OHSU

About Bladder Cancer

In the United States, 60,000 new cases of bladder cancer are diagnosed every year. About  25 percent of these patients will have a type of bladder cancer that spreads to the muscles, called muscle-invasive bladder cancer. Ten or 15 percent of people with cancer that has not spread to the muscles, called superficial bladder cancer, will get muscle-invasive bladder cancer later.

When treated early and appropriately, muscle-invasive bladder cancer can be cured even when it has spread to lymph nodes. Some patients with aggressive superficial bladder cancer will also die of their cancer. This can be because they did not have surgery to remove the bladder. You should know you’re your doctor can create a new bladder, called an orthotopic neobladder if you need to have your bladder removed.

Smoking is the main risk factor for bladder cancer. This includes secondhand smoke. Occupational exposure to chemicals containing hydrocarbons or arylamines also raise your risk of bladder cancer. Occupations with high exposure to these carcinogens include the dye, rubber, leather, painting and aluminum industries. Other risk factors include certain chemotherapy drugs, in particular cyclophosphamide. Some studies have suggested that hairdressers who handle hair dyes have a higher risk of bladder cancer. If you dye your own hair, or have it dyed at a salon, this might not raise your risk. Talk with your doctor about your risk of bladder cancer.

Your treatment for bladder cancer and how well you respond to treatment depends on how deeply the cancer has spread into your bladder tissue. Most people (75 percent) have superficial bladder cancers when they are first diagnosed. This means cancer has only spread into the top layers of bladder tissue. Most of these tumors have low risk of progressing and spreading to other areas of the body. Some people (about 25 percent) have bladder cancer that has spread to the bladder muscle. If your cancer has spread to the muscle layers of the bladder, the best treatment for you is bladder removal. Your surgeon will also take out the nearby lymph nodes to keep cancer from spreading to other areas of the body.

Incidence of Bladder Cancer

According to the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program data base, there were an estimated 70,980 new cases of bladder cancer diagnosed in the United States with more than 14,330 bladder cancer related deaths in 2009. Approximately 870 new cases of bladder cancer (23 cases per 100,000) are diagnosed in the state of Oregon annually, almost 20% higher than the average number of cases in the country. Over a 4-year period from 2002-2006, there were an average of 192 related deaths per year (5.0 deaths per 100,000), compared to 4.3 deaths per 100,000 reported from the entire country. In all countries, incidence rates are generally three to four times higher in men than in women. The incidence of bladder cancer increases dramatically with age among men and women.

Types of Bladder Cancer

There are three main types of bladder cancer.

  • Transitional cell carcinomas. More than 90 percent  of bladder cancers are this type.
  • Squamous cell carcinomas. Approximately 3 percent to 8 percent of bladder cancers are this type. Certain chronic infections and inflammation raise your risk of squamous cell carcinomas.
  • Adenocarcinomas. Just 1 percent to 2 percent of bladder cancers are this type. The prognosis is worse than with transitional cell bladder cancers.
  • Neuroendocrine tumors. Just 1 percent of bladder tumors are this type. The prognosis is not good, even with surgery and chemotherapy.