Bladder Cancer

Doctors use a combination of tests to diagnose bladder cancer and determine how advanced the disease is, including how far the cancer has grown or spread. This information helps your care team recommend the most effective treatment plan.

• Urine test. A doctor may test urine for blood, infection or cancer cells.
• Imaging tests. Imaging tests, such as CT scans, MRI, PET scans or ultrasound, help doctors to determine whether cancer has spread beyond the bladder. For muscle-invasive bladder cancer, imaging is especially important for accurately staging the disease.
• Cystoscopy. A cystoscopy allows doctors to look inside the bladder using a thin, lighted tube inserted through the urethra.
• Biopsy and transurethral resection of bladder tumor (TURBT). If a tumor is found, tissue is removed using a procedure called transurethral resection of bladder tumor, or TURBT. TURBT confirms the diagnosis and helps to determine how deeply the cancer has grown into the bladder wall. In some patients with non-muscle-invasive bladder cancer, a repeat TURBT may be recommended to confirm that the cancer has not spread into the bladder muscle. 

Once bladder cancer is diagnosed, doctors determine its stage and grade. Understanding the stage and grade of your cancer helps your care team recommend the most effective treatment plan.

• Stage describes how far the cancer has spread. It may be confined to the bladder lining (non-muscle-invasive bladder cancer) or invasive, meaning it has grown into the bladder muscle or spread to nearby tissue, lymph nodes or other organs.
• Grade describes how abnormal the cancer cells look under a microscope. High-grade cancers tend to grow and spread more quickly than low-grade cancers.

Understanding the cancer’s stage and grade helps your care team to choose the most effective treatment plan. Once staging is complete, our specialists work together to recommend the treatment approach that is right for you.

Early-stage bladder cancer that has not spread is usually treated with a procedure called transurethral resection of bladder tumor, or TURBT.

With TURBT, the doctor carefully threads a cystoscope – a long, thin tube with a camera – through the urethra into the bladder. This allows the doctor to see inside the bladder and view the tumor. The doctor then uses special instruments to remove the tumor.

After TURBT, patients might need intravesical therapy. This is chemotherapy or immunotherapy that’s delivered directly to the bladder instead of through an IV into the bloodstream.

Your care team will closely monitor your response to treatment to ensure that the cancer has not returned or progressed. Because bladder cancer can recur, ongoing surveillance is an important part of care.

Muscle-invasive bladder cancer is often treated with a combination of therapies. After staging is complete, patients meet with our multidisciplinary bladder cancer team to discuss the treatment options that are best suited to their diagnosis and goals.

Treatment may include chemotherapy or immunotherapy followed by surgery to remove the bladder or radiation therapy. These treatments may be given before, during or after your primary treatment to improve the chances of eliminating the cancer.

For some people with muscle-invasive bladder cancer, it may be possible to treat the cancer without removing the bladder. This approach, called bladder preservation, combines carefully selected therapies to treat the cancer while preserving bladder function. Determining whether bladder preservation is a safe and effective option requires a thorough evaluation of your cancer and overall health.

The goal is always to choose the treatment plan that offers the best chance of curing the cancer while preserving quality of life whenever possible.

No. Blood in urine can have many causes, including infection or kidney stones. However, it should always be checked by a healthcare provider.

There is no guaranteed way to prevent bladder cancer, but you can lower your risk by not smoking, avoiding harmful chemicals, drinking plenty of fluids and seeing a doctor for persistent urinary symptoms.

Most bladder cancers are not inherited. However, having a family history of bladder cancer may increase your risk. Some inherited genetic conditions can also raise cancer risk. Your doctor may recommend genetic counseling if there is a strong history of cancer in your family.

Some bladder cancers have a high chance of returning. Your care team will recommend regular follow-up to monitor for return of the disease.

Not everyone with bladder cancer needs their bladder removed. Early-stage cancers can often be treated without removing the bladder. For more advanced cancers, bladder removal may be recommended, but bladder-sparing approaches are an option for some patients. Your doctor will discuss the best approach based on your cancer stage and overall health.

Intravesical therapies deliver medications directly into the bladder through a catheter. This can include chemotherapy or immunotherapy, and it is often used for early-stage bladder cancer.

Some bladder cancer treatments can affect sexual function or fertility in both men and women, especially surgery or certain chemotherapies. If this is a concern, talk with your doctor before treatment. Options such as fertility preservation or supportive therapies may be available.

Yes. Although bladder cancer is more common in men, thousands of women are diagnosed each year. Women often face delays in diagnosis because early symptoms can resemble more common conditions, such as urinary tract infections (UTIs) or an overactive bladder.

Symptoms such as frequent urination, a sudden urge to urinate, painful urination or blood in urine can occur with both bladder cancer and UTIs. Women who experience persistent symptoms or recurrent UTIs that do not improve with treatment should talk with their healthcare provider about further evaluation.