Overview of the Bladder - Bladder Cancer  |  Johns Hopkins Pathology (2023)

Overview of the Bladder - Bladder Cancer | Johns Hopkins Pathology (2)
  • Home >
  • Overview of the Bladder
Overview of the Bladder - Bladder Cancer | Johns Hopkins Pathology (3)

Anatomy & Physiology

The bladder is a sac-like organ in the pelvis that stores the urine produced by the kidneys. There are two tubular structures called ureters (one from each kidney) that drain the urine into the bladder. The urethra is the outflow tract of the bladder and connects the bladder to the exterior.

It is a musculomembranous sac situated in the pelvis, behind the pubis and in front of the rectum in males and in front of the uterus, cervix and vagina in females. The bladder has the capacity to distend to store urine and it can be palpated in the lower abdomen during physical exam when distended. The upper portion of the bladder is considered the fundus and is covered by peritoneum, which is the membrane that covers the abdominal cavity. The anterior wall rests in the symphysis pubis and the posterior wall lies on top of the prostate, seminal vesicles and ureters in males and cervix, vagina and ureters in females. The most lower aspect of the bladder is the neck, which connects the bladder with the prostatic urethra in males and the urethra in females. Within the inner surface of the bladder neck, posterior and lateral, there are the orifices of the ureters, which are tubular structures connecting the kidneys with the bladder. A triangle that connects the ureteral orifices (posterior and lateral) with the urethral opening is known as the trigone, with the apex directed forward. The urachus is the obliterated remains of the tubular canal allantois which exists in the embryo, and a portion of which becomes expanded to form the bladder. In adults the urachus consists of fibrous tissue and muscle that connects the bladder with the umbilicus.

The wall of the bladder is composed of four coats from inner to outer that include the mucosa, submucosa, the muscularis propria, and the perivesical soft tissue:


The mucosa is thin and smooth and has a pale pink color. It continues upwards with the lining of the ureters and downwards with the lining of the urethra. The ureters, bladder and urethral mucosa is covered by the same type of epithelium called urothelium, and therefore, the same type of cancer seen in the bladder can be seen in these sites. The urothelium is a transitional type of epithelium and consists of a superficial layer of umbrella cells that are flattened and often have more than one nucleus. Below the umbrella cell layer, there is a stratified epithelium composed of oval or club shaped cells with the narrow end of the cells pointing downwards. There are no true glandular structures in the bladder wall although in some persons the epithelium might acquire a glandular architecture and produce mucus. These changes are called cystitis cystica et glandularis.

Submucosa or Lamina Propria

The submucosa or lamina propria consists of loose connective tissue where stroma cells, blood vessels and thin smooth muscle bundles called muscularis mucosae are located and provide nutrients and support to the overlying urothelium and gives the urothelium an undulating or corrugated appearance when the organ is empty. The superficial layer of smooth muscle is not to be confused with the true muscular layer of the bladder called the muscularis propria or detrusor muscle. The subepithelial connective tissue is scant in the area of the trigone where the mucosa is always smooth due to its close attachment to the muscle of the wall (detrusor muscle).

Muscularis Propria or Detrusor Muscle

Muscularis propria or detrusor muscle consists of thick smooth muscle bundles that form the wall of the bladder. Anatomically, there three layers of smooth muscle, an external longitudinal layer, a middle circular layer and an inner longitudinal layer. For purposes of staging bladder cancer, the muscularis propria has been divided into a superficial (inner) half and a deep (outer) half.

(Video) Bladder Cancer | Q&A

Perivesical Soft Tissue

This outermost layer consists of fat, fibrous tissue and blood vessels. When the tumor reaches this layer, it is considered out of the bladder.

Leiomyosarcoma is a rare type of cancer that affects smooth muscle tissue. These tumors are most common in the abdomen, but can occur anywhere in the body, including the uterus.

Rhabdomyosarcoma (RMS) is a rare type of cancer that forms in soft tissue — specifically skeletal muscle tissue or sometimes hollow organs such as the bladder or uterus.

A medical doctor who specializes in the management and surgery of diseases of the genitourinary tract.

A colorless crystalline solid which readily forms water-soluble polymers.

A mucous membrane

The removal and microscopic examination of a tissue sample.

Visual examination of the inside of the bladder by means of a cystoscope (Instrument that is passed through the urethra and allows visualization and biopsy of the bladder).

