What is Bladder Cancer?

What is Bladder Cancer?

Bladder cancer starts when cells on the inside lining of the bladder grow out of control. The bladder is a hollow sac in your pelvis that stores urine. As more cancer cells grow in the bladder lining, they accumulate in masses, called tumors. Over time, a bladder tumor may grow through the bladder wall, and cells may break away and spread cancer to other parts of the body.

Types of Bladder Cancer


Certain cell types found on the bladder’s innermost lining can give rise to different types of bladder cancers.

  • Urothelial carcinoma - The vast majority of bladder cancers begin in urothelial cells. Urothelial carcinoma is also called transitional cell carcinoma.
  • Squamous cell carcinoma - Long-term inflammation or infection can cause thin, flat squamous cells to develop in the bladder lining. Cancer that begins in squamous cells accounts for less than 5% of bladder cancers in North America.
  • Adenocarcinoma - This rare but aggressive form of bladder cancer begins in glandular cells in the bladder lining.

Stages of Bladder Cancer


The bladder wall consists of several layers: the inner lining (urothelial cells), a layer of connective tissue, nerves, and blood vessels; a muscle layer; and a layer of fat that surrounds the bladder.

The stages of bladder cancer refer to how much the tumor has grown and if the cancer has reached other parts of your body. Knowing the different stages of bladder cancer can help in deciding on a treatment plan.

  • Stage 0 - Cancer cells appear only on the surface of the bladder’s inner lining, also called flat carcinoma in situ, or CIS
  • Stage I - Cancer cells are growing within the bladder’s lining, but only that layer
  • Stage II - The tumor has spread to the muscle of the bladder, but not beyond
  • Stage III - The tumor has advanced through the muscle and bladder wall and spread to nearby tissues or organs
  • Stage IV - Cancer has spread to the abdomen wall or to lymph nodes or organs farther away from the bladder. Cancer that spreads beyond its starting place is called metastatic.

If you have surgery, your oncologist may add the letters T, M, and N to describe the stage of your cancer. These letter categories indicate more precisely where and how far a tumor has spread.

Diagram of the four stages of bladder cancer.

Signs & Symptoms of Bladder Cancer


Signs and symptoms of bladder cancer include:

  • Blood in the urine
  • Pain or burning when urinating
  • Frequent urination and urgency
  • Having trouble urinating
  • Lower back pain

Other conditions also can cause these symptoms, including urinary tract infections, bladder stones, or an enlarged prostate. Be sure to see your doctor if your urine is a different color than usual, or if you think it may contain blood.

What Causes Bladder Cancer?


Like all cancers, bladder cancer begins when changes in DNA (genetic mutations) cause cells to divide and grow abnormally. Cells in the bladder’s inner lining are exposed to toxins in urine, which could be the cause of genetic mutations. For example, toxins that enter the body through cigarette smoking end up in urine.

Some genetic mutations are inherited, but bladder cancer does not usually run in families. Once bladder cancer begins growing, it can spread (metastasize) cancer to other parts of the body.

Risk Factors

Risk Factors

The following risk factors increase a person’s chances of developing bladder cancer:

  • Smoking and other tobacco use - Toxins in tobacco can cause changes to the cells that line the bladder and increase the risk of all urologic cancers
  • Chemical exposures - Industrial chemicals used in certain industries and professions can increase bladder cancer risk (for example, dye and manufacturing of rubber, leather, textiles, and paint products and jobs including machinist, printer, and hairdresser)
  • Not drinking enough fluids - Drinking fluids, especially water, leads to more frequent urination and prevents toxins from staying in the bladder
  • Age - Most bladder cancers are diagnosed in people over 55 years old
  • Gender - Men are more likely to develop bladder cancer
  • Long-term (chronic) bladder irritation and infections - Repeated urinary infections, kidney or bladder stones, and other irritants may increase bladder cancer risk. In parts of the world where schistosomiasis infection is common, it is associated with bladder cancer, but this is rare in the US.
  • Previous cancer treatment - Having had another cancer, especially another urologic cancer, increases risk, as do certain cancer treatments such as radiation to the pelvis
  • Family history of cancer - Having a strong family history of cancer, especially urologic cancer, increases the risk of bladder cancer



There is no certain way to prevent bladder cancer, but taking these steps can help reduce your risk:

  • Don’t smoke or use other tobacco products
  • Eat a healthy diet with vegetables, fruits, and whole grains; avoid highly processed foods and sugary beverages
  • Avoid exposure to toxic chemicals
  • Drink plenty of fluids, especially water
Get Care

Trust NewYork-Presbyterian for Bladder Cancer Care

Contact us to learn about advanced surgical treatments for bladder cancer, as well as the latest immunotherapy and targeted therapy approaches. At NewYork-Presbyterian, our multidisciplinary care teams of medical oncologists, urologists, radiation oncologists, surgeons, and pathologists work together to determine the best treatment approach for you.