Bladder Cancer

There are three types of bladder cancer that begin in cells in the lining of the bladder. These cancers are named for the type of cells that become malignant (cancerous):

• Transitional cell carcinoma: Cancer that begins in cells in the innermost tissue layer of the bladder. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the transitional cells. Transitional cell carcinoma can be low-grade or high-grade:
  • Low-grade transitional cell carcinoma often recurs (comes back) after treatment, but rarely spreads into the muscle layer of the bladder or to other parts of the body.
  • High-grade transitional cell carcinoma often recurs (comes back) after treatment and often spreads into the muscle layer of the bladder, to other parts of the body, and to lymph nodes. Almost all deaths from bladder cancer are due to high-grade disease.
• Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells that may form in the bladder after long-term infection or irritation.
• Adenocarcinoma: Cancer that begins in glandular (secretory) cells that are found in the lining of the bladder. This is a very rare type of bladder cancer.

Cancer that is in the lining of the bladder is called superficial bladder cancer. Cancer that has spread through the lining of the bladder and invades the muscle wall of the bladder or has spread to nearby organs and lymph nodes is called invasive bladder cancer.

Signs and symptoms of bladder cancer include blood in the urine and pain during urination.

These and other signs and symptoms may be caused by bladder cancer or by other conditions. Check with your doctor if you have any of the following:

• Blood in the urine (slightly rusty to bright red in color)
• Frequent urination
• Pain during urination
• Lower back pain

Risk factors for bladder cancer include:

• Using tobacco, especially smoking cigarettes.
• Having a family history of bladder cancer.
• Having certain changes in the genes that are linked to bladder cancer.
• Being exposed to paints, dyes, metals or petroleum products in the workplace.
• Past treatment with radiation therapy to the pelvis or with certain anticancer drugs, such as cyclophosphamide or ifosfamide.
• Taking Aristolochia fangchi, a Chinese herb.
• Drinking water from a well that has high levels of arsenic.
• Drinking water that has been treated with chlorine.
• Having a history of bladder infections, including bladder infections caused by Schistosoma haematobium.