Tubular structure that transports urine from the bladder with the urethral meatus in the vulva in women and with the urethral meatus in the glans penis in men

Epithelium that lines the bladder mucosa, the renal pelvis, ureters and urethra

An imaging technique that uses beams of radiation (X-rays) to take an image of the body.

Medical subspecialty that studies tissue abnormalities caused by diseases. Biopsies and resection specimens are read and informed by “surgical pathologists”

The removal of tissue through the use of a cystoscope, without a surgical incision on the skin

Tubular structure that transports urine from the renal pelvis with the bladder

Vessels, connective tissue and cells providing support to epithelial cells

Carcinoma that resembles cancer originating in the skin

A multidisciplinary meeting of the physicians and caretakers involved in cancer care, including pathologists, surgical oncologists, medical oncologists, radiologists, nurses and genetic counselors to discuss the treatment plans for individual patients

A mass or a lump. A tumor mass can be nonneoplastic and be due to something like swelling or inflammation. A tumor mass can also be neoplastic, and includes both benign and malignant tumors

The process by which DNA is copied to make RNA

The process by which the body reads the code in RNA to make proteins

A treatment that can reach cancer cells that have potentially spread throughout the body. Examples include chemotherapy, hormone therapy, and targeted therapy. Systemic therapies can have side effects due to effects on normal body cells, such as hair loss or gastrointestinal distress

A type of treatment that specifically targets a single molecule or pathway involved in cancer cell growth and progression

A physician who specializes in surgical treatment (removal) of cancer

Any change noted by a patient that could be caused by a disease

A disease that widely affects the entire body

A measure of how much a cancer has grown and/or spread in the body (i.e., how advanced a cancer is). The most common staging system is the TNM system, which stands for Tumor, lymph Nodes, and Metastasis. Stage ranges from 0 to 4, with stage 0 being pre-invasive disease, and stage 4 being metastatic disease. The stage is often written using Roman numerals: stage 0, stage I, stage II, stage III and stage IV. Stage is a prognostic factor, such that a high stage is associated with a poorer prognosis or outcome

The term for the usual treatment given for a particular disease, which is based on past research and experience proving the treatment’s efficacy and safety

(Video) Bladder Cancer: Basics of Diagnosis, Workup, Pathology, and Treatment

Cancer that arises from epithelium but transform to look like stromal origin

The process of having a second set of doctors look at your unique medical situation to provide a second opinion on the diagnosis and/or treatment plan

A term used to describe the balance between the risk (such as side effects) and benefit of a therapy, procedure, or other course of action

RNA molecules are a copy of the genetic information encoded in DNA, and the RNA copy is then used to create proteins

Cancer arising from stroma cells

Anything that increases the risk of developing a disease. For bladder cancer, these include smoking history, age and male gender

The chance or probability of developing a disease in a given period of time

Resident physicians are physicians who have finished medical school and are now studying a specific area in depth, such as pathology, internal medicine, surgery, pediatrics, radiology, and more

A research study in which patient records and files are reviewed to look for results (outcomes) that already occurred in the past

When a cancer returns after previously having been eliminated. This can be a local recurrence in the bladder, or a distant recurrence when the cancer metastases to a new organ

Lymph nodes that drain (collect) the lymph fluid from a particular part of the body. The main regional nodes of the bladder are in the pelvis

A reduction is size

A treatment for some forms of cancer that uses high energy radiation to damage the DNA of the cells

A physician who specializes in the use of imaging techniques, such as X-rays, mammograms, CT scans, and MRIs. This can include reviewing scans to detect a physical abnormality or mass, or for placing a needle in an exact location in order to perform a core biopsy

A type of research study in which patients are randomly assigned into treatment groups, either to receive an experimental treatment (“intervention group”) or standard treatment (“control group”).

