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Frequently Asked Questions About Bladder Cancer

It’s normal to have questions about bladder cancer. We are here to make sure you have the answers you need at every stage of your journey, from diagnosis and the development of your treatment plan through survivorship.

Below, we have provided answers to some of the most common questions we hear from patients like you. If you have additional questions, our team is always ready to help. We’re available 24 hours a day, seven days a week to answer your questions. Call us at (888) 777-4167.

Bladder Cancer Basics

Bladder Cancer Symptoms and Diagnosis

Bladder Cancer Treatment

What are the risk factors for bladder cancer?

The risk factors for bladder cancer include:

  • Smoking
  • Exposure to industrial chemicals used in paints, rubber, leather, textiles, and dyes
  • Exposure to diesel fumes
  • High doses of diabetes medicine pioglitazone (Actos)
  • Chronic bladder infections
  • Past radiation exposure
  • Herbs from the Aristolochia family
  • Parasitic infections
  • Arsenic in drinking water

Who has the highest risk for bladder cancer?

People who have the highest risk for bladder cancer include:

  • Smokers who work with industrial chemicals
  • Smokers
  • Painters
  • Machinists
  • Printers
  • Hairdressers
  • Truck drivers
  • Persons who do not drink sufficient fluids
  • Persons who have had cancer in the urinary tract

Is bladder cancer more common in males or females?

Bladder cancer is more common in males than in females. The disease is the fourth most common cancer in men. It is estimated that in 2019 there will be 61,700 new cases of bladder in men and 18,770 new cases in women.

Does a family history of bladder cancer increase my risk?

Having a family history of bladder cancer increases the risk of the disease by 5-10 percent.

Can race/ethnicity affect the risk of bladder cancer?

Caucasians are about two times as likely to develop bladder cancer when compared to African Americans and Hispanics. Asian Americans and American Indians develop bladder cancer at slightly lower rates.

Can inherited genes increase the risk of bladder cancer?

Inherited gene mutations may increase the risk of bladder cancer in a small percentage of people. Also, certain people may inherit the inability to get rid of toxins from tobacco and industrial chemicals that may cause bladder disease.

What are some of the causes of bladder cancer?

Certain factors are linked to bladder cancer. It is unknown if they actually cause bladder cancer.

  • Cigarette smoke
  • Industrial chemicals
  • Genes that prevent the elimination of bladder toxins
  • Mutation of RB1 gene, causes retinoblastoma
  • Mutation of PTEN gene, causes Cowden disease
  • Lynch syndrome
  • Prior radiation exposure
  • Chronic bladder infections

Can bladder infections, bladder stones, or kidney stones cause bladder cancer?

It is unknown if bladder infections, kidney stones, or bladder stones actually cause bladder cancer. However, they have been linked to bladder cancer.

What are the symptoms of bladder cancer?

These are the symptoms of bladder cancer. They may be similar to symptoms of urinary tract infections.

  • Blood in the urine, light or dark colored (Hematuria)
  • Pain or burning when urinating
  • Increased need to urinate
  • Difficulty urinating
  • Weak urine stream
  • Lower back pain
  • Weight and appetite loss
  • Fatigue
  • Urine leakage

Does urine change color with bladder cancer?

Urine can have an orange, pink, or even dark red color when bladder cancer is present. In other cases, the color of urine may be normal. Even a small amount of blood in the urine may be detected by a urine test.

How is bladder cancer found?

Often bladder cancer is found when a person complains of certain symptoms or has lab tests done for other reason. More tests can confirm the disease. Doing a physical exam provides additional information. Sometimes doctors can feel a bladder tumor during a man’s rectal exam, or a woman’s pelvic exam.

What are the tests for bladder cancer?

First, doctors will rule out a urinary tract infection. Then other tests may be done.

  • Additional urine analyses
  • Cystoscopy involving a long, thin and flexible scope with a light and video camera
  • Biopsy involving tumor removal and bladder muscle samples
  • Salt-water washings of the bladder to collect cancer cells

How is bladder cancer diagnosed?

Bladder cancer is diagnosed by a pathologist who studies biopsies and lab tests. This doctor determines the stage of cancer, if the cancer is invasive or non-invasive, and if the disease is a low-grade cancer or high-grade cancer.

How is the stage of bladder cancer determined?

The stage of bladder cancer is commonly determined by the:

  • Visual appearance of the cancer cells
  • Tumor size and cancer growth into adjoining areas
  • Number of diseased lymph nodes near the bladder
  • Metastasis (spread) of cancer into the liver, lungs, or other organs

What tests are done to determine the stage of bladder cancer?

