What you need to know about Bladder Cancer

What
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What
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Know
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Bladder
Cancer
NATIONAL INSTITUTES OF HEALTH
National Cancer Institute

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This booklet is about bladder cancer. The
Cancer Information Service can help you
learn more about this disease. The staff can
talk with you in English or Spanish.
The number is 1–800–4–CANCER
(1–800–422–6237). The number for deaf
and hard of hearing callers with TTY
equipment is 1–800–332–8615. The call is
free.
Este folleto es acerca del cáncer de la
vejiga. Llame al Servicio de Información
sobre el Cáncer para saber más sobre esta
enfermedad. Este servicio tiene personal
que habla español.
El número a llamar es el
1–800–4–CANCER (1–800–422–6237).
Personas con dificultades de audición y que
cuentan con equipo TTY pueden llamar al
1–800–332–8615. La llamada es gratis.

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Contents
The Bladder 2
Understanding Cancer 3
Bladder Cancer: Who’s at Risk? 5
Symptoms 7
Diagnosis 8
Staging 10
Treatment 11
Side Effects of Treatment 19
Nutrition 24
Rehabilitation 25
Followup Care 26
Support for People with Bladder Cancer 26
The Promise of Cancer Research 27
Dictionary 29
National Cancer Institute Information Resources 39
National Cancer Institute Booklets 41
U.S. DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Public Health Service
National Institutes of Health

