The bladder is an important, and sometimes underappreciated, organ in the body. Located in the pelvis, the bladder stores urine, the primary waste product of the kidneys. When we urinate, the bladder muscles tighten, pushing urine out of the bladder. Like other organs, an overgrowth of cells in the bladder tissue can give rise to cancer, and if left untreated, bladder cancer can spread to distant parts of the body.
Several types of bladder cancer exist, with urothelial cancer being the most common. Urothelial cancer (also called transitional cell cancer) develops in the urothelial cells lining the bladder. Several other rare types of cancers also develop in the bladder. Squamous cell carcinoma, characterized by tumor cells appearing flat, makes up less than 2% of the bladder cancers diagnosed in the United States. Adenocarcinomas, which form in glandular cells in the bladder, and small cell carcinomas, which start in neuroendocrine cells, each account for about 1% of bladder cancers in the United States. Sarcomas remain the rarest subtype of bladder cancer, and they begin in the muscle cells of the bladder tissue.
Experts estimate that in 2023 bladder cancer will account for 6% of the new cancer cases in men in the United States and about 4% of cancer-related deaths. Overall, an estimated 82,290 new cases of bladder cancer (about 62,000 in males and 20,000 in females) will occur in 2023. Further, bladder cancer will account for nearly 17,000 estimated deaths (about 12,000 male and less than 5,000 female) in 2023. While bladder cancer remains the fourth most common cancer in men, it is far less prevalent in women. Overall, bladder cancer has a good prognosis, with 77% of patients achieving five-year survival. Five-year survival is highest in patients with low-stage bladder cancer, indicating the importance of early diagnosis.
Several risk factors can increase an individual’s chances of developing bladder cancer. For bladder cancer, Whites develop bladder cancer twice as often as African Americans and Hispanics. Bladder cancer is also associated with age, as most cases occur in those older than 55. Having a close family member with bladder cancer also increases the risk of developing the disease, and this risk factor can be related to similar exposures and genetics.
Like many other cancers, smoking remains the strongest modifiable risk factor for bladder cancer resulting in at least three times higher likelihood of developing bladder cancer. In addition, workplace exposures significantly increase the risk of developing bladder cancer. Workplaces associated with bladder cancer risk often involve paints, dyes, or other compounds containing aromatic amines. Occupations in the rubber, leather, textile, and printing industries often confer a higher workplace exposure to chemicals that increase bladder cancer risk. In addition, those exposed to excessive amounts of diesel fumes, such as truck drivers, may also have an elevated bladder cancer risk.
Individual treatment plans for bladder cancer consider the clinical characteristics of a patient’s cancer as well as the health and prognosis of the individual. Standard treatment plans include surgery, chemotherapy, radiotherapy, and immunotherapy. Many patients will receive multiple treatment forms.
Sources: CA, JAMA Network, Eur Urolog