The stage of bladder cancer is determined through biopsies and tests that indicate the amount of cancer and where it has spread. The tests may include:

  • Intravenous pyelogram (IVP)
  • Retrograde pyelogram
  • Computed tomography (CT) scan
  • Magnetic resonance imaging scan (MRI urogram)
  • Ultrasound
  • Chest x-ray
  • Bone scan

What are the stages of bladder cancer?

 Bladder cancer stages: 

Stage Cancer in the:
0
 (Pre-cancer or abnormal cells) Surface layer of the bladder
1 Inner lining of the bladder
2 Connective tissue on the bladder wall
3 Bladder’s exterior fat, reproductive organs, or nearby lymph nodes
4 Abdomen, pelvis, lymph nodes above pelvis, lung, bone, or liver

Can bladder cancer spread?

 Bladder cancer can spread to the outside of the bladder, the reproductive organs, lymph nodes, abdomen, pelvis, lung, bone, or liver. 

What is the difference between superficial bladder cancer and muscle invasive bladder cancer (MIBC)?

Superficial bladder cancer is a disease that starts in the inside lining of the bladder. It has not spread to the bladder’s muscles. It is sometimes called non-muscle-invasive bladder cancer.
Muscle invasive bladder cancer is a cancer that has spread passed the lining of the bladder into the bladder’s muscle.

What is muscle invasive bladder cancer (MIBC)?

Muscle invasive bladder cancer (MIBC) is an advanced cancer that has spread beyond the bladder’s lining and into the thick muscle deep inside the bladder wall. Nearly one in four people with bladder cancer have this disease.

How is muscle invasive bladder cancer diagnosed?

Diagnosis of muscle invasive bladder cancer involves:

  • Tests: Urine and blood
  • Imaging: CT, MRI, PET, or X-ray
  • Procedure: Cystoscopy involving a tiny camera inserted into the bladder
  • Procedure: Transurethral resection of bladder tumor to remove the tumor through the urethra and determine if cancer spread into the bladder wall

What are the treatments for superficial bladder cancer?

Possible treatments for superficial bladder cancer:

  • Surgery — removal of cancer
  • Intravesical therapy — drug inserted into the bladder kills cancer
  • Systemic chemotherapy — oral or injected drugs kill cancer
  • Radiation therapy — radiation kills cancer
  • Immunotherapy — drugs boosts immune system to help destroy cancer
  • Targeted drugs — drugs modify the cellular changes that cause cancer

Do all patients with bladder cancer need surgery?

Not all patients have surgery for bladder cancer. The decision depends on a person’s age, health conditions, stage of cancer, and other factors. The most common surgery – a transurethral resection (TUR) – involves removing only abnormal tissue or tumors. A cystectomy involves removing all or part of the bladder.

What is intravesical therapy for superficial bladder cancer?

Intravesical therapy is a procedure that involves inserting anti-cancer medication into the bladder by using a catheter. The medicine remains in the bladder for about two hours. This procedure kills cancerous cells and reduces the effect of the anti-cancer medication on other parts of the body.

What to expect after transurethral resection (TUR or TURBT) of the bladder?

After outpatient surgery for a transurethral resection of the bladder, expect to have a catheter and possibly blood in the urine for a few days. Drink eight glasses of water daily. No heavy lifting for three weeks. Short walks are OK. Ask the doctor about driving and returning to work.

What is the follow-up care after transurethral resection (TUR or TURBT) for superficial bladder cancer?

After a transurethral resection for superficial bladder cancer, the doctor may recommend chemotherapy or immunotherapy treatments.

What are the treatment options for muscle invasive bladder cancer?

Muscle invasive bladder cancer is often treated by bladder removal. Chemotherapy may be recommended before or after surgery if cancer has spread or is at a high risk for spreading to the lymph nodes or other areas of the body. For certain patients, radiation combined with chemotherapy is an option.

How is the bladder preserved when muscle invasive bladder cancer is treated?

In rare cases, patients may undergo a partial bladder removal. Depending on the progression of the disease, the bladder may be preserved by treating muscle invasive bladder cancer with a combination of radiation therapy and chemotherapy. Candidates for this treatment include patients who can tolerate chemotherapy, but cannot tolerate surgery.

What is a radical cystectomy in a male?