A term used to describe continued growth of a cancer

A research study that is conducted using new patients and following their course to observe the outcome

Is the removal of the urinary bladder in women and the urinary bladder, prostate and seminal vesicles in men

A term that describes variation in size and shape of a cell’s nucleus

A description for how a cancer has responded to therapy, as seen under the microscope

A physician who specializes in the diagnosis of disease; pathologists use a microscope to examine the cells from tissue to determine if the tissue is normal or cancer

Urothelial carcinoma characterized by cells with an appearance similar to plasma cells and a pattern of single cell infiltration

Treatments given to relieve pain and symptoms rather than to cure the disease

Cancer originated in the urothelium that forms exophytic or endophytic papillary structures (protrusions with a fibrovascular core)

The tissue of an organ

Thick muscle bundles that serve as the contractile unit that expulses the urine out during urination

Therapy that is given to the patient before surgery to attempt to shrink the tumor size. Neoadjuvant therapy is typically chemotherapy or targeted therapy, but can also include radiation therapy

An abnormal growth of cells that are clonal, that is, they arose from each other and share genetic material. Neoplasms can be benign or malignant

A change in a cell’s DNA. Some mutations lead to a favorable change in a gene or a protein’s function, an unfavorable change, a loss of function, or no change at all (see also genetic mutation)

Thins smooth muscle bundles located underneath the urothelium

(Video) A Dummies Guide to Bladder Cancer Diagnosis

An approach to patient care that incorporates several disciplines of medicine and allows for communication between physicians and caretakers of different specialties. In bladder cancer care, this includes genetic counselors, medical oncologists, nurse navigators, pathologists, radiation oncologists, radiologists, and oncologic urologists. By sitting everyone down at one time, medical providers can better coordinate care, leading to better patient care

An imaging technique that uses a powerful magnetic field and radio waves to take pictures of tissue deep in the body

A device used by pathologists to examine tissue on slides; the microscope magnifies the tissue so that pathologist can examine the individual cells and make a diagnosis

The process by which a cell divides into two cells. Under the microscope, dividing cells can be identified by their exposed chromosomes (DNA)

Classification of cancer based on its gene expression. There are 2 main molecular subtypes in bladder cancer, luminal and basal

Tumor established in a distant place from its origin. Most common metastatic sites are lymph nodes, lungs, liver, brain, and bone

Morphologic variant of urothelial carcinoma forming micropapillae. It is considered a clinically aggressive deviant morphology

Tumor cells entering the lymphatic system and in-route to lymph nodes

Cancer cells with the ability to invade surrounding tissue and with the potential to metastasize (spread) to lymph nodes and distant organs

The ‘edge’ of specimen containing a rim of normal-appearing tissue around the tumor. Pathologists evaluate the margin tissue under the microscope to see if the tumor has been entirely removed. “Negative” or clean margins means that all of the tumor was removed. “Positive” or involved margins means that the tumor was not entirely removed and additional therapy may be necessary

A lump or swelling. A mass can be due to excess fluid or an abnormal growth of cells; the growth of cells can be benign or malignant

A doctor specialized in the treatment of cancer using chemotherapy, immune check point inhibitors, and targeted therapy

Connective tissue immediately underneath the urothelium

Cancer that has not yet spread to nearby tissues (by direct invasion) or to distant organs (by metastasis)

Cancer that is expected to progress more slowly that high-grade cancer

Part of the immunologic system where antigens are presented to immune cells to develop an immunologic response. In cancer, lymph nodes are where the tumor cells go after they leave the primary tumor

Something that occurs during an operation. For instance, a frozen section is done intraoperatively

A pattern of growth where the cancer cells grow into (invade) the surrounding tissues (see also infiltrating)

Refers to therapy applied using intravesical instillation of drugs or BCG

Cancer that has invaded into the stroma and can give rise to metastases

A type of treatment that uses the immune system to fight cancer; these therapies target proteins expressed by immune cells or on the cancer cell

A pattern of growth where the cancer cells grow into (invade) the surrounding tissues (see also invasive).

The result of the presence of immune cells (“inflammatory” cells) to a part of the body. Areas of the body that are inflamed often look swollen and red

Cancer that is expected to behave aggressively

The body’s natural defense against infection with microorganisms such as bacteria and viruses. The immune cells are constantly on the lookout for cells that look “foreign.” In addition to microorganism, immune cells can also recognize cancer cells as “foreign,” since the cancer cells may express abnormal proteins. In this way, the immune system can sometimes be a part of the body’s attack against cancer

A type of laboratory test that can detect the proteins expressed by a cell. The test uses special antibodies (“immunostains”) that each binds to a particular protein in question; the immunostain will change the color of the tissue to show whether a protein is present

