Bladder & Urothelial Cancer

What is Bladder/Urothelial Cancer?

Bladder cancer occurs when abnormal cells grow uncontrollably in the lining of the bladder, forming tumors. The most common type, urothelial carcinoma (transitional cell carcinoma), starts in the urothelial cells lining the bladder, ureters, and urethra. Bladder cancer is one of the most common urologic cancers and, when detected early, is highly treatable.

Risk Factors

Several factors can increase the risk of developing bladder or urothelial cancer, including:

• Smoking – The leading cause of bladder cancer, as harmful chemicals accumulate in the urine.
• Age & Gender – Most common in older adults, with men being at higher risk.
• Chemical Exposure – Industrial chemicals, dyes, and certain pesticides increase risk.
• Chronic Bladder Irritation – Frequent UTIs, long-term catheter use, or bladder stones may contribute to cancer development.
• Family History & Genetics – A history of bladder cancer in close relatives may increase susceptibility.
• Previous Cancer Treatments – Chemotherapy (cyclophosphamide) and pelvic radiation may elevate risk.

Symptoms

Bladder cancer symptoms may vary but often include:

• Blood in the urine (hematuria) – May appear pink, orange, or dark red.
• Frequent urination – Increased urgency or frequency without an obvious cause.
• Pain or burning during urination – A possible sign of bladder irritation.
• Pelvic pain or lower back pain – More common in advanced stages.
• Urinary obstruction – Difficulty urinating or weak urine flow.

 

Treatment

Treatment depends on the cancer’s stage and grade (non-invasive, muscle-invasive, or metastatic).

Transurethral Resection of Bladder Tumor (TURBT)

• A minimally invasive procedure where a surgeon removes tumors from the bladder using a scope inserted through the urethra.
• Often the first-line treatment for non-invasive bladder cancer and used for diagnosis.

Robotic Surgery (Cystectomy & Partial Bladder Removal)

• Robotic-assisted surgery (da Vinci® Surgical System) allows for greater precision and quicker recovery.
• Radical Cystectomy – Complete removal of the bladder for muscle-invasive cancer; may involve urinary diversion techniques.
• Partial Cystectomy – Removal of part of the bladder while preserving function, when possible.

Immunotherapy

• Bacillus Calmette-Guérin (BCG) therapy – A bladder-specific immunotherapy used to prevent recurrence in non-invasive bladder cancer.
• Checkpoint inhibitors (e.g., Atezolizumab, Pembrolizumab) help the immune system attack cancer cells in advanced cases.

Chemotherapy

• Intravesical chemotherapy – Delivered directly into the bladder for early-stage cancer.
• Systemic chemotherapy – Used for muscle-invasive or metastatic bladder cancer, often combined with surgery or immunotherapy.

Prevention

While not all cases of bladder cancer are preventable, reducing risk factors can help:

• Quit smoking – Reduces exposure to harmful carcinogens in the bladder.
• Stay hydrated – Drinking plenty of water may help flush out toxins.
• Limit chemical exposure – Use protective equipment in workplaces with industrial chemicals.
• Maintain a healthy diet – A diet rich in fruits and vegetables may support bladder health.
• Regular screenings – Individuals with a high risk of bladder cancer should have regular checkups for early detection.

Bladder cancer is highly treatable when detected early. If you experience persistent urinary symptoms or notice blood in your urine, consult a urology specialist for further evaluation.