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What is Bladder Cancer?

The bladder is a hollow organ in the lower part of the abdomen. It is shaped like a small balloon and has flexible, muscular walls that can stretch to store urine made by the kidneys.

Bladder cancer is a disease in which malignant (cancer) cells form in the tissues of the bladder. As more cancer cells develop, they can form a tumor and, with time, spread to other parts of the body.


Urothelial carcinoma, also known as transitional cell carcinoma (TCC), is by far the most common type of bladder cancer, accounting for about 90% of all bladder cancers. These cancers start in the urothelial cells that line the inside of the bladder. Urothelial cells also line other parts of the urinary tract, such as the part of the kidney that connects to the ureter, the ureters, and the urethra. People with bladder cancer sometimes have tumors in these places, too, so all of the urinary tract needs to be checked for tumors.

Other less common types of bladder cancer include squamous cell carcinoma, adenocarcinomas, small cell carcinoma, and sarcoma.


Bladder cancer can often be found early because it causes blood in the urine or changes in urination, such as:

  • Having to urinate more often than usual
  • Pain or burning during urination
  • Feeling the need or a sense of urgency to urinate, but not being able to pass urine
  • Having trouble urinating or having a weak urine stream
  • Having to get up to urinate many times during the night

Bladder cancers that have grown large or have spread to other parts of the body can sometimes cause other symptoms, such as:

  • Being unable to urinate
  • Lower back pain on one side
  • Loss of appetite and weight loss
  • Feeling tired or weak
  • Swelling in the feet
  • Bone pain

These symptoms could also be caused by a urinary tract infection, bladder stones, an overactive bladder, or an enlarged prostate (in men), so it is important to have them checked by a physician so that the cause can be found and properly treated.


Bladder cancer is often found because of signs or symptoms a person is having, or it might be found because of lab tests a person gets for another reason. If bladder cancer is suspected, exams and tests will be needed to confirm the diagnosis, and if cancer is found, more tests will be done to help determine the stage of the cancer.

The following tests may be used to diagnose and learn more about bladder cancer:

  • Urine test – If your doctor has found any amount of blood in the urine, a urine cytology test can be ordered. Urine cytology often uses a random urine sample from normal urination to find out if the urine contains tumor cells.
  • Cystoscopy – A cystoscopy is the key diagnostic procedure for bladder cancer. It allows the urologist to see inside the bladder and detect growths using a long, thin, flexible tube with a light and a lens or a small video camera on the end called a cystoscope.
  • Transurethral resection of bladder tumor (TURBT) – If abnormal tissue is found during a cystoscopy, the doctor will do a biopsy to remove a small amount of tissue for examination under a microscope. This surgical procedure is called a transurethral bladder tumor resection or TURBT.
  • Imaging tests – If you have bladder cancer, your physician may order imaging tests such as a CT scan, an MRI, a PET scan, a bone scan, or ultrasound to see if the cancer has spread to tissues and organs near the bladder, nearby lymph nodes, or distant parts of your body.

After diagnostic tests are done, your physician will review the results with you. Physicians use these diagnostic tests to confirm the presence of cancerous cells and to determine the cancer’s stage. Staging is the process physicians use as a way to describe where the cancer has invaded or spread, and whether it is affecting other parts of the body. The stage is one of the most important factors in deciding how serious the cancer is, how to treat the cancer, and determining how successful treatment might be.

After someone is diagnosed with bladder cancer, physicians try to figure out if it has spread, and if so, how far, through a process is called staging. The stage of a cancer describes the extent, or amount, of cancer in the body. The stage is one of the most important factors in deciding how serious the cancer is, how to treat the cancer, and determining how successful treatment might be.

The staging system most often used for bladder cancer is the American Joint Committee on Cancer (AJCC) TNM system, which is based on 3 key pieces of information:

  • T describes how far the main tumor has grown through the bladder wall and whether it has grown into nearby tissues.
  • N indicates any cancer spread to lymph nodes near the bladder.
  • M indicates if the cancer has metastasized, or spread, to distant sites, such as other organs, like the lungs or liver, or lymph nodes that are not near the bladder.

Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a cancer’s T, N, and M categories have been determined, usually, after surgery, this information is combined in a process called stage grouping to assign an overall stage. The earliest stage cancers are called stage 0 and then range from stages I (1) through IV (4).

Here are more details on each part of the TNM system for bladder cancer.

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