Overview

What is bladder cancer? A Mayo Clinic expert explains

Learn more about bladder cancer from urologist Mark Tyson, M.D., M.P.H.

Hi. I'm Dr. Mark Tyson, a urologist at Mayo Clinic. In this video, we'll cover the basics of bladder cancer: What is it? Who gets it? The symptoms. Diagnosis and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Bladder cancer is almost always one certain type of cancer called urothelial carcinoma, because it starts when urothelial cells that line the inside of the bladder over multiply and become abnormal. Most bladder cancer is caught in the early stages and therefore very treatable.

Who gets it?

While bladder cancer can happen to anyone, it affects certain groups more than others. For instance, smokers. As the bladder works to filter the harmful chemicals ingested in cigarette smoke, it becomes damaged. In fact, smokers are three times more likely to get bladder cancer. People over the age of 55 are more at risk, as are men, more than women. Exposure to harmful chemicals, either at home or at work, previous cancer treatments, chronic bladder inflammation, or a family history of bladder cancer can also play a role.

What are the symptoms?

Bladder cancer symptoms are usually clear and easy to notice. If any of these symptoms are present, it may be worth making an appointment to see a doctor: Blood in the urine, frequent urination, painful urination or back pain. Your doctor may investigate the more common causes of the symptoms first, or may refer you to a specialist, like a urologist or an oncologist.

How is it diagnosed?

To determine if you have bladder cancer, your doctor may start with a cystoscopy, where a tiny camera is passed through the urethra to see into the bladder. If your doctor finds something suspicious, they can take a biopsy or a cell sample that is sent to a lab for analysis. In some cases, your doctor may do a urine cytology, where they examine a urine sample under a microscope to check for cancer cells. Or they may even do imaging tests of your urinary tract, like a CT urogram or a retrograde pyelogram. In both procedures, a safe dye is injected and travels to your bladder, illuminating the cancer cells so they can be seen in X-ray images.

How is it treated?

When creating a treatment plan for bladder cancer, your doctor is considering several factors, including the type and stage of cancer and your treatment preferences. There are five types of treatment options for bladder cancer: Surgery to remove the cancerous tissue. Chemotherapy, which uses cancer-cell-killing chemicals that can travel either locally into the bladder or through the whole body, if needed. Radiation therapy, which uses high-power beams of energy to target cancer cells. Targeted drug therapy focusing on blocking specific weaknesses present within cancer cells. And immunotherapy, a drug treatment that helps your immune system recognize cancer cells and attack them.

What now?

Getting a cancer diagnosis or worrying that cancer will return can be very stressful. However, there are ways to feel more in control and deal with less stress. Stay on top of your follow-up tests and appointments. Even though they might feel uncomfortable or unpleasant, ultimately, they can empower you and your health. Take care of yourself outside of your appointments. Be good to your body with plenty of fruits and vegetables, whole grains, consistent exercise and the ever important sleep. Be good to your mind. Try different methods to cope with stress, like journaling or meditation. Maybe find a support group of cancer survivors who understand how you're feeling. If you'd like to learn even more about bladder cancer, watch our other related videos or visit mayoclinic.org. We wish you well.

Bladder cancer is a common type of cancer that begins in the cells of the bladder. The bladder is a hollow muscular organ in your lower abdomen that stores urine.

Bladder cancer most often begins in the cells (urothelial cells) that line the inside of your bladder. Urothelial cells are also found in your kidneys and the tubes (ureters) that connect the kidneys to the bladder. Urothelial cancer can happen in the kidneys and ureters, too, but it's much more common in the bladder.

Most bladder cancers are diagnosed at an early stage, when the cancer is highly treatable. But even early-stage bladder cancers can come back after successful treatment. For this reason, people with bladder cancer typically need follow-up tests for years after treatment to look for bladder cancer that recurs.

Symptoms

Bladder cancer signs and symptoms may include:

  • Blood in urine (hematuria), which may cause urine to appear bright red or cola colored, though sometimes the urine appears normal and blood is detected on a lab test
  • Frequent urination
  • Painful urination
  • Back pain

When to see a doctor

If you notice that you have discolored urine and are concerned it may contain blood, make an appointment with your doctor to get it checked. Also make an appointment with your doctor if you have other signs or symptoms that worry you.

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Causes

Bladder cancer begins when cells in the bladder develop changes (mutations) in their DNA. A cell's DNA contains instructions that tell the cell what to do. The changes tell the cell to multiply rapidly and to go on living when healthy cells would die. The abnormal cells form a tumor that can invade and destroy normal body tissue. In time, the abnormal cells can break away and spread (metastasize) through the body.

Types of bladder cancer

Different types of cells in your bladder can become cancerous. The type of bladder cell where cancer begins determines the type of bladder cancer. Doctors use this information to determine which treatments may work best for you.

Types of bladder cancer include:

  • Urothelial carcinoma. Urothelial carcinoma, previously called transitional cell carcinoma, occurs in the cells that line the inside of the bladder. Urothelial cells expand when your bladder is full and contract when your bladder is empty. These same cells line the inside of the ureters and the urethra, and cancers can form in those places as well. Urothelial carcinoma is the most common type of bladder cancer in the United States.
  • Squamous cell carcinoma. Squamous cell carcinoma is associated with chronic irritation of the bladder — for instance, from an infection or from long-term use of a urinary catheter. Squamous cell bladder cancer is rare in the United States. It's more common in parts of the world where a certain parasitic infection (schistosomiasis) is a common cause of bladder infections.
  • Adenocarcinoma. Adenocarcinoma begins in cells that make up mucus-secreting glands in the bladder. Adenocarcinoma of the bladder is very rare.

Some bladder cancers include more than one type of cell.

Risk factors

Factors that may increase bladder cancer risk include:

  • Smoking. Smoking cigarettes, cigars or pipes may increase the risk of bladder cancer by causing harmful chemicals to accumulate in the urine. When you smoke, your body processes the chemicals in the smoke and excretes some of them in your urine. These harmful chemicals may damage the lining of your bladder, which can increase your risk of cancer.
  • Increasing age. Bladder cancer risk increases as you age. Though it can occur at any age, most people diagnosed with bladder cancer are older than 55.
  • Being male. Men are more likely to develop bladder cancer than women are.
  • Exposure to certain chemicals. Your kidneys play a key role in filtering harmful chemicals from your bloodstream and moving them into your bladder. Because of this, it's thought that being around certain chemicals may increase the risk of bladder cancer. Chemicals linked to bladder cancer risk include arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products.
  • Previous cancer treatment. Treatment with the anti-cancer drug cyclophosphamide increases the risk of bladder cancer. People who received radiation treatments aimed at the pelvis for a previous cancer have a higher risk of developing bladder cancer.
  • Chronic bladder inflammation. Chronic or repeated urinary infections or inflammations (cystitis), such as might happen with long-term use of a urinary catheter, may increase the risk of a squamous cell bladder cancer. In some areas of the world, squamous cell carcinoma is linked to chronic bladder inflammation caused by the parasitic infection known as schistosomiasis.
  • Personal or family history of cancer. If you've had bladder cancer, you're more likely to get it again. If one of your blood relatives — a parent, sibling or child — has a history of bladder cancer, you may have an increased risk of the disease, although it's rare for bladder cancer to run in families. A family history of Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC), can increase the risk of cancer in the urinary system, as well as in the colon, uterus, ovaries and other organs.

Prevention

Although there's no guaranteed way to prevent bladder cancer, you can take steps to help reduce your risk. For instance:

  • Don't smoke. If you don't smoke, don't start. If you smoke, talk to your doctor about a plan to help you stop. Support groups, medications and other methods may help you quit.
  • Take caution around chemicals. If you work with chemicals, follow all safety instructions to avoid exposure.
  • Choose a variety of fruits and vegetables. Choose a diet rich in a variety of colorful fruits and vegetables. The antioxidants in fruits and vegetables may help reduce your risk of cancer.

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April 19, 2022

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