Key Points for This Section

Bladder and other urothelial cancers are diseases in which malignant (cancer) cells form in the urothelium. Most newly diagnosed bladder cancers occur in people 60 years and older. Smoking, gender, and diet can affect the risk of developing bladder cancer.

Bladder and other urothelial cancers are diseases in which malignant (cancer) cells form in the urothelium.

The bladder is a hollow organ in the lower part of the abdomen. It is shaped like a small balloon and has a muscle wall that allows it to get larger or smaller. The bladder holds urine until it is passed out of the body. Urine is the liquid waste that is made by the kidneys as they clean the blood. The urine passes from the two kidneys into the bladder through two tubes called ureters. When the bladder is emptied during urination, the urine goes from the bladder to the outside of the body through another tube called the urethra.

The urothelium is a layer of tissue that lines the urethra, bladder, ureters, prostate, and renal pelvis. Cancer that begins in the urothelium of the bladder is much more common than cancer that begins in the urothelium of the urethra, ureters, prostate, or renal pelvis. Because it is the most common form of urothelial cancer, bladder cancer is the focus of this summary.

There are 3 types of cancer that begin in the urothelial cells of the bladder. These cancers are named for the type of cells that become malignant (cancerous):

• Transitional cell carcinoma: Cancer that begins in cells in the innermost layer of the bladder urothelium. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the transitional cells.
• Squamous cell carcinoma: Cancer that forms in squamous cells, which are thin, flat cells that may form in the bladder urothelium after long-term infection or irritation.
• Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the bladder urothelium make substances such as mucus.

Most newly diagnosed bladder cancers occur in people 60 years and older.

In the United States, bladder cancer occurs more often in men than in women, and more often in whites than in blacks. As the U.S. population has gotten older, the number of people diagnosed with bladder cancer has increased, but the number of deaths from bladder cancer has decreased. This is true for men and women of all races over the last 30 years. However, blacks and women with bladder cancer are more likely to die from the disease than white men with bladder cancer are.

Smoking, gender, and diet can affect the risk of developing bladder cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for bladder cancer include:

• Using tobacco, especially smoking cigarettes.
• Being 60 years or older, male, or white.
• Being exposed to certain substances, such as soot from coal, or chemicals used to make rubber, certain dyes, or textiles.
• Working as a dry cleaner or in places where paper, rope, twine, or clothing is made.
• Taking A. fangchi, a Chinese herb.
• Drinking water that has high levels of arsenic.
• Having a history of many bladder infections.
• Long-term use of urinary catheters.
• Past treatment with certain anticancer drugs or radiation therapy to the pelvis.
• Having a kidney transplant.
• Having an inherited disorder called hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome).

Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Cancer that begins in cells that line certain internal organs and that have gland-like (secretory) properties.

A poisonous chemical used to kill weeds and pests. Also used in cancer therapy.

The organ that stores urine.

Cancer that forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation.

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A flexible tube used to deliver fluids into or withdraw fluids from the body.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

The process of identifying a disease, such as cancer, from its signs and symptoms.

In medicine, a disturbance of normal functioning of the mind or body. Disorders may be caused by genetic factors, disease, or trauma.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

An organ that makes one or more substances, such as hormones, digestive juices, sweat, tears, saliva, or milk. Endocrine glands release the substances directly into the bloodstream. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.

HNPCC. An inherited disorder in which affected individuals have a higher-than-normal chance of developing colorectal cancer and certain other types of cancer, often before the age of 50. Also called HNPCC and Lynch syndrome.

Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

Transmitted through genes that have been passed from parents to their offspring (children).

One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.

Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body.

A thick, slippery fluid made by the membranes that line certain organs of the body, including the nose, mouth, throat, and vagina.

A part of the body that performs a specific function. For example, the heart is an organ.

The lower part of the abdomen, located between the hip bones.

A gland in the male reproductive system. The prostate surrounds the part of the urethra (the tube that empties the bladder) just below the bladder, and produces a fluid that forms part of the semen.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

Flat cell that looks like a fish scale under a microscope. These cells cover inside and outside surfaces of the body. They are found in the tissues that form the surface of the skin, the lining of the hollow organs of the body (such as the bladder, kidney, and uterus), and the passages of the respiratory and digestive tracts.

Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma.

A group or layer of cells that work together to perform a specific function.

A plant with leaves that have high levels of the addictive chemical nicotine. The leaves may be smoked (in cigarettes, cigars, and pipes), applied to the gums (as dipping and chewing tobacco), or inhaled (as snuff). Tobacco leaves also contain many cancer-causing chemicals, and tobacco use and exposure to secondhand tobacco smoke have been linked to many types of cancer and other diseases. The scientific name is Nicotiana tabacum.

A cell that varies in shape depending on whether the tissue is being stretched. Transitional cells may be stretched without breaking apart. They line hollow organs such as the bladder.

Cancer that forms in transitional cells in the lining of the bladder, ureter, or renal pelvis (the part of the kidney that collects, holds, and drains urine). Transitional cells are cells that can change shape and stretch without breaking apart.

The replacement of tissue with tissue from the person’s own body or from another person.

The tube that carries urine from the kidney to the bladder.

The tube through which urine leaves the body. It empties urine from the bladder.

Having to do with urine or the organs of the body that produce and get rid of urine.

Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.

The lining of the urinary tract, including the renal pelvis, ureters, bladder, and urethra.