Bladder Cancer

Bladder cancer is most commonly caused by tobacco exposure, which accounts for approximately half of all cases. Additionally, a small proportion of bladder cancers are associated with a genetic cancer predisposition (an increased chance of developing cancer due to inherited genetic mutations) called Lynch syndrome. However, it is important to note that some patients with risk factors never develop bladder cancer, while others with the disease have little to no risk factors.

Risk factors for bladder cancer

Certain patient-specific and environmental factors can increase a patient’s risk of developing the disease, including:

Smoking
Cigarettes, cigars, and pipes contain harmful chemicals that can gather in the urine and damage the lining of the bladder. As a result, smoking can increase bladder cancer risk by more than threefold.

Increasing age
Bladder cancer can happen at any age, but your risk increases as you age. That is because your body’s ability to repair itself decreases over time.

Being male  
Men are four times more likely to develop bladder cancer than women. The reason for this is unknown.  

Exposure to certain chemicals
The kidneys filter harmful chemicals from your bloodstream to your bladder. Because of this process, it is thought that exposure to certain chemicals may increase a person’s risk of bladder cancer. Chemicals linked to bladder cancer include dyes, rubber, leather, paint, arsenic, and certain textiles.  

Chronic bladder inflammation  
Repeated urinary infections, bladder inflammation, and chronic urinary catheterization can increase a patient’s risk for bladder cancer, especially squamous cell carcinoma.  

Family or personal history of cancer
People who have had a history of bladder cancer are susceptible to getting it again. Patients with a family history of cancer may also be at increased risk of the disease. Specifically, patients with Lynch syndrome — a condition characterized by a family-linked risk for cancer — are at increased risk for developing bladder cancer.  

Bladder Cancer Screening and Diagnosis

While there is no validated screening test for people at average risk for bladder cancer, there are tests available to diagnose bladder cancer. Bladder cancer is typically diagnosed through cystoscopy and a combination of blood and urine tests. Roughly 70% to 80% of newly diagnosed bladder cancer patients have early-stage bladder cancer, which is cancer that has not yet invaded the muscle layer of the bladder. It is often termed “non-muscle-invasive bladder cancer (NMIBC).” NMIBC is highly curable with prompt urologic intervention. Bladder cancer that has invaded the muscle-layer of the bladder — called “muscle-invasive bladder cancer (MIBC)” — is far more aggressive and poses a significant threat to life but is still highly treatable. Any patient with muscle-invasive bladder cancer should seek immediate consultation with a medical oncologist experienced in the treatment of bladder cancer. At Texas Oncology, our specialists are trained to diagnose and treat cancers of the bladder and bring years of experience to each case.  

Tests to screen and diagnose bladder cancer

Urinalysis

A urinalysis examines the components of urine and may detect the presence of blood, which can be visible under a microscope or using a special test strip.  

Urine cytology

A lab test where urine is inspected under a microscope for abnormal cells.  

Cystoscopy

Performed by a urologist, this procedure involves a tiny tube with a camera being inserted into the bladder through the urethra to look for tumors.  

Biopsy

If tumors are found using cystoscopy, a urologist will generally recommend a special biopsy called “transurethral resection of the bladder tumor (TURBT) — a specialized surgical procedure to accurately stage and simultaneously treat bladder cancer. The tissue sample is reviewed under a microscope to determine how deeply into the bladder lining the cancer has invaded and differentiate between NMIBC and MIBC.  

Stages of bladder cancer

Stage 0

Early stage of bladder cancer where the cancer is growing in the inner lining of the bladder only. At this stage, connective tissue and muscle of the bladder wall have not been affected. This stage is classified as non-invasive bladder cancer (NMIBC).

Stage I

Patients with stage I bladder cancer have cancer that invades beneath the surface of the bladder into connective tissue, but does not invade the muscle of the bladder and has not spread to lymph nodes. This stage is also classified as NMIBC.

Stage II

Patients at this stage have cancer that invades through connective tissues into the muscle wall, but has not spread outside the bladder or to local lymph nodes. This stage is classified as muscle-invasive bladder cancer (MIBC).

Stage III

Stage III is when cancer invades through connective tissue, muscle, and immediate tissue outside the bladder and/or the prostate gland in males or the uterus and/or vagina in females. At this stage, cancer has not yet spread to lymph nodes or distant sites. Similar to stage II, stage III is also classified as MIBC or “node-positive” bladder cancer.

Stage IV

At this stage, the cancer has passed through the bladder wall and invaded the pelvic and/or abdominal wall as well as spread to the lymph nodes and/or distant sites. Stage IV constitutes “advanced” or “metastatic” disease.

