Bladder cancer

What is bladder cancer?

Bladder cancer occurs when abnormal cells within the bladder grow in an uncontrolled way.

The bladder is located in the lower abdomen. It is a hollow organ with a muscular wall that allows it to get bigger or smaller as needed. The bladder stores urine until it is released from the body through the urethra.1

If cancer cells do not spread beyond the lining of the bladder, this is called superficial bladder cancer.1,2

Sometimes, cancer cells can spread into the muscle wall of the bladder or to other organs and lymph nodes. This is called invasive bladder cancer.1,2

What are the different types of bladder cancer?

There are three main types of bladder cancer. These are named after the cell type in which the cancer first develops.

  • The most common type of bladder cancer starts in the urothelial cells in the inner-most layer of the bladder wall.2 This is called urothelial cell carcinoma (or transitional cell carcinoma).1,2,3 Over 90 per cent of cases of bladder cancer start in the urothelial cells.  
  • Squamous cell carcinoma starts in the thin, flat cells lining the bladder.1 About 6 to 8 per cent of bladder cancers start in squamous cells.3
  • Adenocarcinoma is a rare type of bladder cancer that starts in glandular cells lining the bladder.1 Adenocarcinoma occurs in 2 per cent of bladder cancer cases.3

What are the symptoms of bladder cancer?

The most common symptoms of bladder cancer are:

  • blood in the urine – this is called haematuria4
  • frequent urination or urgency of urination (a feeling of needing to urinate immediately)4
  • pain during urination or pain in the pelvis/lower back.4

There are a number of conditions that may cause these symptoms, not just bladder cancer. If any of these symptoms are experienced, it is important that they are discussed with a doctor.

What are the risk factors for bladder cancer?  

A risk factor is any factor that is associated with an increased chance of developing a particular health condition, such as bladder cancer. There are different types of risk factors, some of which can be modified and some which cannot.

It should be noted that having one or more risk factors does not mean a person will develop bladder cancer. Many people have at least one risk factor but will never develop bladder cancer, while others with bladder cancer may have had no known risk factors. Even if a person with bladder cancer has a risk factor, it is usually hard to know how much that risk factor contributed to the development of their disease.

While the causes of bladder cancer are not fully understood, there are a number of factors associated with the risk of developing the disease. These factors include:

  • tobacco smoking4
  • exposure to certain chemicals, such as benzene derivatives and arylamines4
  • exposure to radiotherapy treatment for cancers in the pelvis/lower abdomen.4

How is bladder cancer diagnosed?

A number of tests may be performed to investigate symptoms of bladder cancer and confirm a diagnosis. Some of the more common tests include: 4

  • a physical examination
  • examination of a urine sample
  • imaging of the bladder and nearby organs, which may include ultrasound, X-ray, computed tomography (CT) scans or magnetic resonance imaging (MRI)
  • examination of the inside of the bladder using a cystoscope (a camera on a thin tube inserted into the urethra)
  • taking a sample of tissue (biopsy) from the bladder wall for examination under a microscope.

Treatment options

Treatment and care of people with cancer is usually provided by a team of health professionals – called a multidisciplinary team.

Treatment for bladder cancer depends on the stage of the disease, the severity of symptoms and the person’s general health. Treatment options can include surgery to remove part or all of the bladder, radiotherapy and/or chemotherapy to destroy cancer cells.

Research is ongoing to find new ways to diagnose and treat different types of cancer. Some people may be offered the option of participation in a clinical trial to test new ways of treating bladder cancer.

Finding support

People often feel overwhelmed, scared, anxious and upset after a diagnosis of cancer. These are all normal feelings.

Having practical and emotional support during and after diagnosis and treatment for cancer is very important. Support may be available from  family and friends, health professionals or special support services.

More information about finding support can be found on this website - Living with cancer. This information deals with some of the challenges experienced by people affected by cancer. It includes information about managing some of the longer term side effects of treatment, how people close to you might feel after a diagnosis of cancer, and where to find practical and emotional support. 

Cancer support organisations

In addition, State and Territory Cancer Councils provide general information about cancer as well as information on local resources and relevant support groups. The Cancer Council Helpline can be accessed from anywhere in Australia by calling 13 11 20 for the cost of a local call.  Click here for a list of Cancer Councils and other cancer support organisations.

Disclaimer

While Cancer Australia develops material based on the best available evidence, this information is not intended to be used as a substitute for an independent health professional’s advice. Cancer Australia does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information contained in this document.

 

References

  1. National Cancer Institute. Bladder cancer treatment (PDQ) – patient version. Available from http://www.cancer.gov/cancertopics/pdq/treatment/bladder/Patient. [Accessed July 2012].
  2. Arianayagam M, Rashid P. Bladder cancer – current management. Australian Family Physician 2011; 40(4): 209–13.
  3. National Cancer Institute. Bladder cancer treatment (PDQ) – health professional version. Available from http://www.cancer.gov/cancertopics/pdq/treatment/bladder/HealthProfessional. [Accessed July 2012].
  4. Stenzl A, Witjes JA, Comperat E et al. Guidelines on bladder cancer – muscle-invasive and metastatic. European Association of Urology 2012. Available from http://www.uroweb.org/gls/pdf/07_Bladder%20Cancer_LR%20II.pdf. [Accessed July 2012].