Bladder Cancer Care

About Bladder Cancer

Your bladder is located in the lower part of your abdomen. Your kidneys produce liquid waste (urine) that travels to the bladder through the ureters and exits your body through the urethra.

Your bladder walls are made of layers of muscle. In many cases, bladder cancer starts in the innermost layer and spreads to the outer layers. Bladder cancer can spread beyond the bladder to other organs, making it harder to treat.

People with bladder cancer have one of the following types:

• Urothelial carcinoma: Also known as transitional cell carcinoma, urothelial carcinoma starts in the cells lining the inside of the bladder. It is the most common type of bladder cancer and accounts for 9 in 10 cases of the disease.
• Squamous cell carcinoma: Accounting for only 3% to 5% of bladder cancers, squamous cell carcinoma often develops due to irritation caused by a parasitic infection.
• Adenocarcinoma: This is another rare cancer that occurs in the bladder cells responsible for mucus production. Adenocarcinoma accounts for just 1% to 2% of bladder cancers.
• Small cell carcinoma of the bladder: This rare cancer begins in quick-growing cells responsible for releasing hormones and makes up fewer than 1% of bladder cancers. 

Bladder cancers can also be classified as non-muscle-invasive or superficial, which means they have not yet grown into the outer layers of bladder muscle. This type of cancer is usually easier to treat. Muscle-invasive bladder cancers, on the other hand, have grown into the outer layers of bladder muscle, making them harder to treat. There is a risk they will spread to other organs.

Bladder Cancer Risk Factors

Bladder cancer can affect anyone, but age, sex and race are leading risk factors. Nine in 10 cases occur in adults age 55 and over, while three times as many men as women develop bladder cancer. White people have a higher risk than people who are Black, Hispanic and Asian American.

While researchers aren’t sure what causes bladder cancer, you might be at higher risk if you:

• Are a smoker
• Are regularly exposed to cancer-causing metals and chemicals, such as arsenic and chemicals used in the rubber, dye, aluminum and pesticide industries
• Do not drink enough fluids
• Have a close family member who has had bladder cancer
• Have had a chronic bladder infection
• Received radiation treatment to your pelvis
• Received chemotherapy for another form of cancer

While it’s not always possible to prevent bladder cancer, you can lower your risk by stopping smoking, eating a healthy diet, drinking plenty of water and reducing your exposure to cancer-causing chemicals if possible.

Bladder Cancer Symptoms

Blood in your urine, also known as hematuria, is often the first sign of bladder cancer. The blood can come and go. It might change your urine to a pink, orange or red, or it could go unnoticed and be detected only when you have a urinalysis test.

Changes in urination habits can also occur with bladder cancer. You may:

• Feel and urgent need to urinate, even if your bladder isn't full
• Feel pain or burning when you urinate
• Have a week urine stream
• Have difficulty urinating
• Need to go more often than usual, especially at night

You can have blood in your urine and experience these symptoms for many reasons, such as an infection. If you have these symptoms, talk to a urologist or primary care provider to identify the cause.

When bladder cancer becomes advanced or spreads, symptoms can include:

• Abdominal or low-back pain
• Appetite loss
• Bone pain
• Fatigue or weakness
• Swollen feet
• Unintentional weight loss

Bladder Cancer Diagnosis

Your provider will discuss your symptoms and your medical history. They will carry out a physical exam, including a rectal exam and a pelvic exam.

Your primary care provider may refer you to a urologist, who specializes in urinary tract conditions. A urologist will order tests, which could include:

• Abdominal CT or MRI: These imaging tests allow your doctor to see pictures of the inside of your bladder and other organs to check for cancer cells.
• Cystoscopy: A small tube with a lighted camera, called a cystoscope, is inserted through your urethra and into your bladder. It can be used to examine the bladder lining and take a biopsy, or tissue sample, that can be analyzed for cancer.
• Ultrasound: This imaging test uses sound waves to see inside your organs. Your provider may use it to guide a biopsy.
• Urinalysis: Your urine will be checked for blood.
• Urine cytology: Your urine is tested for cancerous cells.

If these tests suggest you have bladder cancer, your urologist or an oncologist may order additional tests to see if it has spread to other parts of your body.

A urologist may also recommend some of these tests if you are at high risk of developing bladder cancer or have had the disease before. Cystoscopy, urine cytology and tests to check urine for blood can serve as screening and diagnostic tests.

Bladder Cancer Treatment at Beaufort Memorial

A diagnosis of cancer can be very worrying for you and your loved ones. Your caring team at Beaufort Memorial will work with you to develop a treatment plan, putting your health and well-being at the center of everything they do.

First, your doctor will evaluate your cancer to identify its stage. Bladder cancer stages depend on a tumor’s size and location and how far it has spread.

Your treatment will depend on the stage and type of cancer you have. Beaufort Memorial medical oncologists, radiation oncologists and surgeons work together to create an integrated treatment plan that could include a combination of the following treatments:

• Chemotherapy to target the tumor, including shrinking it before surgery
• Immunotherapy, which prompts your immune system to attack the cancer cells
• Radiation therapy, often combined with chemotherapy
• Transurethral resection of bladder tumor, a minimally invasive procedure involving lasers that remove cancer
• Surgery, which may involve removing the tumor or, in advanced cases, the entire bladder and surrounding lymph nodes (radical cystectomy)

Your doctor will discuss the options, explaining the expected outcomes and side effects.

Read more about bladder cancer treatment at Beaufort Memorial.

Life After Bladder Cancer Treatment

Bladder cancer treatments have improved in recent years. According to the American Cancer Society, the five-year bladder cancer survival rate is 78%, but survival rates depend on your overall health and many other factors. They are higher when providers diagnose bladder cancer in the early stages.

Bladder cancer can return after treatment, so your team will develop a long-term care plan that includes follow-up appointments. Your urologist will monitor your health and may order tests to identify bladder cancer early if it returns.

Support for Your Journey

Beaufort Memorial urologists and oncologists have decades of experience diagnosing and treating bladder cancer. Your team will include a dedicated cancer nurse navigator who will help you with all aspects of your treatment and care, keep track of appointments and provide emotional and mental support.

They will focus on your overall well-being and connect you with the resources and support you need. You also have access to a social worker and financial navigator, who can help with practical needs and refer you to support groups.