Bladder Cancer Symptoms

What Is Bladder Cancer?

The bladder is responsible for storing urine and waste from the kidney through the ureters [¹]. When urinating, the bladder muscles contract. Urine gets released through the urethra.

Bladder cancer occurs when cells in the bladder start to grow at an uncontrollable pace [²]. As these cells grow, they can form a tumor and even spread to other organs of the body.

Types of Bladder Cancer

Bladder cancer has many types, and your treatment plan will depend on the type of bladder cancer you have. Here are the different types of bladder cancers that can occur.

Urothelial or Transitional

Around 90% of bladder cancers are this type, making it the most common form of bladder cancer [³]. It develops in the lining of the bladder, called the Urothelial. The cells of the lining bunch together when the bladder is empty. The cells stretch to accommodate the incoming urine by creating a single layer of tissue to hold the waste. Chemicals in the waste, like cigarette smoke, can harm these cells, causing cancer.

Cancer can be invasive or non-invasive. Non-invasive cancer means that it is not penetrating the muscles of the bladder or the deeper layers of tissue. Muscle-invasive cancers can go beyond the layer. Hence, treatment for both will be different.

Squamous Cell Carcinoma

This is the second most common form of bladder cancer, with about 5% of all cases. It starts in the flat, thin squamous cells that can form in the bladder in the case of chronic infection or inflammation. It is most common in regions where schistosomiasis, a parasitic infection, is widespread, like Asia and the Middle East.

Adenocarcinoma

1-2% of cases of bladder cancer are the Adenocarcinoma type. It is quite rare and is usually more invasive too. The bladder has a skin-like, moist tissue lining where gland cells exist. These cells produce mucus, where cancer can persist inside the bladder’s lining.

Small-Cell Carcinoma

This is an extremely rare form of bladder cancer, with less than 1% of cases out of all bladder cancers [⁵]. It starts in the neuroendocrine cells that are kind of similar to nerve cells.

How Is Bladder Cancer Diagnosed?

There are different tests for bladder cancers, but not every patient takes all of them. The doctor prescribes the tests based on the following factors [⁶]:

• Signs and symptoms
• General health and age
• Results from previous medical tests
• The suspected type of cancer

Early detection increases the chances of survival, cure, and treatment. There are no screening tests for bladder cancer. So, patients are usually diagnosed with the disease once they exhibit symptoms. Hence, most people get their diagnosis at later stages, but most still have non-invasive cancer, so there is hope.

Here are all the tests used to diagnose bladder cancer [⁷]:

• Cystoscopy
• Imaging scans like MRI and CT scans
• Biopsy
• Urine lab tests
• Transurethral Resection of Bladder Tumor (TURBT)
• Intravenous Pyelogram (IVP)
• Ultrasounds

Doctors might also prescribe x-rays, bone scans, and other biopsies to look for the spread of cancer, too [⁸].

Bladder Cancer Staging

The bladder cancer stage depends on the size of a tumor and its area of spread. There are five stages of cancer, from 0 to 4 [⁹]. The higher the stage of cancer, the more the tumor has spread. The stage of the cancer is determined during the diagnosis stage. For example, if you have Stage III cancer and it returns, having spread to the bone, it means you are at Stage III with metastasis to the bone.

Bladder cancer uses the TNM scale of classification [¹⁰], which is as follows:

• T= Tumor size (measured in centimeters)
• N= Number of lymph nodes nearby with cancer
• M= Whether the bladder cancer has metastasized to other organs

Is Bladder Cancer Hereditary?

No, bladder cancer is usually not hereditary [¹¹]. It is mostly associated with mutations that can occur in the bladder cells. In some rare cases, inheritance is possible. In such scenarios, bladder cancer’s risk increases due to an autosomal dominant pattern. This means a copy of altered genes in the cell is enough to increase the overall risk of developing bladder cancer. Not every person who has inherited these genes is likely to develop bladder cancer.

