Bladder Cancer: What you need to know

Dr. Badrinath Konety

Badrinath Konety, MD, MBA

Chairman of the Department of Urology

Director of the Institute for Prostate and Urologic Cancers

University of Minnesota







The majority of bladder cancers are diagnosed at an early stage, when the cancer is highly treatable. Bladder cancer typically affects older adults.
More than 90% of all bladder cancers begin in the inner lining of the bladder (urothelium). Most tumors in the bladder remain in the lining or the next layer (the lamina propria) and do not spread into the bladder muscle.


What are the Symptoms of Bladder Cancer?

Blood in the urine is the most common bladder cancer symptom. In some cases, blood is visible but in many cases blood is invisible and can only be seen under a microscope. Blood in the urine does not mean you have bladder cancer, a urinary tract infection or kidney stones may also be the cause. Although less common, frequent or painful urination is another symptom.

What Causes Bladder Cancer?

Certain risk factors increase the chance of developing bladder cancer. Tobacco smoking increases the risk of developing bladder cancer. Approximately 50% of bladder cancer cases in the United States are related to smoking. Long term exposure to chemicals in the workplace used to make plastics, paints, textiles, leather and rubber may also increase the risk of developing bladder cancer. In particular, hairdressers, machinists, printers, painters and truck drivers may be at increased risk. To prepare for the test, the bowel must be cleansed by taking laxatives to induce diarrhea, which can be time consuming and can cause nausea in some patients.

Other risk factors include:

• Frequent or long lasting bladder infections
• Previous radiation for other cancers, such as prostate, cervix or rectum
• Certain diabetes medications
• High levels of arsenic in drinking water
• Family History
• Chemotherapy with specific medications

How is Bladder Cancer Diagnosed?

Urine cytology. A urine sample is viewed under a microscope to look for cancer cells
Imaging tests. CT scan of the urinary tract
Cystoscopy. The urologist uses a cystoscope, a soft thin tube with a light and a lens or a small video camera on the end, to see directly inside the bladder and inspect the inner surfaces for signs of cancer
Biopsy. A sample of tissue removed from the bladder is examined to check for cancer cells


How is Bladder Cancer Treated?

Treatment is based on the extent and aggressiveness of the cancer. If the cancer is restricted to the surface lining of the bladder it can be scraped and the bladder preserved. If it invades deep into the walls of the bladder, the bladder may need to be removed. Additional chemotherapy or radiation may also be used in some instances. After
the bladder cancer is treated, it often recurs. Because
it tends to recur, those treated for bladder cancer must undergo years of follow-up monitoring and possible
re-treatment. Generally, it is recommended that the bladder be examined every 3-6 months for the first few years following successful treatment.

What are some ways to prevent Bladder Cancer?

• Don’t smoke
• Use caution handling chemicals
• Drink adequate amounts of water throughout the day – at least 1.5 – 2 L per day
• Chose a diet with a variety of fruits and vegetables