Blood in the urine

The area of tissue that is seen at a microscope’s highest magnification (i.e., the most “zoomed in”)

Relating to appearance of cells and tissues under the microscope

A histologic description of how closely the cancer cells resemble their normal cell of origin

(Video) Johns Hopkins Greenberg Bladder Cancer Institute

A type of dye that is applied to tissue sections so that the cells absorb the color and can be seen with the eye when looking under the microscope. This dye turns the nuclei blue and the cytoplasm pink

Blood in semen

A test of a patient’s DNA to look for specific gene mutations or other abnormalities that might cause cancer or other conditions

A mutation in DNA that is present at birth and that can be transferred from parent to child

A small, thin rectangular piece of glass where tissue slices from a biopsy or a surgical specimen are placed and stained with dye so that the tissue can be evaluated under a microscope

A change in a cell’s DNA. Some mutations lead to a favorable change in gene or protein’s function, an unfavorable change, a loss of function, or no change at all (see also mutation)

A single sequence of DNA that codes for a protein

A laboratory test that analyzes the expression of multiple genes to characterize what proteins tumor cells are creating

A meeting between a patient and a medical geneticist or counselor to discuss the potential impact of a genetic test result on the health of a patient and for their family

A term used to describe how fresh tissue samples are processed and stored so that slides of the tissue can be made and examined by a pathologist. The fresh tissues are “fixed” in a preservative called formalin, so that the tissues will not degrade or decompose. They are then “embedded” into paraffin wax, which means they are placed into a little block or wax similar to candle wax so that they can be easily sliced into thin slices and placed on a glass slide for a pathologist to review

A method that pathologists can perform intra-operatively (i.e., while a surgery is underway) to quickly freeze a piece of tissue from the patient in order to take thin slices and make a slide to evaluate “in real time” while the surgery is still ongoing. This is sometimes performed on lymph nodes or margins to tell the surgeon whether there are cancer cells there. The results are only preliminary, however, and must be confirmed with review of the final FFPE sections

A negative result for a test that should actually be positive (i.e., an incorrect test result that states a person is disease-free, which the person actually has the disease)

A positive result for a test that should actually be negative (i.e., an incorrect test result that states a person is positive for disease, which the person is actually disease-free)

The medical history of all of the biological (blood-related) members of a family; this family medical history can show patterns of shared diseases. Because you share genes with your family members, a “positive family history” of certain diseases may be considered a risk factor for an individual to develop the disease.

The layer of cells that lines the outside of the body, lines the inside of the body cavities, and lines the outside and inside of body organs. Epithelium is one of four types of tissues in the body; the other three types are connective tissue (like fat and fibrous tissue), muscle tissue, and neural/nervous system tissue. The epithelium lining each of the surfaces in the body has different names; for instance, the epithelium lining the outside of the body is called skin, and the epithelium lining the inside of the chest cavity is called the pleura. The epithelium that lines the urinary system is called urothelium

Swelling of a part of the body from excess fluid

A type of cell in the body that makes up many different tissue types, including urothelium in the bladder. Epithelial cells in other parts of the body line the body surface (such as the “squamous epithelium” of the skin) and the body cavities. The epithelial cell is the cell or origin of carcinomas

Synonym with muscularis propria

The molecule which contains all of your genes, located within a cell’s nucleus … a long, complex molecule with which your genes are encoded

The portion of a cell outside the nucleus, but still within the cell membrane

A study organized by a hospital, organization, or other group to systematically and thoroughly investigate a new medication, technique, or other approach to treatment. Clinical trials are extensively monitored to make sure that they are conducted in a safe, ethical, and equitable manner

A consultation in pathology occurs when a specimen is sent to a second (or sometimes third) institution to review the findings. This can occur when other pathologists need assistance with a particularly challenging or rare case, or if a patient or clinician would like a second opinion on a case.

Flat carcinoma that is non-invasive

A neoplastic (clonal) growth of cells with the potential to metastasize (spread throughout the body). Cancers can arise from epithelial cells (“carcinomas”), melanocytes (“melanomas"), stromal or connective tissue cells (“sarcomas”), and lymphoid cells (“lymphomas and leukemias”)

Cancer arising from epithelial cells

drugs used to kill tumor cells

A tubular structure that carry blood both to and from various parts of the body. This includes arteries, veins, and capillaries.

