What is bladder cancer?Bladder cancer is a disease that typically begins in the inside wall of the bladder, a balloon-like organ that lies in the center of the pelvis. As part of the urinary tract, the bladder's role is to store urine created by the kidneys until it is excreted during urination. When abnormal cells begin to multiply uncontrollably, they can form a tumor. Bladder tumors are often categorized as noninvasive or invasive, depending on how far they have grown within the bladder wall.
Although this urologic cancer is more common in men, it can affect women as well. More than 80,000 patients are diagnosed annually with this disease in the United States, according to the American Cancer Society.
At MedStar Health, our fellowship-trained urologic oncologists specialize in bladder cancer treatment. Working as a team of multidisciplinary experts in surgery, radiation, and medical oncology, we personalize care using the latest, research-backed treatments to effectively target your cancer while protecting your quality of life. Many patients benefit from minimally invasive surgical options that preserve natural urinary function whenever possible. We also offer access to advanced techniques and therapies only available in clinical trials. As a result, we commonly care for patients with complex tumors who may have run out of treatment options elsewhere.
Bladder Cancer Overview
As with all organs in the urinary system, the bladder is susceptible to developing cancer - the uncontrolled growth of abnormal cells. The wall of the bladder has several layers of tissue. Bladder cancer type depends on the types of cells and layers of tissue affected.
Bladder cancer symptoms and risk factors
What are the signs of bladder cancer?
Not everyone with this disease experiences symptoms. However, early bladder cancer signs may include:
- Blood in the urine
- Pain during urination
- Pain in the pelvis
As this cancer advances, other signs may include unexplained weight loss and fatigue. However, all of these symptoms could be related to other health conditions, so it's important to get evaluated by a doctor.
Who has the greatest risk of developing this cancer?
A risk factor is something that increases your chances of developing a disease. Not everyone with the following risk factors will develop bladder cancer, and some people with the disease don't have any known risk factors. However, knowing your risk factors can help you take steps to lower your risk, if possible.
- Smoking: Tobacco use is strongly linked to bladder cancer. The more you smoke, the higher your risk. However, it's never too late to quit smoking and lower your risk of this disease.
- Chemical exposure: Certain environmental or work-related chemicals can elevate your risk of this type of cancer. As a result, people who work the following jobs may have an increased risk:
- Dry cleaners
- Machinists and metalworkers
- Textile workers
- Truck drivers
- Age: Your risk of bladder cancer increases as you get older, as most diagnoses occur in people over 65.
- Gender: Men are three to four times more likely to develop this cancer than women, although it can affect anyone.
- Personal history of cancer: If you had the disease in the past, you may be more likely to develop recurrent bladder cancer.
- Chronically infected bladder and other problems: Long-term urinary tract infections (UTIs) and other issues related to an inflamed bladder, like bladder or kidney stones, may elevate your risk.
Screening and prevention
Can I prevent bladder cancer?
Because there are no screening guidelines that help detect this cancer early, it's also important to be aware of what is normal for your body and seek care when something is unusual.
While it's impossible to prevent it completely, there are things you can do to lower your risk of the disease. Because smoking is the number one risk factor associated with this cancer, avoiding or quitting smoking can significantly reduce your chances of developing it. If you need help with smoking cessation, we're here for you at several locations throughout the region.
How is bladder cancer diagnosed?
Some people find out about their cancer after discovering something abnormal on imaging for an unrelated health problem, while others seek urology care for bladder cancer signs, such as blood in the urine (hematuria). To confirm a bladder cancer diagnosis, our urologic oncologists perform a full medical evaluation, including ordering advanced imaging.
When cancer is suspected, our urologic oncologists use cystoscopy to examine the inside of the bladder. This involves passing a tiny camera and lights mounted on a thin, flexible tube through the urethra into the bladder. During a cystoscopy, your doctor may remove a biopsy sample or surgically remove the tumor at the same time.
At MedStar Health, we're also one of few in the region to offer blue light cystoscopy, which uses a special dye that is absorbed by cancerous cells in the bladder pre-operatively. When exposed to blue light during the procedure, these abnormal cells glow pink. This allows us to see tumors that may be invisible under standard white light.
Following biopsy or resection, the cancer cells are evaluated by a pathologist under a microscope to determine additional details about the cancer, such as its grade and invasiveness. Both of these factors are important in determining the next steps for bladder cancer treatment.
Types of cancer
Bladder cancer is categorized based on the type of cell where it begins. Most of these cancers begin in the urothelial cells that line the inside of the bladder. Other rare types of this disease include squamous cell carcinoma, adenocarcinoma, and small cell carcinoma (neuroendocrine cells in the bladder). At MedStar Health, we're experienced in diagnosing and treating all types, including the less common subtypes of urothelial carcinoma of the bladder.
Invasive vs. non-muscle invasive bladder cancer (NMIBC)
The majority of urothelial carcinomas are non-muscle invasive bladder cancers (NMIBC). Noninvasive forms are contained within the bladder's innermost lining and can typically be treated more easily. In contrast, invasive bladder cancer spreads into the muscles around the bladder, requiring a more complex, multimodal approach to treatment.
When this disease has spread beyond nearby organs to distant parts of the body, it is classified as metastatic bladder cancer.
Bladder cancer treatment
Each patient’s bladder cancer treatment depends on several factors, including the stage of the cancer as well as an individual’s overall health and preferences. In many cases, treatment involves chemotherapy, radiation therapy, and/or surgery. A team of specialists in various medical fields meets weekly to review each patient’s cancer and determine a personalized approach that will be most effective, case-by-case. For some patients, treatment may involve clinical trials that offer access to emerging therapies not yet widely available.
Looking for expert care?
With multiple locations throughout the region, patients have access to many of the nation’s renowned cancer specialists offering high quality care, second opinions and a chance for better outcomes close to where they live and work. Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI), serves as the research engine allowing patients access to clinical trials that often lead to breakthroughs in cancer care.
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Mohit Gupta, MD
Urologic Oncology & Urology
Jonathan J Hwang, MD
Urology & Urologic Oncology
Keith John Kowalczyk, MD
Ross E. Krasnow, MD
Urologic Oncology & Urology
Lambros Stamatakis, MD
Urologic Oncology & Urology
Kevin Y. Chen, MD
Medical Oncology & Hematology Oncology
Nancy Ann Dawson, MD
Hira Latif, MD
Paul Denis Leger, MD, MPH
Charles A. Padgett, MD
George K. Philips, MD
Kristen D Whitaker, MD
Hematology Oncology & Medical Oncology
Sean Philip Collins, MD,PhD
Andrew Satinsky, MD
Katherine Chen, MD
Paul Byron Fowler, MD
Kelly E. Orwat, MD
Stephen Krystjan Ronson, MD
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5601 Loch Raven Blvd. Russell Morgan Building First Floor Baltimore, MD 21239
9103 Franklin Square Dr. The Harry and Jeanette Weinberg Cancer Institute Suite 220 Baltimore, MD 21237
12 MedStar Blvd. Ste. 180 Bel Air, MD 21015
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7501 Surratts Rd. Ste. 101 Clinton, MD 20735