Webinar: What You Should Know About Bladder Cancer: Causes, Symptoms and Management
Highlights from a webinar on bladder cancer featuring Dr. Juan Garisto, Director of Urologic Oncology at NewYork-Presbyterian Brooklyn Methodist Hospital and Assistant Professor in the Department of Urology at Weill Cornell Medicine.
Overview
The bladder is a hollow organ that stores urine before it is expelled from the body. Bladder cancer develops when abnormal cells grow and multiply uncontrollably in the lining of the bladder. In 2025, more than 2 million new cancer cases, including 85,000 bladder cancer cases, are projected to occur in the United States. However, the number of deaths has decreased dramatically since 1991 due to:
- a decline in smoking rates
- earlier detection
- improved treatment options
Types of Bladder Cancer
Bladder cancer is broadly categorized into three main types:
Urothelial carcinoma
- accounts for approximately 90% of all bladder cancer cases
- originates in the transitional cells lining the bladder
- can also occur in the renal pelvis, ureters and urethra
Adenocarcinoma
- a rare form of bladder cancer, representing about 1 percent of cases
- typically associated with chronic inflammation or obstruction
- often arises from bladder diverticula or areas of long-standing irritation
Squamous cell carcinoma
- also rare, accounting for about 1 to 2 percent of bladder cancers
- risk factors include chronic inflammation, radiation therapy and bladder stones, often associated with infections such as schistosomiasis, which is prevalent in certain developing regions
Causes and Risk Factors
Several factors increase the risk of developing bladder cancer, including:
- smoking (the most significant risk factor)
- radiation therapy to the pelvis
- cyclophosphamide, a chemotherapy drug
- occupational exposures to chemicals, plastics, rubber, dyes or industrial compounds
- chronic bladder infections and parasitic infections (e.g., schistosomiasis)
Common Symptoms
Bladder cancer often presents with a range of symptoms, including:
- blood in the urine (hematuria) – the most common and often the first noticeable sign
- frequent and urgent need to urinate
- pain during urination
- pain in the lower abdomen or lower back
Treatment Approaches
Bladder cancer is classified into two major categories, each requiring distinct treatment approaches:
Non-Muscle Invasive Bladder Cancer (NMIBC)
- affects only the inner lining of the bladder
- typically treated with cystoscopy and transurethral resection (TURBT) to remove visible tumors
- Bacillus Calmette-Guérin (BCG) therapy, an immunotherapy derived from a weakened form of the tuberculosis bacterium, can significantly reduce recurrence rates, benefiting 60 to 70 percent of patients
- intravesical chemotherapy may be required for those at higher risk of recurrence.
Muscle-Invasive Bladder Cancer (MIBC)
- penetrates the muscle layer of the bladder wall
- often requires more aggressive treatment, including radical cystectomy (bladder removal) and urinary diversion (ileal conduit, or neobladder created from intestinal tissue)
- other types of treatment for selected patients include trimodal therapy (combination of TURBT and chemoradiation therapy)
Advanced and Metastatic Bladder Cancer
Even in advanced stages, metastatic bladder cancer can be managed with a combination of chemotherapy, immunotherapy and, in some cases, targeted precision medicine, significantly extending patient survival and quality of life.
Conclusion
Bladder cancer is a complex disease with a wide range of presentations and outcomes. Early detection, personalized treatment plans and ongoing advancements in therapy are critical in improving patient outcomes and survival rates.