Bacillus Calmette-Guérin (BCG) a live attenuated strain of Mycobacterium bovis, is currently an agent approved by the US Food and Drug Administration for primary therapy of carcinoma in situ, non-invasive papillary urothelial carcinoma, and carcinoma invading the lamina propria (stage pT1) of the bladder.

Non-cancerous. A benign tumor cannot invade nearby tissues or spread to other parts of the body

Any chemical or protein created by the body that can be measured, and can be used to provide useful information such as whether a cancer is growing or shrinking during treatment. Biomarkers can also provide information about the prognosis of a cancer (prognostic biomarker), as well as whether a cancer will respond to certain therapies (predictive biomarker).

(Video) Diagnosing Bladder Cancer 2 - Stages, Grades & Pathology

Pelvic reservoir of urine.

Tumor cells invading blood vessels to travel to a distant location and form a metastasis

Adjuvant therapy is any treatment given in addition to surgery. It can include chemotherapy, radiation therapy, or other treatment. This is in contrast to neoadjuvant chemotherapy, which is given before surgery


What is bladder cancer overview? ›

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.

What is the most common pathology for bladder cancer? ›

Urothelial carcinoma is the predominant histologic type in the United States and Europe, where it accounts for 90 percent of all bladder cancers.

What are 4 types of bladder cancer? ›

Small cell bladder cancer is a rare type of bladder cancer that is likely to spread to other parts of the body.
Types of bladder cancer
  • Urothelial carcinoma. Urothelial carcinoma (or UCC) accounts for about 90% of all bladder cancers. ...
  • Squamous cell carcinoma. ...
  • Adenocarcinoma.

What is bladder BCG treatment pathology? ›

BCG is a germ that's related to the one that causes tuberculosis (TB), but it doesn't usually cause serious disease. When BCG is put into the bladder as a liquid through a catheter, it helps "turn on" the immune system cells there, which then attack the bladder cancer cells.

What dictates the pathologic stage of bladder cancer? ›

The staging system in the table below uses the pathologic stage. It's based on the results of the physical exam, biopsy, imaging tests, and the results of surgery. This is likely to be more accurate than clinical staging, which only takes into account the tests done before surgery.

What is the gold standard for diagnosing bladder cancer? ›

While white light cystoscopy (WLC) is the gold standard for bladder cancer detection, there is room for improvement with this technique. Due to the chronic nature of the disease, bladder cancer is very expensive to manage. Surveillance and recurrence costs account for the majority of this economic burden.

Where does bladder cancer most often metastasize? ›

Lymph nodes, bones, lung, liver, and peritoneum are the most common sites of metastasis from bladder cancer. Tumors in a more advanced T category and those with atypical histologic features metastasize earlier. Tumors with atypical histologic features also have a higher frequency of peritoneal metastasis.

What is the number 1 risk factor for bladder cancer? ›

Smoking. Smoking is the most important risk factor for bladder cancer.

Where is the first place bladder cancer spreads? ›

Where can bladder cancer spread to? Not all bladder cancers will spread. But If it does it's most likely to spread to the structures close to the bladder, such as the ureters, urethra, prostate, vagina, or into the pelvis.

Can you live 10 years with bladder cancer? ›

Survival for all stages of bladder cancer

almost 55 out of every 100 (almost 55%) survive their cancer for 5 years or more after they are diagnosed. around 45 out of every 100 (around 45%) survive their cancer for 10 years or more after diagnosis.

What is the rarest type of bladder cancer? ›

Small-cell carcinoma is extremely rare, accounting for fewer than 1 percent of all bladder cancers diagnosed in the United States. This type of bladder cancer begins in neuroendocrine cells, which are similar to nerves.

How many times can you have BCG treatments? ›

Maintenance BCG is typically given once per week for three weeks at 3, 6, and 12 months after the initial BCG treatment. In some cases, maintenance BCG treatment will be recommended for one year for those at intermediate risk of recurrence and for three years for those at higher risk for recurrence.

Is BCG better than chemo? ›

BCG is most commonly used in intravesical immunotherapy for NMIBC and appears to be more effective than intravesical chemotherapy in preventing tumor recurrence and progression. Especially for those with high-risk NMIBC, BCG immunotherapy is considered as a gold-standard treatment (29).

