According to the American Cancer Society, approximately 81,000 Americans will be diagnosed with bladder cancer in 2022. It’s the fourth most common cancer among men. Urothelial carcinoma, also known as transitional cell carcinoma, is the most common type of bladder cancer, accounting for approximately 97% of all cases.

For Bladder Cancer Awareness Month, Dr. Roger Li, a genitourinary oncologist at Moffitt Cancer Center, answered frequently asked questions about the disease.

Common Questions:

Q: What is bladder cancer?

A: Bladder cancer arises from the urothelium, or the inside lining of the bladder. The inside lining of the bladder, the urethra and the ureters that go all the way up into the kidneys are made of the same tissue. Urothelial cancer really can arise from anywhere along the urinary tract. The bladder just happens to be the most common site where urothelial cancer occurs.

Q: What are the symptoms of bladder cancer?

A: The most common symptom patients get is blood in the urine. Other less common symptoms are discomfort when urinating, which can come in the form of burning while urinating or just having the urgency to go to the bathroom. Very rarely some of these tumors can cause obstruction to the lower urinary tract and that can cause difficulty urinating.

Q: Who is at risk for bladder cancer?

A: It typically happens in the older population, most frequently affecting men in their 70’s. Smoking has been known to cause bladder cancer. Some of the rarer causes include exposure to aniline dye in the textile industry. Agent orange has recently been shown to be a risk factor for bladder cancer in the veteran population.

Q: How is bladder cancer diagnosed?

A: The workup for seeing blood in the urine has three parts. First, we look inside the bladder with a camera. This is the most sensitive method to detect bladder cancer and is usually performed by a urologist. We also get a CT scan that covers the abdomen and pelvis. Finally, we will also get a urine sample to see if there are any cancer cells. From the combination of those three tests, we usually get a good sense of whether or not there is any cancer along the urinary tract.

Q: What are the treatment options for bladder cancer?

A: Treatment for bladder cancer depends on the depth of the invasion into the wall of the bladder. For non-muscle invasive tumors, a urologist will typically resect or scrape away the tumor using an electric loop, along with some of the tissue that's surrounding the tumor at its base on the surface of the bladder. This is sometimes followed by infusion of medicines into the bladder to prevent recurrence and progression of the tumor. For muscle invasive disease, the primary treatment is surgery to remove the bladder. In addition, we have to rebuild the patient’s urinary tract. Often times that’s done using the patient’s own intestine. An alternative would be to treat the cancer with radiation and chemotherapy.