Treating Bladder Cancer

Our bladder cancer specialists leverage the latest treatment advancements, lead ground-breaking clinical trials to optimize outcomes for each patient, and develop the next generation of bladder cancer therapies. They will work with you to discuss your diagnosis, explore treatment options, and help you plan while keeping your priorities and preferences top of mind.  

Bladder cancer treatment depends on the stage of the cancer, as well as the patient’s overall health. Common treatments can include a combination of surgery, immunotherapy, targeted therapy, chemotherapy, and/or radiation.  

Transurethral resection (TUR)

A transurethral resection is a specialized surgical procedure in which a urologist inserts a thin instrument through the urethra and into the bladder in order to remove visible tumors, allowing accurate diagnosis, staging, and initial treatment.  

Radical cystectomy

This highly complex procedure refers to the complete surgical removal of the bladder and the surrounding organs. For women, this may involve removing the uterus, ovaries, fallopian tubes, part of the vagina, and the urethra. For men, the prostate, seminal vesicles, and possibly, the urethra, are often removed. Once the bladder is removed, the urologist usually creates a permanent opening in the abdominal wall through which the urine is diverted into an ostomy bag, a pouch that collects waste from the body.  

Partial cystectomy

In contrast to radical cystectomy, which involves the removal of the entire bladder, a partial cystectomy involves the surgical removal of part of the bladder affected by cancer. Since patients have residual bladder function after a partial cystectomy, they do not require an ostomy and may be able to urinate normally.  

Creation of alternative bladders or neobladders

In select radical cystectomy patients, a highly-skilled urologist may create a substitute bladder, called a neobladder. Constructing a neobladder involves using a part of the intestine to form a new bladder, then connecting one end of the neobladder to the ureters.  
 

Your Bladder Cancer Team

Our doctors work together to deliver comprehensive multidisciplinary bladder cancer care. Your team will vary on your specific needs, but your team may include: 

Medical Oncologists specialize in using systemic therapies like immunotherapy, targeted therapy, and chemotherapy. In contrast to local therapies such as surgery or radiation, systemic therapies go throughout the body to attack all cancer cells, even microscopic tumors and clusters of cancer cells, which are too small to detect on scans. 

Leading expertise
Our specialists trained at leading institutions across the country. They bring their extensive knowledge and skills of treating each case.

Experts close to home
We make it as easy as possible to access the care you need. With locations across the state, you are likely to find a provider near where you live and work.

Latest treatment options
Our providers always have a finger-on-the-pulse on the latest research studies and national guidelines. We also offer treatments through clinical trials.  

Care tailored to you
We are equal partners in your care and provide you with all the information you need to make the best decision for you.  

Expert Bladder Cancer Care, Close to Home

A bladder’s main function is to store urine. It has a muscular wall that allows it to get smaller or larger as urine is stored or emptied. The wall of the bladder is lined with a specialized layer of cells called the urothelium, which extends throughout the urinary tract, from the kidneys to the ureters, bladder, and urethra. Cancer arising from urothelial cells is called urothelial cancer, and because most urothelial cancers start in the bladder, the terms “bladder cancer” and “urothelial cancer” are sometimes used interchangeably. However, many urothelial cancers actually arise in the kidneys, ureters, and urethra. While urothelial cancer makes up the vast majority of all bladder cancers, rare variant cancers are also possible, including squamous cell carcinoma, adenocarcinoma, and small cell carcinoma.  

In Texas, an estimated 5,160 Texans are expected to be diagnosed with bladder cancer in 2025. That is why Texas Oncology and Texas Urology Specialists are here to provide expert care, support, and the latest treatment options no matter where you are.

Bladder Cancer Screening and Diagnosis

While there is no validated screening test for people at average risk for bladder cancer, there are tests available to diagnose bladder cancer. Bladder cancer is typically diagnosed through cystoscopy and a combination of blood and urine tests. Roughly 70% to 80% of newly diagnosed bladder cancer patients have early-stage bladder cancer, which is cancer that has not yet invaded the muscle layer of the bladder. It is often termed “non-muscle-invasive bladder cancer (NMIBC).” NMIBC is highly curable with prompt urologic intervention. Bladder cancer that has invaded the muscle-layer of the bladder — called “muscle-invasive bladder cancer (MIBC)” — is far more aggressive and poses a significant threat to life but is still highly treatable. Any patient with muscle-invasive bladder cancer should seek immediate consultation with a medical oncologist experienced in the treatment of bladder cancer. At Texas Oncology, our specialists are trained to diagnose and treat cancers of the bladder and bring years of experience to each case.  