What is next if BCG treatments don't work? ›

Radical cystectomy is the recommended treatment for high-risk patients failing BCG.

What is the latest treatment for bladder cancer? ›

New Bladder Cancer Treatments
  • Immunotherapy. Immunotherapy is treatment that helps the body's immune system fight cancer more effectively. ...
  • Targeted Therapy. ...
  • Combination Therapy. ...
  • Antibody Drug Conjugates. ...
  • Clinical Trials for Bladder Cancer.
Jun 22, 2022

Are most bladder cancers curable? ›

These cancers can almost always be cured with treatment. During long-term follow-up care, more superficial cancers are often found in the bladder or in other parts of the urinary system. Although these new cancers do need to be treated, they rarely are deeply invasive or life threatening.

What are the signs of advanced bladder cancer? ›

If bladder cancer reaches an advanced stage and begins to spread, symptoms can include: pelvic pain. bone pain. unintentional weight loss.
Symptoms of bladder cancer
  • a need to urinate on a more frequent basis.
  • sudden urges to urinate.
  • a burning sensation when passing urine.

What is the high grade prognosis for bladder cancer? ›

If the cancer extends through the bladder to the surrounding tissue or has spread to nearby lymph nodes or organs, the 5-year survival rate is 38%. If the cancer has spread to distant parts of the body, the 5-year survival rate is 6%. About 4% of people are diagnosed with this stage.

At what stage is bladder cancer usually diagnosed? ›

However, there is not yet a test accurate enough to screen the general population for bladder cancer, so most people are diagnosed with bladder cancer once they have symptoms. As a result, some people have more advanced (later stage) disease when the cancer is found.

Which of the following is the most important prognostic factor in bladder tumors? ›

The most significant prognostic factors for bladder cancer are grade, depth of invasion, and the presence of CIS. In patients undergoing radical cystectomy for muscle-invasive bladder cancer, the presence of nodal involvement is the most important prognostic factor.

What is the most accurate test for bladder cancer? ›

Pathology Tests

The most efficient, noninvasive and inexpensive test is a urinalysis/cytology. Here, a sample of urine is taken from the patient and evaluated for cancer cells, red and white blood cells (which fight urinary tract infections), and microscopic hematuria or infection.

How accurate is cystoscopy in bladder cancer? ›

While cystoscopy is a key tool for detecting bladder cancers, like other diagnostic tests it is not 100% accurate.

What are biomarkers for bladder cancer? ›

1. FDA-Approved Urine Biomarkers. The bladder tumor antigen (BTA) is a complement factor H related protein secreted by malignant cells, which confers them survival advantage, as it interferes in the complement cascade [79].

Does bladder cancer progress quickly? ›

They tend to grow and spread slowly. High-grade bladder cancers look less like normal bladder cells. These cancers are more likely to grow and spread.

What are the second cancers after bladder cancer? ›

Lung cancer (most common, accounts for about 1 out 4 second cancers in bladder cancer survivors) Vaginal cancer. Prostate cancer. Kidney cancer.

How quickly does bladder cancer recur? ›

Even after tumor removal with transurethral resection of bladder tumor (TURBT), up to 50 percent of people will have a recurrence of their cancer within 12 months.

What foods should be avoided with bladder cancer? ›

Eat things at room temperature and avoid foods that are greasy, sugary and spicy. Avoid milk products, alcohol, sugar and caffeine.

What toxins cause bladder cancer? ›

Chemicals known to increase the risk of bladder cancer include: aniline dyes. 2-Naphthylamine. 4-Aminobiphenyl.
Occupations linked to an increased risk of bladder cancer are manufacturing jobs involving:
  • dyes.
  • textiles.
  • rubbers.
  • paints.
  • plastics.
  • leather tanning.

Can stress cause bladder cancer? ›

Chronic psychological stress has been shown to intervene in immune function and play a role in the tumor growth and progression in diverse carcinomas. However, the effects of chronic psychological stress on the biological behaviors of bladder cancer and possible underlying mechanisms are unknown.

Can bladder cancer return after bladder removal? ›

Low-grade bladder cancers recur frequently, and recurrences require treatment with a procedure called transurethral resection for bladder tumor, or TURBT. Some patients experience multiple recurrences and, as a result, undergo repeated surgeries.

