About Bladder Cancer

Bladder cancer begins in the bladder, a hollow, expandable organ in the pelvis that stores urine until it’s emptied from the body. This cancer usually begins in the cells that line the inside of the bladder. It mostly affects people older than 70 and occurs more often in men.

Bladder cancer is usually found in its early stages and it generally responds well to treatment when it’s diagnosed early on. However, people who have been successfully treated for bladder cancer should be monitored afterward because it can return (recur) even years later.


The earliest sign of bladder cancer is usually blood in the urine, called hematuria, which often occurs without pain or other urinary symptoms. It may be very faint or a pink tinge, or the blood may be obvious. The blood may not be present in the urine all the time – it may come and go.

Many people dismiss this symptom since it may go away for several weeks before it returns. Men with blood in their urine should have a complete workup of their genitourinary tract, including the kidneys and bladder.

Other signs and symptoms of bladder cancer include:

  • burning, irritation, or pain when urinating
  • difficulty urinating or inability to urinate
  • frequency (the need to urinate often)
  • pain in the bladder area or bladder spasms
  • urgency (the intense need to urinate immediately)

These signs and symptoms don’t necessarily mean that you have bladder cancer. Speak with your doctor if you have any of these symptoms so that you can be sure to get a proper diagnosis. 

Types of Bladder Cancer

Most bladder cancers — about 90 percent — begin in the cells on the surface of the bladder’s inner lining, known as transitional epithelial cells. This type of cancer is called transitional cell carcinoma (TCC) or urothelial carcinoma. Most TCCs are noninvasive, meaning the cancer stays within the bladder’s inner lining.

In about 30 percent of cases, however, TCC tumors eventually penetrate the bladder’s lining and grow into the muscle wall. Muscle-invasive bladder cancer can also metastasize (spread) to other parts of the urinary system, such as the kidneys, ureters, and urethra.

Less common types of bladder cancer can develop in the inner lining of the bladder as a result of chronic irritation and inflammation. These rare types usually grow into the muscle of the bladder over time and are characterized according to the cell type involved.

Squamous cell carcinoma: Approximately 8 percent of bladder cancers begin in the thin, flat squamous cells that may form in the bladder after a long-term infection or irritation.

Small cell carcinoma: Approximately 1 percent of bladder cancers start in the small, nerve-like cells in the bladder called neuroendocrine cells.

Adenocarcinoma: Approximately 1 percent of bladder cancers begin in cells that make and release mucus and other fluids in the bladder.

Bladder Cancer Prevention & Risk Factors

Several factors can increase your risk of developing bladder cancer, but one in particular stands out: tobacco use. People who smoke cigarettes are up to four times more likely than nonsmokers to develop the disease. Cigar and pipe smoking also appear to increase your risk, although it’s unclear by how much.

Studies have shown that smoking is responsible for approximately 50 percent of bladder cancers, and researchers suspect that genetic differences may increase the risk for the disease in some smokers.

Because toxins often leave the body through the bladder, the risk of bladder cancer persists for many years after a person stops smoking. Quitting can still reduce your risk of developing bladder cancer as well as your risk that the disease will come back, though.

Tobacco Treatment Program

Since the mid-1990s, Memorial Sloan Kettering’s Tobacco Treatment Program has helped thousands of individuals stop using tobacco products.

You may also be at an increased risk for bladder cancer if you work in the textile, dye, rubber, leather, paint, or printing industries. This is because you may have been exposed to a class of organic chemicals called aromatic amines, some of which are cancer-causing.

Most other risk factors for bladder cancer are beyond your control, however.

  • Gender: Bladder cancer is nearly three times more common in males than in females.
  • Age: You are most likely to develop bladder cancer after age 70.
  • History of chronic bladder problems: You are more likely to develop bladder cancer if you have had long-term bladder irritation and inflammation, such as that caused by infections and bladder or kidney stones.
  • Use of lymphoma medicine: If you have taken the lymphoma drug cyclophosphamide (Cytoxan®), you are at a higher-than-average risk for bladder cancer.
  • Parasitic infection: In developing countries, 75 percent of bladder cancers are squamous cell carcinomas caused by infection with the parasitic organism Schistosoma haematobium, which is often present in untreated drinking water.