrence rates of any cancer — meaning regular monitoring is required for life. Smoking is the single biggest risk factor.

Biology

How It Develops

Carcinogens concentrated in urine — particularly from tobacco — repeatedly damage the DNA of urothelial cells. Mutations in FGFR3, TP53, and RB1 are common. Most bladder cancers begin as non-muscle-invasive tumors confined to the inner lining; if left untreated or recurrent, they can become muscle-invasive and life-threatening.

Warning signs

Symptoms

• —Blood in the urine (hematuria) — often painless
• —Frequent urination or urge to urinate
• —Painful urination
• —Back or pelvic pain (advanced disease)

Detection

Diagnosis Methods

• —Urinalysis and urine cytology
• —Cystoscopy (direct visualization)
• —Transurethral resection of bladder tumor (TURBT) for diagnosis and treatment
• —CT urography
• —MRI for muscle invasion assessment

Medical care

Treatment Options

• —TURBT (transurethral resection)
• —Intravesical therapy (BCG or chemotherapy directly into bladder)
• —Radical cystectomy (bladder removal for muscle-invasive disease)
• —Systemic chemotherapy (cisplatin-based)
• —Immunotherapy (atezolizumab, pembrolizumab)
• —Targeted therapy (erdafitinib for FGFR mutations)

Data

Statistics

Prevention

Risk Factors

• —Cigarette smoking (single biggest risk factor)
• —Exposure to industrial chemicals (arylamines, benzene)
• —Chronic bladder infections or inflammation
• —Prior bladder cancer (high recurrence)
• —Age over 55 and male sex

Further reading

Resources