Tests to screen and diagnose bladder cancer

Urinalysis

A urinalysis examines the components of urine and may detect the presence of blood, which can be visible under a microscope or using a special test strip.  

Urine cytology

A lab test where urine is inspected under a microscope for abnormal cells.  

Cystoscopy

Performed by a urologist, this procedure involves a tiny tube with a camera being inserted into the bladder through the urethra to look for tumors.  

Biopsy

If tumors are found using cystoscopy, a urologist will generally recommend a special biopsy called “transurethral resection of the bladder tumor (TURBT) — a specialized surgical procedure to accurately stage and simultaneously treat bladder cancer. The tissue sample is reviewed under a microscope to determine how deeply into the bladder lining the cancer has invaded and differentiate between NMIBC and MIBC.  

Stages of bladder cancer

Stage 0

Early stage of bladder cancer where the cancer is growing in the inner lining of the bladder only. At this stage, connective tissue and muscle of the bladder wall have not been affected. This stage is classified as non-invasive bladder cancer (NMIBC).

Stage I

Patients with stage I bladder cancer have cancer that invades beneath the surface of the bladder into connective tissue, but does not invade the muscle of the bladder and has not spread to lymph nodes. This stage is also classified as NMIBC.

Stage II

Patients at this stage have cancer that invades through connective tissues into the muscle wall, but has not spread outside the bladder or to local lymph nodes. This stage is classified as muscle-invasive bladder cancer (MIBC).

Stage III

Stage III is when cancer invades through connective tissue, muscle, and immediate tissue outside the bladder and/or the prostate gland in males or the uterus and/or vagina in females. At this stage, cancer has not yet spread to lymph nodes or distant sites. Similar to stage II, stage III is also classified as MIBC or “node-positive” bladder cancer.

Stage IV

At this stage, the cancer has passed through the bladder wall and invaded the pelvic and/or abdominal wall as well as spread to the lymph nodes and/or distant sites. Stage IV constitutes “advanced” or “metastatic” disease.

Treating Bladder Cancer

Our bladder cancer specialists leverage the latest treatment advancements, lead ground-breaking clinical trials to optimize outcomes for each patient, and develop the next generation of bladder cancer therapies. They will work with you to discuss your diagnosis, explore treatment options, and help you plan while keeping your priorities and preferences top of mind.  

Bladder cancer treatment depends on the stage of the cancer, as well as the patient’s overall health. Common treatments can include a combination of surgery, immunotherapy, targeted therapy, chemotherapy, and/or radiation.  

Transurethral resection (TUR)

A transurethral resection is a specialized surgical procedure in which a urologist inserts a thin instrument through the urethra and into the bladder in order to remove visible tumors, allowing accurate diagnosis, staging, and initial treatment.  

Radical cystectomy

This highly complex procedure refers to the complete surgical removal of the bladder and the surrounding organs. For women, this may involve removing the uterus, ovaries, fallopian tubes, part of the vagina, and the urethra. For men, the prostate, seminal vesicles, and possibly, the urethra, are often removed. Once the bladder is removed, the urologist usually creates a permanent opening in the abdominal wall through which the urine is diverted into an ostomy bag, a pouch that collects waste from the body.  

Partial cystectomy

In contrast to radical cystectomy, which involves the removal of the entire bladder, a partial cystectomy involves the surgical removal of part of the bladder affected by cancer. Since patients have residual bladder function after a partial cystectomy, they do not require an ostomy and may be able to urinate normally.  

Creation of alternative bladders or neobladders

In select radical cystectomy patients, a highly-skilled urologist may create a substitute bladder, called a neobladder. Constructing a neobladder involves using a part of the intestine to form a new bladder, then connecting one end of the neobladder to the ureters.  
 

Your Bladder Cancer Team

Our doctors work together to deliver comprehensive multidisciplinary bladder cancer care. Your team will vary on your specific needs, but your team may include: 

Medical Oncologists specialize in using systemic therapies like immunotherapy, targeted therapy, and chemotherapy. In contrast to local therapies such as surgery or radiation, systemic therapies go throughout the body to attack all cancer cells, even microscopic tumors and clusters of cancer cells, which are too small to detect on scans. 

Leading expertise
Our specialists trained at leading institutions across the country. They bring their extensive knowledge and skills of treating each case.

Experts close to home
We make it as easy as possible to access the care you need. With locations across the state, you are likely to find a provider near where you live and work.

Latest treatment options
Our providers always have a finger-on-the-pulse on the latest research studies and national guidelines. We also offer treatments through clinical trials.  

Care tailored to you
We are equal partners in your care and provide you with all the information you need to make the best decision for you.