What is life expectancy with bladder cancer? ›

Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed.
5-year relative survival rates for bladder cancer.
SEER* Stage5-year Relative Survival Rate
All SEER stages combined77%
2 more rows

Is bladder cancer likely to metastasize? ›

Lymph nodes, bones, lung, liver, and peritoneum are the most common sites of metastasis from bladder cancer. Tumors in a more advanced T category and those with atypical histologic features metastasize earlier. Tumors with atypical histologic features also have a higher frequency of peritoneal metastasis.

What is the best bladder cancer hospital in the US? ›

Mayo Clinic in Rochester, Minnesota, and Mayo Clinic in Phoenix/Scottsdale, Arizona, have been ranked among the Best Hospitals for urology and cancer in the nation by U.S. News & World Report. Mayo Clinic in Jacksonville, Florida, is ranked high-performing for urology and cancer by U.S. News & World Report.

What causes death with bladder cancer? ›

What causes death from bladder cancer? The cause of death for many people with nonmetastatic bladder cancer isn't the bladder cancer itself. One 2020 study found that about 44% of deaths in people with bladder cancer weren't related to bladder cancer but to nonbladder cancers (10%) and other noncancer causes (34.2%).

Is bladder cancer a big deal? ›

Malignant bladder cancer may be life threatening, as it can spread quickly. Without treatment, it can damage tissues and organs. In this article, we cover everything you need to know about bladder cancer, including types, symptoms, causes, and treatments.

Can bladder cancer be aggressive? ›

This is always a high-grade cancer (see “Grades,” below) and is considered an aggressive disease because it can lead to muscle-invasive disease. Stage I: The cancer has grown through the inner lining of the bladder and into the lamina propria.

Is bladder cancer a silent cancer? ›

Bladder cancer is the most expensive cancer to treat, and it has a reputation for being a silent killer. As with most cancers, awareness and early detection are critical in saving lives.

How many grades of bladder cancer are there? ›

grade 1 – the cancer cells look very similar to normal bladder cells, they are usually slow-growing and are less likely to spread. grade 2 – the cancer cells look less like normal cells and are slightly faster growing. grade 3 – the cancer cells look very different to normal cells and usually grow more quickly.

Why do you not get BCG anymore? ›

It was replaced in 2005 with a targeted programme for babies, children and young adults at higher risk of TB. This is because TB rates in this country are very low in the general population. TB is difficult to catch because this requires close contact with an infected person (for example, living together).

What is the failure rate of BCG? ›

Evidence synthesis: Overall, the failure rate in response to BCG is about 40-50%. Most guidelines recommend that patients failing BCG should be offered radical cystectomy (RC).

Why is BCG not given after 5 years? ›

BCG vaccination is not usually offered to people over the age of 16 because there is limited evidence of how well the vaccine works in adults.

What is the success rate for BCG? ›

This method of treatment is considered a form of immunotherapy, which is an emerging form of cancer treatment. The success rate for BCG treatment for bladder cancer is about 90%, which is considered the best life-saving rate by any treatment.

How long are you contagious after BCG treatment? ›

Precautions. While you are being treated with BCG, and for 6 to 12 weeks after you stop treatment with it, avoid contact with people who have tuberculosis. If you think you have been exposed to someone with tuberculosis, tell your doctor.

What is the alternative to BCG treatment? ›

The continuing BCG shortage has forced doctors to rely on other treatments for their patients with high-risk NMIBC. Among the alternatives they have turned to is a combination of two chemotherapy drugs, gemcitabine and docetaxel.

What is the recurrence rate after BCG? ›

While BCG is the current standard of care for NMIBC, BCG failures do exist. Specifically, recurrence and progression can happen with treatment via BCG, with 1- and 5-year recurrence rates of 15% to 61% and 31%to 78%, respectively.

How long does BCG stay in your bladder? ›

BCG is given directly into the bladder (called intravesicular) through a catheter. The medicine is left in the bladder for 1-2 hours. The dosage and schedule is determined by your healthcare provider. It is not uncommon to have urinary frequency (need to go often) or painful urination for 48 hours after treatment.

Does everyone scar from BCG? ›

BCG vaccination scar

Almost everyone when given the BCG vaccination will develop a raised bubble at the site of the injection, which may disappear soon afterwards. About 2 to 6 weeks after the injection, a small spot may appear at the site of the injection.