Bladder Cancer Symptoms

Patients with bladder cancer can experience some symptoms and signs of the disease. Symptoms are any physical indications or changes that one can feel in the body, while signs are the feelings of a patient with regard to their physical symptoms. Together, they can indicate a medical problem.

What Are the Symptoms of Bladder Cancer?

Symptoms of bladder cancer could include [¹²]:

• Feeling the need to pass urine but being unable to do so
• Feeling the need to pass urine several times through the night
• Pain in the specific area of the lower back
• Trouble with urination or weak stream of urine
• Burning sensation or pain while passing urine
• Urinating more than usual
• Weight loss without any obvious cause
• Loss of appetite
• Feeling weak and fatigued

Often, bladder cancer gets diagnosed when patients discover blood in the urine, called hematuria. Gross hematuria is where there is a visible presence of blood. Microscopic hematuria gets detected via urine tests.

What Are Some Signs of Bladder Cancer?

As mentioned, signs refer to clinical manifestations, something that could be noticed during medical tests or examinations. Some early signs of bladder cancer could include:

• Blood clots or blood in the urine
• Frequent urination
• Lower back pain on a particular side of the back
• Inability to pass urine
• Swelling of feet

Symptoms of Bladder Cancer in Women Vs. Symptoms of Bladder Cancer in Men*

Bladder cancer is three times more common among men than women. It is also the fourth most common for men [¹³]. Smokers are twice as likely to develop bladder cancer; since men smoke more than women generally, they are more at risk for bladder cancer.

However, the symptoms are the same for both. Men are generally more likely to get diagnosed with bladder cancer since women may often mistake blood in the urine for menstruation.

*Note that here, we are using the terms “women” and “men” to refer to female and male biological sex at birth, respectively.

Risk Factors for Bladder Cancer

Risk factors of bladder cancer can include factors you can control and factors that you cannot control. Having an increased risk for a disease does not mean that you will get it, but you are more likely to get it than the average person.

Here are risk factors that you can actually work on or change:

• Smoking
• Workplace exposure to some harmful chemicals
• Some herbal supplements and medicines
• Exposure to arsenic in drinking water
• Not drinking enough water

Here are risk factors that you cannot change:

• Being white
• Age
• Being a man
• Chronic infections and inflammation in the bladder
• History of bladder cancer
• Birth defects of the bladder
• Genetics
• Previous cancer treatment (chemo can impact the bladder if there is low consumption of fluids)

Bladder Cancer Prevention

If you are at a higher risk for bladder cancer, it can be prudent to apply some lifestyle changes to lower your risk for bladder cancer [¹⁵].

• Don’t smoke
• Be cautious of some chemicals at work
• Ensure you are properly hydrated

Bladder Cancer Prognosis and Treatment

The prognosis for bladder cancer is highly dependent on the stage and type of bladder cancer. In general, bladder cancers caught at earlier stages (stage 0/in situ, stage 1) have a better outlook. If the cancer has metastasized, treatment is more difficult, but it is important to maintain hope.

Bladder Cancer Survival Rate

The 5-year survival rate for carcinoma in situ of bladder cancer is 96% [¹⁶]. For localized cancer, it is 77%. For regional cancer, where it has spread to nearby organs or lymph nodes, it is 39%. For metastatic cancer, it is 8%.

Hence, earlier detection and diagnosis is quite important for the treatment of bladder cancer.

Bladder Cancer Treatment Options

There are different treatment options for those with bladder cancer. You might receive one or a combination of treatments [¹⁷]:

• Surgery
• Chemotherapy
• Radiation therapy
• Targeted drug therapy
• Immunotherapy

Conclusion

Takeaway

Bladder cancer is a serious condition where it is necessary to seek help from doctors if you see any symptoms. Ignoring or delaying symptoms can lead to the cancer spreading to other parts of the body. So, if you or someone you know is experiencing some of the bladder cancer symptoms mentioned above, make sure to visit a doctor at once.