Bladder Cancer

General and more comprehensive text about cancer diseases, their behavior, causes and treatment can be found here.


Urinary bladder cancer is a malignant disease whose frequency slowly increases. It is more common in men, but it may affect also women. The bladder is a hollow organ. Anatomically, it is located in the pelvis and it serves as a reservoir, in which the urine is accumulated. In the upper part, the bladder is connected to two ureters (one from each kidney) and in its lower part, the bladder opens to urethra.


There are many possible causes of bladder tumor, for example smoking. This is not a surprising fact as the cigarette smoke contains a vast amount of carcinogenic substances and it plays a significant role in development of many tumors. Furthermore, there is may be an influence of chronic inflammation of the bladder’s wall, which can be caused for example by certain medications (cyclophosphamide), or by chronic recurring urinary tract infections that are often associated with urinary stones. Bladder cancer may also occur because of long-term contact with certain industrial chemicals. Such hazardous substances are aromatic amines, aluminum compounds and certain pigments.


In addition, many scientists speculate about the role of artificial sweeteners. In the past, due to this suspicion, some sweeteners have been withdrawn (sodium cyclamate). Artificial sweeteners used in the present seem to be safe, but some doubts still exist.


The symptoms of bladder cancer are usually absent in the first stages of the disease. Sometimes, the patient can find a small amount of blood in urine. There may be also present unspecific troubles when urinating such as pain and burning during urination. Given that the tumors frequently grow inside the bladder as polyp structures, they can cause obstruction to the outflow of urine. This may result in hydronephrosis or in considerable pain during urination.


Finding visible amount of blood in urine or confirmation of trace amounts of blood in urine by urinalysis is always suspicious, especially in older patients. Tumor mass may be visualized by ultrasound or more accurately by computed tomography. The cavity of the bladder may be also examined by an X-ray using a contrast medium. The medium shows the cavity of the bladder and any irregularities of its wall. Probably the best examination is cystoscopy. It is an endoscopic examination when the doctor inserts a tube-like device equipped with camera and light source through the urethra into the bladder. This examination allows to see any suspicious lesions and to take samples for histological examination.


Total prevention is not possible, but the risk of the disease may be lowered by avoiding smoking, by adequate treatment of any urinary infections and urinary stones. When working with any potentially hazardous chemicals, it is necessary to comply with health and safety protocols and use proper protective equipment.


The therapy depends on the extent of the disease. Small tumors with shape of bladder polyps may be easily removed during the cystoscopy. Locally advanced forms may need surgical interventions of various extent including large operations with removal of the whole bladder and nearby anatomical structures and organs. Chemotherapy serves as s supportive therapy and alone, it can not cure the disease.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources