Bladder Cancer: Frequently Asked Questions

Listed below are some frequently asked questions about bladder cancer.

What is bladder cancer?

Bladder cancer is cancer that starts in the bladder. The bladder is a hollow, muscular organ in the lower stomach.

The bladder's role is to hold urine until it leaves the body through the urethra. There are different types of bladder cancer. The most common type is transitional cell carcinoma, or TCC. A small percentage of bladder cancers is either adenocarcinomas or squamous cell carcinomas. Rarely, there can be lymphomas, sarcomas, or small cell cancers. 

Who is most likely to get bladder cancer?

Some people are more at risk for bladder cancer than others. Bladder cancer most often happens in people ages 50 to 80. Smokers get bladder cancer more often than nonsmokers. White people get bladder cancer more often than people of other races. Men are more likely to get bladder cancer than women. People who have worked in the rubber and leather industries are more likely to get bladder cancer. So are people who have been exposed to chemicals through their job, such as painters, hairdressers, and machinists.

What are the common signs of bladder cancer?

Common signs of bladder cancer include blood in the urine, pain while urinating, and the need to urinate often or an urgent need to urinate. These can also be signs of other, less serious problems. Anyone who has these signs should see a healthcare provider.

If I have blood in my urine, does this mean I have bladder cancer?

Blood in the urine may be a sign of bladder cancer. However, it can also be a sign of kidney cancer, or another, less serious problem. These problems may include a bladder infection or kidney stone. Anyone who has blood in the urine should see a healthcare provider right away. That way, the cause can be found and treated.

What tests are done to diagnose bladder cancer?

The healthcare provider examines samples of the person’s urine. The healthcare provider will also do a physical exam. This exam may include a vaginal or rectal exam so that the healthcare provider can feel for a tumor. The healthcare provider may do a cystoscopy. That procedure uses a tool called a cystoscope. This tool is a thin, lighted tube that the healthcare provider inserts through the urethra to look in the bladder. If the healthcare provider sees anything unusual during the cystoscopy, he or she may do a biopsy. That involves removing small cell and tissue samples from the bladder so that they can be looked at under a microscope for cancer. The healthcare provider may do other tests if bladder cancer is diagnosed. These tests include imaging studies, which help the healthcare provider see inside the body. They include chest X-rays, CT scans, and MRIs. The healthcare provider may also do bone scans and blood tests.

If bladder cancer spreads, where does it go?

Bladder cancer tends to grow slowly and often does not spread to other parts of the body. When it does spread, it is called metastatic bladder cancer. If it spreads, bladder cancer may go to lymph nodes in the pelvic area or invade other nearby organs, such as the prostate or uterus. Bladder cancer can also spread to distant areas, most commonly to the lungs, bones, and liver.

What are the treatments for bladder cancer?

The treatment a person gets depends on the stage and grade of the cancer. It also depends on the person’s age and health. Here’s an overview of the treatments for bladder cancer:

• Surgery to take out all or part of the bladder

• Immunotherapy

• Chemotherapy

• Radiation

• Combinations of these treatments

If all of the bladder is taken out during surgery, there will also be reconstructive surgery. Its role is to create a new place to store urine and a new path for it to leave the body.

Are any new treatments being studied?

Healthcare providers are always looking for new and better ways to treat bladder cancer. These methods are tested in clinical trials. For a list of clinical trials, go to www.cancer.gov/clinicaltrials.

Should everyone told they have bladder cancer get a second opinion?

Many people with cancer get a second opinion from another healthcare provider. There are many reasons to get a second opinion. Here are some of those reasons:

• Not feeling comfortable with the treatment decision

• Being diagnosed with a rare type of cancer

• Having several options for how to treat the cancer

• Not being able to see a cancer expert

• A second opinion may be required by your health insurance company 

How can someone get a second opinion?

There are many ways to get a second opinion:

• Ask a primary healthcare provider. A person’s healthcare provider may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes, these healthcare providers work together at special cancer centers or hospitals. Do not be afraid to ask your healthcare provider about getting a second opinion.

• Call the National Cancer Institute’s Cancer Information Service. The number is 800-4-CANCER (800-422-6237). They have information about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute.

• Seek other choices. Here are some other ways to get names of healthcare providers who give second opinions. Check with a local medical society, nearby hospital or medical school, or cancer advocacy group. Or ask other people who have had bladder cancer.

What are the side effects of bladder cancer treatments?

The side effects you have depend on the kind of treatment given. It’s a good idea for patients to ask their healthcare provider what to expect a treatment to do for them, as well as what side effects to watch for.

Can a person live without a bladder?

A person can live without a bladder. In fact, many people do. If a surgeon has to remove the bladder to get rid of the cancer, he or she will create a new way for the body to eliminate urine. Before surgery to remove the bladder, the patient meets with the surgeon. At that time they will talk in detail how urination will happen after surgery.