What happens to your body when you have bladder cancer? ›

Bladder cancer can sometimes cause changes in urination, such as: Having to urinate more often than usual. Pain or burning during urination. Feeling as if you need to go right away, even when your bladder isn't full.

What is the primary symptom of bladder cancer? ›

For most people, the first symptom of bladder cancer is blood in the urine, also called hematuria. Sometimes the blood is visible, prompting the patient to visit a doctor.

How does bladder cancer begin? ›

Bladder cancer forms when the DNA in cells in the bladder mutate or change, disabling the functions that control cell growth. In many cases, these mutated cells die or are attacked by the immune system. But some mutated cells may escape the immune system and grow out of control, forming a tumor in the bladder.

What is the classic symptom of bladder cancer? ›

The symptoms of bladder cancer can vary from person to person. The most common symptom is blood in the urine, called hematuria. It's often slightly rusty to bright red in color. You may see blood in your urine at one point, then not see it again for a while.

What are the signs that bladder cancer is getting worse? ›

If bladder cancer reaches an advanced stage and begins to spread, symptoms can include: pelvic pain. bone pain. unintentional weight loss.
Symptoms of bladder cancer
  • a need to urinate on a more frequent basis.
  • sudden urges to urinate.
  • a burning sensation when passing urine.

Where does bladder cancer usually spread to first? ›

Not all bladder cancers will spread. But If it does it's most likely to spread to the structures close to the bladder, such as the ureters, urethra, prostate, vagina, or into the pelvis.

What hurts when you have bladder cancer? ›

Other symptoms of advanced bladder cancer may include pain in the back or pelvis, unexplained appetite loss, and weight loss. If you are concerned about any changes you experience, please talk with your doctor.

Does coffee cause bladder cancer? ›

While sometimes these alcohol or caffeine exposures have been associated with the development of bladder cancer, when these are rigorously studied, they're not found to be primary risk factors for the development of bladder cancer.

What age do most people get bladder cancer? ›

Bladder cancer occurs mainly in older people. About 9 out of 10 people with this cancer are over the age of 55. The average age of people when they are diagnosed is 73.

Does bladder cancer affect the bowels? ›

Cancer and cancer treatment may cause bowel or bladder changes or problems such as diarrhea, constipation, incontinence, or retention.

Can you see bladder cancer on a CT scan? ›

CT Scans. A CT scan uses X-rays and a computer to create three-dimensional, cross-sectional pictures of the bladder, as well as the ureters and kidneys. A CT scan may be used to see whether bladder cancer has invaded the bladder wall or has spread to other organs or nearby lymph nodes.

Can you have bladder cancer for a year and not know it? ›

Can bladder cancer go undetected for years? If symptoms such as blood in the urine and changes in urinary habits are ignored by an individual and/or repeatedly misdiagnosed, it's possible that bladder cancer may not be detected for months or, in some cases, even years.


1. Understanding Bladder Cancer
(Nucleus Medical Media)
2. Bladder Cancer in Women | What You Should Know from a Medical Oncologist at the Johns Hopkins GBCI
(Johns Hopkins Medicine)
3. Greenberg Bladder Cancer Institute Virtual Grand Rounds: Decoding Bladder Cancer Pathology
(Johns Hopkins Medicine)
4. Bladder Cancer - Pathology mini tutorial
(Pathology mini tutorials)
5. Bladder Cancer Overview: types, pathophysiology, diagnosis, treatment | The Basics | Understanding
6. Navigating Clinical Trials in Bladder Cancer
(Johns Hopkins Medicine)
Top Articles
Latest Posts
Article information

Author: Clemencia Bogisich Ret

Last Updated: 06/27/2023

Views: 5265

Rating: 5 / 5 (60 voted)

Reviews: 83% of readers found this page helpful

Author information

Name: Clemencia Bogisich Ret

Birthday: 2001-07-17

Address: Suite 794 53887 Geri Spring, West Cristentown, KY 54855

Phone: +5934435460663

Job: Central Hospitality Director

Hobby: Yoga, Electronics, Rafting, Lockpicking, Inline skating, Puzzles, scrapbook

Introduction: My name is Clemencia Bogisich Ret, I am a super, outstanding, graceful, friendly, vast, comfortable, agreeable person who loves writing and wants to share my knowledge and understanding with you.