Bladder Cancer

Compassionate bladder cancer care focused on your needs.

Urologic cancer specialist speaking with patient about bladder cancer

What you need to know about bladder cancer

More than a half million people in the U.S. are bladder cancer survivors. New bladder cases have been on the decrease for men and women in recent years. Survival rates have increased for women and remained stable for men.

The bladder wall is made up of many layers of cells. It has an outer layer of muscle cells and an inner lining layer of transitional cells. Bladder cancer can affect any one or all of these cells (and layers). There are three types of cells that most commonly become bladder cancer:

  • Urothelial cells or transitional cells. These cells make up the tissue that lines the inside of the bladder. This tissue is called the urothelium. Cancer that starts here is called urothelial carcinoma or transitional cell carcinoma (TCC). This is, by far, the most common type of bladder cancer.
  • Squamous cells. These look like cells from the surface of the skin. They can start in the bladder if there's a lot of inflammation. Over time, they can become cancer. This type is rare, causing less than 1 in 50 of all bladder cancers.
  • Cells that make up glands. This type of bladder cancer is called adenocarcinoma. It’s very rare. Only about 1 in 100 people with bladder cancer have this type.

Another way to talk about bladder cancer is by how deeply it spreads into the layers of the bladder wall. This puts the cancer into 1 of 2 groups:

  • Nonmuscle invasive. This type of cancer affects only the inner lining of the bladder. (It's urothelial carcinoma or transitional cell carcinoma.) It hasn't grown deeper into the bladder's muscle layer. After treatment, nonmuscle invasive bladder cancer often comes back, usually as another nonmuscle invasive cancer.
  • Muscle invasive. This cancer affects deeper muscle layers of the bladder and maybe the fatty tissue around the bladder. Invasive bladder cancer is more likely to spread to nearby organs. Almost all squamous cell bladder cancers and adenocarcinomas are invasive.

Types of transitional cell carcinomas

Transitional cell carcinomas (TCCs) may also be described as being either papillary or flat:

  • Papillary tumors. These look like small mushrooms and grow into the open part of the bladder. They rarely go deeper into other layers of the bladder. Some types of papillary tumors tend to come back. But they can be removed without damaging the bladder.
  • Flat tumors. These don't grow into the open part of the bladder. They spread along the lining.

If either of these grow into the deeper layers of the bladder, it's called invasive TCC.

In rare cases, other cancers can start in the bladder. These include lymphoma, sarcoma, and small cell carcinoma.

Symptoms of bladder cancer

Blood in your urine is often the first sign of bladder cancer. The color the urine may be pink or deep red, depending on the amount of blood present. There may be clots of blood in the urine.

Changes in urinary habits can also be a sign of bladder cancer, which include:

  • Urinating more often than normal
  • Burning, discomfort, or pain when urinating
  • Need to urinate right away
  • Trouble urinating
  • Weak urine stream
  • Need to get up to urinate many times during the night

Seeing a healthcare provider at the first sign of symptoms is the best way to find and treat bladder cancer. The earlier bladder cancer is found, the easier it is to treat.

Bladder cancer experts

Legacy Cancer Institute, located in Portland, OR, ranks among the nation’s best cancer programs. We have a team of urologic cancer specialists who work together to diagnose and develop a personalized treatment plan for you. Find the right provider and treatment close to home.

Legacy Cancer Institute is accredited as an integrated network cancer program by the American College of surgeons Commission on Cancer (CoC). Learn more about our quality cancer care.

Next steps after a bladder cancer diagnosis

Being told you have bladder cancer can be scary and you may have a lot of questions. Your Legacy Health healthcare team is here to help. In order to diagnose your condition you’ve likely had a physical exam and reviewed your health history with your provider. You may have also had a biopsy to confirm your diagnosis. Following a diagnosis of bladder cancer, you may have more tests to help your doctor understand your cancer stage.

Cancer staging includes identifying where the cancer is located, if or where it has spread, and if it is affecting other parts of your body. Knowing the stage allows your doctor to develop your personalized treatment plan.

Some tests your doctor may now recommend include:

  • Chest X-ray, CT scan, MRI or positron emission tomography (PET): Imaging technology to look inside the body to see if the cancer has spread.
  • Bone scan: To see if it has spread to your bones. 

Bladder cancer treatment options

There are several ways to treat bladder cancer depending on the type, stage and location of the tumor. Your treatment plan options may include surgery, chemotherapy or radiation. Transurethral surgery, alone or with intravesical chemotherapy (medicine put into the bladder), is used in nearly all cases.

Talk to your doctor to see if a clinical trial may be right for you. Learn more about your treatment options.

More support

You are not alone. Legacy offers support throughout your cancer journey, as well as care for your emotional, social and spiritual needs.

Nurse navigators
Legacy Cancer Healing Center 
Support groups and classes
Cancer rehabilitation 
Survivorship services