Bladder cancer - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Bladder cancer is the 10th most common cancer worldwide and is more prevalent in men. While nearly half of patients with bladder cancer are nonsmokers, cigarette smoking is the most causative risk factor.
Nearly all patients with bladder cancer report hematuria as the primary symptom. The diagnostic evaluation of bladder cancer involves cystoscopy and abdominal/pelvic imaging.
Transurethral resection of a bladder tumor (TURBT) is the procedure to remove the tumor and stage the depth of invasion.
Guideline-directed risk stratification based on grade and stage after initial TURBT determines the frequency of cystoscopy and, in many patients, the number of doses and duration of intravesical (bladder-directed) therapy.
Muscle-invasive tumors are treated with systemic therapy and bladder removal or chemo-radiation therapy.

Low-grade, noninvasive (Ta) papillary urothelial carcinoma. Note adjacent satellite tumor, illustrating the field effect

From the collection of Donald Lamm, MD, FACS

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Definition

Epidemiology

Etiology

Pathophysiology

Images

Low-grade, noninvasive (Ta) papillary urothelial carcinoma. Note adjacent satellite tumor, illustrating the field effect
Low-grade urothelial carcinoma seeding in the prostatic urethra; illustrated is the loop electrode used to resect bladder tumors
Low-grade tumors surrounded by small satellite tumors with small, uniform fronds. In the foreground is a solid tumor on a broad base, a typical appearance of high-grade tumors. Low- and high-grade tumors often occur in the same patient
Methylene blue-stained tumor at the right bladder neck. Staining with 0.2% methylene blue (or use of the now Food and Drug Administration-approved hexaminolevulinate blue-light fluorescence cystoscopy) can help identify tumors not seen otherwise
Carcinoma in situ of the bladder; this can appear as a rough, erythematous patch in the bladder, but often the urothelium appears normal; random biopsy or biopsy of areas stained by 0.2% methylene blue, illustrated here, is needed to make the diagnosis
European Organisation for Research and Treatment of Cancer (EORTC) scoring system: weighting used to calculate recurrence and progression scores. CIS, carcinoma in situ
European Organisation for Research and Treatment of Cancer (EORTC) risk tables: probability of recurrence and progression according to score

Citations

Key Articles

American Urological Association. Diagnosis and treatment of non-muscle invasive bladder cancer: AUA/SUO joint guideline. 2020 [internet publication].[Full Text]
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: bladder cancer [internet publication].[Full Text]
European Association of Urology. Non-muscle-invasive bladder cancer. 2023 [internet publication].[Full Text]
European Association of Urology. Muscle-invasive and metastatic bladder cancer. 2023 [internet publication]. [Full Text]
American Urological Association. Treatment of non-metastatic muscle-invasive bladder cancer: AUA/ASCO/ASTRO/SUO guideline. 2020 [internet publication].[Full Text]

Other Online Resources

European Organisation for Research and Treatment of Cancer (EORTC) scoring system and risk tables for stage Ta T1 bladder cancer
CDC: bladder cancer

Referenced Articles

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