Bladder Cancer

The bladder is located in the lower abdomen and its main function is to store urine made by the kidneys. Bladder cancer usually starts in the innermost lining of the bladder but can grow through other layers of the bladder wall.

Wilmot Cancer Institute, in partnership with UR Medicine’s Department of Urology, is the leader in bladder cancer care in the Finger Lakes region and is actively conducting research to improve care.

Bladder cancer types

By far the most common is transitional cell carcinoma. It starts in the urothelial cells that line the bladder wall and the ureters, which are the tubes that transport urine from the kidneys to the bladder. Transitional cell carcinoma can be low-grade or high-grade, and it can be superficial or invasive. The latter type means the cancer has begun to invade the muscle wall of the bladder or has spread to lymph nodes or nearby organs.

Rarer types of bladder cancer include squamous cell carcinoma and adenocarcinoma, each of which begins in other tissues and cells in the bladder. Small-cell carcinoma, like small-cell carcinoma of the lung, can also grow in the bladder.

Bladder cancer facts

About 75,000 new cases are diagnosed annually in the U.S., and bladder cancer is three times more common in men than in women. More than 75 percent of people survive five years. Men have a one in 26 chance of developing it; for women the chance is about one in 88. Women tend to be diagnosed when the disease is in its later stages, and based on this and other unclear factors women have a higher death rate than men for bladder cancer.

Causes and risk factors

Older age and smoking are major risk factors. The average age at diagnosis is 73. Other risk factors include:

• Workplace exposures to industrial chemicals used in paints, dyes, metals, and petroleum products.
• Family history, which might be due to exposure to cancer-causing chemicals such as tobacco smoke, or shared changes in certain genes that make it harder for the body to break down toxins. The risk is also greater for people who have inherited genetic syndromes such as Cowden disease (linked to breast and thyroid cancer) or Lynch syndrome (linked to colon and endometrial cancer).
• Medicines or herbal supplements such as Aristolochia fangchi, a Chinese herb which boosts the risk, as well as the use of the diabetes drug Actos for more than one year. The link between bladder cancer and Actos is still being investigated, though.
• Chemicals in drinking water, such as arsenic and chlorine.
• Radiation treatment or taking certain chemotherapies. Radiation to the pelvis and anti-cancer drugs such as cyclophosphamide increase bladder cancer risk later.
• History of bladder infections, UTIs, kidney and bladder stones, and bladder catheters left in place for long periods. All of these have been linked to cancer, especially squamous cell carcinoma of the bladder. Also, an infection known as schistosomiasis, is a common cause of bladder infections and cancer in Africa and the Middle East.
• Race/ethnicity. Whites are twice as likely to get bladder cancer in the U.S. as African Americans, Hispanics, Asian Americans or Native Americans.

Prevention

There is no sure way to prevent bladder cancer. Risk factors such as age, race and family history can’t be controlled. But several controllable prevention strategies are recommended:

• Don’t smoke and avoid second-hand smoke when possible.
• Avoid exposure to workplace chemicals used in making rubber, leather, printing materials, paint, and textiles.
• Eat several servings of fruits and vegetables daily. 
• Drink plenty of water.