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What You Need To Know About™ Bladder
Cancer
his National Cancer Institute (NCI) booklet has
T important information about cancer* of the
bladder. Each year in the United States, bladder cancer
is diagnosed in 38,000 men and 15,000 women. This is
the fourth most common type of cancer in men and the
eighth most common in women.
This booklet discusses possible causes, symptoms,
diagnosis, treatment, and rehabilitation. It also has
information to help patients cope with bladder cancer.
Research is increasing what we know about bladder
cancer. Scientists are learning more about its causes.
They are exploring new ways to prevent, detect,
diagnose, and treat this disease. Because of research,
people with bladder cancer have an improved quality of
life and less chance of dying from this disease.
Information specialists at the NCI’s Cancer
Information Service can answer callers’ questions
about cancer and can send NCI publications. The
number to call is 1–800–4–CANCER. Also, anyone
may view or order NCI publications on the Internet at
http://cancer.gov/publications.
*Words that may be new to readers appear in italics. The
“Dictionary” section gives definitions of these terms. Some words in
the “Dictionary” have a “sounds-like” spelling to show how to
pronounce them.
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The Bladder
he bladder is a hollow organ in the lower
T abdomen. It stores urine, the liquid waste
produced by the kidneys. Urine passes from each
kidney into the bladder through a tube called a ureter.
An outer layer of muscle surrounds the inner lining
of the bladder. When the bladder is full, the muscles in
the bladder wall can tighten to allow urination. Urine
leaves the bladder through another tube, the urethra.
Female Urinary Tract
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Male Urinary Tract
Understanding Cancer
ancer is a group of many related diseases. All
C cancers begin in cells, the body’s basic unit of
life. Cells make up tissues, and tissues make up the
organs of the body.
Normally, cells grow and divide to form new cells as
the body needs them. When cells grow old and die,
new cells take their place.
Sometimes this orderly process goes wrong. New
cells form when the body does not need them, and old
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cells do not die when they should. These extra cells can
form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant:
• Benign tumors are not cancer. Usually, doctors can
remove them. Cells from benign tumors do not
spread to other parts of the body. In most cases,
benign tumors do not come back after they are
removed. Most important, benign tumors are rarely a
threat to life.
• Malignant tumors are cancer. They are generally
more serious. Cancer cells can invade and damage
nearby tissues and organs. Also, cancer cells can
break away from a malignant tumor and enter the
bloodstream or lymphatic system. That is how cancer
cells spread from the original (primary) tumor to
form new tumors in other organs. The spread of
cancer is called metastasis.
The wall of the bladder is lined with cells called
transitional cells and squamous cells. More than 90
percent of bladder cancers begin in the transitional
cells. This type of bladder cancer is called transitional
cell carcinoma. About 8 percent of bladder cancer
patients have squamous cell carcinomas.
Cancer that is only in cells in the lining of the
bladder is called superficial bladder cancer. The doctor
might call it carcinoma in situ. This type of bladder
cancer often comes back after treatment. If this
happens, the disease most often recurs as another
superficial cancer in the bladder.
Cancer that begins as a superficial tumor may grow
through the lining and into the muscular wall of the
bladder. This is known as invasive cancer. Invasive
cancer may extend through the bladder wall. It may
grow into a nearby organ such as the uterus or vagina
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(in women) or the prostate (in men). It also may invade
the wall of the abdomen.
When bladder cancer spreads outside the bladder,
cancer cells are often found in nearby lymph nodes. If
the cancer has reached these nodes, cancer cells may
have spread to other lymph nodes or other organs, such
as the lungs, liver, or bones.
When cancer spreads (metastasizes) from its original
place to another part of the body, the new tumor has the
same kind of abnormal cells and the same name as the
primary tumor. For example, if bladder cancer spreads
to the lungs, the cancer cells in the lungs are actually
bladder cancer cells. The disease is metastatic bladder
cancer, not lung cancer. It is treated as bladder cancer,
not as lung cancer. Doctors sometimes call the new
tumor “distant” disease.
Bladder Cancer: Who’s at Risk?
o one knows the exact causes of bladder cancer.
However, it is clear that this disease is not
N contagious. No one can “catch” cancer from
another person.
People who get bladder cancer are more likely than
other people to have certain risk factors. A risk factor is
something that increases a person’s chance of
developing the disease.
Still, most people with known risk factors do not get
bladder cancer, and many who do get this disease have
none of these factors. Doctors can seldom explain why
one person gets this cancer and another does not.
Studies have found the following risk factors for
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bladder cancer:
• Age. The chance of getting bladder cancer goes up
as people get older. People under 40 rarely get this
disease.
• Tobacco. The use of tobacco is a major risk factor.
Cigarette smokers are two to three times more likely
than nonsmokers to get bladder cancer. Pipe and
cigar smokers are also at increased risk.
• Occupation. Some workers have a higher risk of
getting bladder cancer because of carcinogens in the
workplace. Workers in the rubber, chemical, and
leather industries are at risk. So are hairdressers,
machinists, metal workers, printers, painters, textile
workers, and truck drivers.
• Infections. Being infected with certain parasites
increases the risk of bladder cancer. These parasites
are common in tropical areas but not in the United
States.
• Treatment with cyclophosphamide or arsenic.
These drugs are used to treat cancer and some other
conditions. They raise the risk of bladder cancer.
• Race. Whites get bladder cancer twice as often as
African Americans and Hispanics. The lowest rates
are among Asians.
• Being a man. Men are two to three times more
likely than women to get bladder cancer.
• Family history. People with family members who
have bladder cancer are more likely to get the
disease. Researchers are studying changes in certain
genes that may increase the risk of bladder cancer.
• Personal history of bladder cancer. People who
have had bladder cancer have an increased chance
of getting the disease again.
Chlorine is added to water to make it safe to drink.
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It kills deadly bacteria. However, chlorine by-products
sometimes can form in chlorinated water. Researchers
have been studying chlorine by-products for more than
25 years. So far, there is no proof that chlorinated water
causes bladder cancer in people. Studies continue to
look at this question.
Some studies have found that saccharin, an artificial
sweetener, causes bladder cancer in animals. However,
research does not show that saccharin causes cancer in
people.
People who think they may be at risk for bladder
cancer should discuss this concern with their doctor.
The doctor may suggest ways to reduce the risk and
can plan an appropriate schedule for checkups.
Symptoms
ommon symptoms of bladder cancer
include:
C •Blood in the urine (making the urine slightly
rusty to deep red),
• Pain during urination, and
• Frequent urination, or feeling the need to urinate
without results.
These symptoms are not sure signs of bladder
cancer. Infections, benign tumors, bladder stones, or
other problems also can cause these symptoms. Anyone
with these symptoms should see a doctor so that the
doctor can diagnose and treat any problem as early as
possible. People with symptoms like these may see
their family doctor or a urologist, a doctor who
specializes in diseases of the urinary system.
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Document Outline

• Contents
• Introduction
• The Bladder
• Understanding Cancer
• Bladder Cancer: Who?s at Risk?
• Symptoms
• Diagnosis
• Staging
• Treatment
• Side Effects of Treatment
• Nutrition
• Rehabilition
• Followup Care
• Support for People with Bladder Cancer
• The Promise of Cancer Research
• Dictionary
• National Cancer Institute Information Resources
• National Cancer Institute Booklets

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