Bladder cancer is a malignant growth of cells that form a tumor inside the bladder. They typically arise from the cells that line the inside of the bladder called transitional cells. These tumors can grow as papillary (polyp-like) or as sessile (flat) tumors. They can be very small or very large. Bladder cancer can metastasize to other areas of the body. Treatment for bladder cancer depends on tumor size, grade (how aggressive tumor looks under a microscope), and depth of invasion into the bladder wall (non-muscle invasive or muscle invasive).
Certain environmental factors are thought to contribute to the development of bladder cancer. Cigarette smoking is the most common factor. Others causes include exposure to certain industrial chemicals, previous radiation treatment to the pelvis, cancer treatment with cyclophosphamide, chronic irritation of the bladder lining, and certain types of parasitic infections. Some people diagnosed with bladder cancer have no obvious risk factors.
The most common symptom of bladder cancer is passing visible blood in the urine (gross hematuria). Sometimes patients don’t see the blood in the urine but it can be detected on a urinalysis (microscopic hematuria). Other symptoms include urinary frequency or urgency, painful urination, flank or back pain.
Diagnosis is typically made after a detailed history and physical examination, imaging of the kidneys and ureters with CT scan of the abdomen and pelvis with intravenous contrast, and cystoscopy (using a flexible tube-like instrument with built in light and camera to visualize the inside of the urethra and bladder).
Treatment mainly depends on the grade of the tumor, depth of invasion into the wall of the bladder, and stage of the disease. This is determined after the tumor has been removed from the bladder with a special cystoscope in surgery and appropriate imaging has been completed.