A radical cystectomy in a male involves making an incision in the abdomen and removing the whole bladder and some nearby lymph nodes. Also, the prostate and seminal vesicles are removed. Robotic bladder surgery may be done to reduce recovery time and complications, and spare nerves to preserve sexual function.

What is a radical cystectomy in a female?

A radical cystectomy in a female involves making an incision in the abdomen and removing the entire bladder and nearby lymph nodes. In addition, the ovaries, fallopian tubes, uterus, cervix, and part of the vagina are removed. To reduce recovery time and complications, robotic surgery may be performed.

What to expect after a cystectomy for bladder cancer?

After a cystectomy, expect some pain and swelling around the stoma (opening) in the belly for two or three weeks. It is normal to have blood in the urine for three weeks. Work and usual activities may begin in about four to six weeks. Full recovery may take eight weeks.

How will urine leave the body after a cystectomy?

Surgeons enable urine to leave the body by using a piece of intestine to make:

  • An ileal conduit, a process called incontinent diversion, or
  • A pouch, a process called continent diversion, or
  • A new bladder (neobladder)

What is an ileal conduit for incontinent diversion?

An ileal conduit is a passageway made from a piece of intestine. Urine moves from the kidneys through the ureters and into the conduit. The conduit is connected to an opening in the belly. A small bag sticks to the belly and collects urine. The bag is emptied when full.

What is a pouch for continent diversion?

Continent diversion involves a pouch made from a piece of intestine. The pouch is attached to the tubes (ureters) that carry urine from the kidneys. The pouch with urine remains inside of the body. It is emptied by putting a catheter into a valve in the stoma (opening) in the belly.

What is a neobladder?

A neobladder is a new bladder made from a piece of intestine. Urine moves from the kidneys to the ureters and into the neobladder. When it is full, the sensation is similar to eating a large meal. Urine is released by pressing the belly and bearing down, or pushing down.

What is a Foley catheter?

A Foley catheter is a thin, soft tube inserted through the urethra and into the bladder to drain urine. The tube has two channels. One channel drains urine into a collection bag. The other channel has a little balloon on its tip. The water-filled balloon prevents slippage from the bladder.

How to take care of a Foley catheter?

Taking care of a Foley catheter requires a little time before it feels like a routine:

  • Clean the genital area first
  • Clean the catheter with mild soap and water 
  • Change the drain collection bags
  • Wash the drainage bags
  • Use a new Cath-Secure to attach the catheter to the leg

What is the follow-up care after treating muscle invasive bladder cancer?

Follow-up care after treating muscle invasive cancer include:

  • Regular medical visits, lab tests, and imaging to identify any side effects of treatments or recurrence of cancer
  • Possible routine treatments of chemotherapy, immunotherapy, or other medical care
  • Possible counseling to address lifestyle changes and quality-of-life issues

When is chemotherapy used for bladder cancer?

In the early stage of bladder cancer, chemotherapy drugs may be inserted into the bladder. Chemotherapy pills, muscle injections, or intravenous injections may be used:

  • Before surgery to shrink a tumor
  • After surgery to kill hidden cancer
  • After radiation therapy to improve results
  • To treat advanced cancer that has spread

When is radiation therapy used for bladder cancer?

Radiation therapy is used for bladder cancer at different times and stages:

  • To treat early bladder cancer
  • To avoid surgery and removal of the bladder
  • After surgery that removes part of the bladder
  • To avoid chemotherapy
  • To treat advanced bladder cancer
  • To prevent or treat symptoms of advanced bladder cancer

How can the treatment for bladder cancer affect the quality of life?

Treatment for bladder cancer may affect the quality of life and cause:

  • Incontinence — lack of control over urination
  • Radiation cystitis — long-term problems with painful urination and blood in the urine
  • Chemotherapy cognitive changes — problems with memory, concentration, and behavior
  • Erection problems — caused by damaged nerves and blood vessels

How can the quality of life be improved after bladder cancer?

The healthcare team — including urologists and gynecologists — can suggest ways to improve the quality of life after bladder cancer. Also, support groups and advocacy networks are available to patients and their family members. 

What is the survival rate for bladder cancer? 

Cancer type
 Estimated survival for at least 5 years after diagnosis
Carcinoma in situ: Abnormal cells may become cancer cells. 95%
Localized: Cancer identified only in the bladder. 69%
Regional: Cancer spread to lymph nodes and nearby structures. 35%
Distant: Cancer spread to lungs, liver, bones, or other areas. 5%
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