Bladder Cancer: Symptoms, Causes, Diagnosis, and Treatment

What is bladder cancer?

Bladder cancer begins when cells in the bladder lining change and grow too fast. These cells can spread deeper into the bladder wall and sometimes to other parts of the body. Finding bladder cancer early is important because treatment works better before the cancer spreads.¹

Bladder Cancer Symptoms

The most common sign of blood cancer is blood in the urine (hematuria), which may look pink, red, or brown. You might also notice changes in how often you urinate, pain or burning when urinating, or a strong need to go urgently. Some people feel pain in the lower back or pelvis or have repeated urinary tract infections. In advanced cases, fatigue and weight loss can occur.²

Blood in urine isn’t always cancer. It can also be caused by infections or kidney stones. But, blood in urine should never be ignored. If you notice this symptom, see a doctor right away.

Bladder Cancer Causes

Smoking is the biggest risk factor for bladder cancer because chemicals in tobacco can damage bladder cells. Age also matters: most bladder cancer cases occur in people over 55. Men are more likely to develop bladder cancer than women.³

Other things that can increase your risk include:

• Jobs that involve chemicals, such as in dye, rubber, leather, and paint industries³ 
• Long-term or chronic bladder problems like infections or stones³
• Past cancer treatments, including certain chemotherapy drugs and radiation in the pelvic area³

How can you lower your bladder cancer risk?⁴

Quitting smoking is the best way to lower your risk. Workplace safety and protective gear can also help reduce chemical exposure. You can also lower your risk by drinking plenty of water, eating fruits and vegetables, and limiting exposure to harmful chemicals.

Bladder Cancer Diagnosis

Early diagnosis improves treatment options and outcomes. Doctors use several tests to diagnose bladder cancer:⁵

• Urine tests: Urinalysis checks for blood, and urine cytology looks for cancer cells.
• Imaging: CT urogram, MRI, or ultrasound can show tumors or blockages.
• Cystoscopy: A thin scope is inserted into the bladder to look for tumors.
• Biopsy: A tissue sample is taken during cystoscopy for lab testing.

What are the stages of bladder cancer?

Bladder cancer is classified by stage (how far it has spread) and grade (how abnormal the cells look). Your stage and grade guide treatment decisions:⁶

• Non–muscle-invasive: Cancer is in the bladder lining but hasn’t grown into the muscle wall.
• Muscle-invasive: Cancer has spread into the bladder muscle or beyond.
• Grades: Low-grade cancers grow slowly; high-grade cancers are more aggressive.

Bladder Cancer Treatment

What are treatment options for bladder cancer?

Treatment for bladder cancer also depends on the stage and grade of the cancer:⁷

Early Disease (Non–Muscle-Invasive)

• TURBT (Transurethral Resection): Removes tumors through the urethra.
• Intravesical therapy: Medicine placed directly into the bladder, such as BCG (a type of immunotherapy) or chemotherapy.

Muscle-Invasive Disease

• Surgery: Partial or radical cystectomy (removal of part or all the bladder). Urinary diversion may be needed.
• Chemotherapy: Often given before or after surgery to shrink tumors or kill remaining cancer cells.
• Radiation therapy: Sometimes combined with chemotherapy for bladder-sparing treatment.

Advanced or Metastatic Disease

• Immunotherapy: Drugs that help your immune system fight cancer.
• Targeted therapy and clinical trials: New treatments may be available for certain patients.

What are the side effects of bladder cancer treatment?

Treatment can cause tiredness, changes in urination, and sexual health issues. Supportive care in the form of nutrition help, physical therapy, and counseling can make recovery easier. It’s important for you to ask your care team about resources for coping and recovery.

Bladder Cancer Prognosis

Your outlook depends on stage, grade, and overall health. Early-stage cancers often have good results with treatment. Advanced cancers are harder to treat but can still respond well. Regular checkups are important because bladder cancer can return even after successful treatment. Most patients need cystoscopy every 3–6 months for the first few years after treatment.⁸

Life after bladder cancer can feel overwhelming, but many people continue to work, travel, and enjoy life after treatment. Support groups and counseling can help you cope. Check if your employer offers Employee Assistance Program (EAP) benefits for additional mental health support. Ask your care team about emotional support and practical tips for daily living.

¹ What Is Bladder Cancer?, American Cancer Society, March 12, 2024, https://www.cancer.org/cancer/types/bladder-cancer/about/what-is-bladder-cancer.html.

² Bladder Cancer Symptoms, National Cancer Institute, Updated February 16, 2023, https://www.cancer.gov/types/bladder/symptoms.

³ What Causes Bladder Cancer?, American Cancer Society, March 12, 2024, https://www.cancer.org/cancer/types/bladder-cancer/causes-risks-prevention/what-causes.html

⁴ Can Bladder Cancer Be Prevented?, American Cancer Society, March 12, 2024, https://www.cancer.org/cancer/types/bladder-cancer/causes-risks-prevention/prevention.html

⁵ Tests for Bladder Cancer, American Cancer Society, March 12, 2024, https://www.cancer.org/cancer/types/bladder-cancer/detection-diagnosis-staging/how-diagnosed.html.

⁶ Bladder Cancer Stages, American Cancer Society, March 12, 2024, https://www.cancer.org/cancer/types/bladder-cancer/detection-diagnosis-staging/staging.html

⁷ Bladder Cancer Treatment, National Cancer Institute, September 12, 2024, https://www.cancer.gov/types/bladder/treatment

⁸ Living as a Bladder Cancer Survivor, American Cancer Society, Last revised March 12, 2024, https://www.cancer.org/cancer/types/bladder-cancer/after-treatment/follow-up.html.

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