According to the American Cancer Society, a person has bladder cancer when the cells located in the urinary bladder begin to grow out of control.
Tumors can develop as the cancerous cells continue to multiply. Cancer that originates in the bladder can also spread to other areas of the body. The most common areas for bladder cancer to spread include the bones, liver, lungs, and lymph nodes.
The bladder has several layers and cells. The majority of bladder cancers originate in the innermost lining of the bladder. This name of this area is the transitional epithelium. Bladder cancer is easiest to treat at this point. Once it grows and makes its way through additional layers in the bladder wall, it becomes much more difficult.
Symptoms of Bladder Cancer
One of the first indications of bladder cancer is blood in the urine. The urine may appear dark red, pink, or orange. Sometimes the urine returns to normal for a while, but it will always resume an unusual color if bladder cancer is present. Discolored urine is also a symptom of several other conditions. At this early stage of bladder cancer, it’s common to not experience any pain or other symptoms.
Possible signs that bladder cancer has advanced include:
- The need to urinate more frequently
- Burning or pain while urinating
- An urgent sense of needing to urinate, even when the bladder is not full
- A weak urine stream or difficulty starting the urination process
Symptoms of Advanced Bladder Cancer
These symptoms indicate that cancer has reached the advanced stages:
- Bone pain
- Inability to urinate at all
- Swollen feet
- Weakness and fatigue
- Decreased appetite and unplanned weight loss
- Low back pain on only one side
Types of Bladder Cancer and Staging
Urothelial carcinoma, also called a transitional cell carcinoma or TCC, is by far the most prevalent type of bladder cancer. The name urothelial carcinoma comes from the fact that it originates in the urothelial cells that line the bladder. They are also present in other parts of the urinary tract. Other types of bladder cancer include:
- Small cell carcinoma
- Squamous cell carcinoma
However, the prevalence of these four types of bladder cancer range from less than one percent to a maximum of two percent for each one. Doctors treat them similarly to TCC when they detect early stage tumors but may prescribe different drugs if any of these types of bladder cancers spread.
Two other major considerations with this cancer are whether it is invasive or non-invasive and whether it is papillary or flat. Invasive cancer of the bladder has spread into deeper layers of its wall. This makes it easier for tumors to spread and harder for doctors to treat the disease. Non-invasive bladder cancer means that it remains within the transitional epithelium, or inner layer of cells, and has not spread beyond that point.
See also: Keeping Your Bladder Healthy.
A flat carcinoma does not grow towards the bladder’s hollow part. Doctors refer to this type of bladder cancer as non-invasive flat carcinoma if it remains within the inside cells of the bladder. A papillary carcinoma is slender and grows in the shape of a finger. It originates in the inner surface of the bladder and grows towards the center without invading the deeper layers of the bladder. The diagnosis is non-invasive papillary carcinoma, which typically responds well to early treatment.
Staging for bladder cancer uses a system designed by the American Joint Committee on Cancer. A patient’s stage will have the letter T, N, or M followed by a number.
T describes how far the original tumor has grown beyond the bladder wall and if it has advanced to nearby tissues. N indicates that the cancer has spread to lymph nodes near the bladder. M describes whether the original cancer has metastasized, meaning it has spread to other organs. Higher numbers next to the letter mean the bladder cancer is more advanced.
The doctor and patient will begin planning for treatment once he or she has received an official diagnosis and the doctor has staged the cancer. It’s important for patients and their families to understand both the diagnosis and the stage before moving forward with treatment.