Bladder cancer is a tumour that affects both men and women. In Canada, it is the 5th most common cancer. It ranks 10th for women and 4th for men. This disease generally develops in the cells that form the inner lining of the bladder. Several risk factors have been identified for the disease, which has a significant mortality rate in Canada. The Marois clinics present the essentials to know about bladder cancer.

What is bladder cancer?

The bladder is part of the urinary system. It is a hollow organ in the pelvis. It is used to store urine before it is released into the body. Sometimes the cells of the bladder undergo changes that make them behave or grow abnormally. These changes can lead to the development of benign, non-cancerous tumors such as papillomas.

However, in the most severe cases, changes in the bladder can also lead to bladder cancer. Bladder cancer is a disease that occurs primarily in the cells of the bladder. It affects both men and women. The malignant cancerous tumor can then invade and even destroy nearby tissue. If not treated in time, bladder cancer can gradually spread to other parts of the body. This malignant tumor usually develops in the transitional epithelium (the cells of the urothelium). The urothelium is found inside the bladder and in the urethra.

Bladder cancer that occurs in urothelial cells is called transitional or urothelial carcinoma. 90% of bladder cancers are urothelial carcinomas. Superficial bladder cancer is defined as cancer of the urothelium only. At this level, a transurethral resection is applied to treat the tumor. On the other hand, it becomes invasive bladder cancer if the malignant tumor spreads to the muscles of the bladder wall or connective tissue. There are also rare types of bladder cancer (adenocarcinoma or squamous cell carcinoma) that can occur.

The main risk factors for bladder cancer

Each year in Canada, approximately 12,000 Canadians are diagnosed with bladder cancer. Several risk factors have been identified for this disease.

  • Smoking

    It is one of the main risk factors for bladder cancer. According to several studies, the risk of bladder cancer increases with the amount of cigarettes smoked per day and with the number of years of smoking. In 2007, there were 1,798 bladder cancer deaths in Canada. Research has shown that in almost 60% of bladder cancer deaths, smoking was the primary cause.

    Several studies have also shown that some of the chemicals in tobacco smoke may promote the development of cancer. Tobacco contains more than 4000 different chemicals. The substances cause a genetic change in the bladder cells, which can lead to a tumor in the bladder.

    The causal relationship between bladder cancer and tobacco use was recognized in 1985. A U.S. smoking survey conducted in 2002-2004 showed that smokers have 5.5 times the risk of bladder cancer compared to non-smokers.

  • The age

    Age is also a proven risk factor for bladder cancer. There is a clear increase in the number of bladder tumours with age. 43% of men with bladder tumours are over 75 years old and 85% are over 60 years old. For women, the figures are 61% and 89% respectively.

  • Family history and genetic factors

    Inherited genetic mutations are not always a primary cause of bladder tumors. Bladder cancer does not run in families. However, in some cases, when a person comes from a family where several members have had bladder cancer, it is very likely that the person will eventually develop tumors in his or her bladder. This is because most people from the same family are exposed to the same carcinogens, such as tobacco.

    There may also be genetic mutations such as the NAT (N-acetyltransferase) gene or the GST (Gluthatione-N-transferase) gene that make the body more vulnerable to certain toxic elements. Acquired variations in certain genes, such as the RB1 tumor suppressor gene or the TP53 gene, seem to have an important responsibility in the development of bladder tumors in some people. In addition, men are more often affected than women and bladder cancer is more common in Caucasian populations.

  • Certain chemical substances

    Pelvic radiotherapy and drugs containing chlornaphazine, cyclophosphamide, phenacetin (painkillers), are also associated with bladder cancer. This is the reason why the marketing of chlornaphazine has been stopped. The IARC (International Agency for Research on Cancer) has classified some of these substances as bladder carcinogens. Chronic bladder irritation, exposure to cyclophosphamide and arsenic are also risk factors for bladder tumors.

What are the stages of bladder cancer?

There are 6 stages of bladder cancer.

  • Stage 0 or Tis: this is called carcinoma in situ. It is a flat tumor.
  • Stage I or Ta: At this stage, the fungus-like tumor is found in the inner lining of the bladder. It is called non-invasive papillary carcinoma.
  • Stage T1: The connective tissue layer of the bladder wall is invaded by the tumor. However, the muscles surrounding the bladder are not affected.
  • Stage T2: Here, the muscle layer of the bladder is invaded by the tumor. From stage T2a, the tumor spreads to the inner half of the muscle layer. It reaches the outer half in stage T2b.
  • Stage T3: The cancer progresses to stage T3 when the tumor has spread to the fatty tissue around the bladder muscle. At T3a, the tumor is microscopic and invisible. At T3b the tumor grows in size. It is visible and can be palpated.
  • Stage T4: This is the most worrisome stage of bladder cancer. At this level, the tumor has invaded the abdominal or pelvic wall and has spread to organs other than the bladder. It should be noted, however, that it can sometimes be difficult for oncologists to know the precise extent of the disease without having performed surgery.

Stades d'évolution du cancer de la vessie


How is bladder cancer diagnosed in men and women?

Several methods are used to diagnose bladder cancer in both men and women. There are also a number of symptoms that can identify the disease in a patient.

  • Symptoms of bladder cancer

    It is not possible to detect the signs or symptoms of bladder cancer at an early stage of the disease. Symptoms usually appear when the tumor has already grown and is sufficiently advanced in the bladder wall. However, there are some symptoms that can give you a warning that bladder cancer is present in your body. One of the most common is hematuria, or the presence of blood in the urine.

    The color of the urine of a person with bladder cancer may range from a pale yellow-red to a rusty red or bright red. Blood may be found in the urine intermittently or continuously. Blood can sometimes be detected in urine tests under a microscope. Apart from the presence of blood in the urine, you should also look out for symptoms such as

    • a high urinary frequency,
    • urinary urgency,
    • difficulty in urinating,
    • a sensation of pain or burning during urination,
    • pelvic pain.

    Sometimes metastatic bladder cancer can cause symptoms such as:

    • loss of appetite or weight loss,
    • general weakness or fatigue,
    • bone pain,
    • swelling of the feet,
    • coughing or shortness of breath,
    • enlarged lymph nodes.

    It should be noted that a person with bladder cancer may not have all of these symptoms. In addition, the signs listed may indicate the presence of other conditions in the body. Symptoms vary depending on the part of the body affected by the spread of the disease. It is best to consult a professional for a proper diagnosis.

  • Diagnostic methods

    Cancer that is detected early is easier to treat. Generally, people are diagnosed after the onset of symptoms since there is no real screening test for cancer. Several diagnostic methods can be used to detect bladder cancer in a man or woman.

  • Cystoscopy

    It is one of the main methods of diagnosing bladder cancer. To perform a cystoscopy, a hollow tube with a lens is inserted through the urethra. The tube is slowly inserted so that the doctors can examine the bladder wall for tumors. Usually a local anesthetic is given before a cystoscopy is performed. However, sometimes the procedure is performed on a sleeping patient in outpatient departments.

  • Medical imaging

    This helps the doctor know if the cancer has spread to other parts of the body. Medical imaging is used to do staging. Doctors usually use a medical imaging machine to perform the procedure. Depending on the course of the disease and the capabilities of the medical facility, a "magnetic resonance imaging" (MRI) or "computerized tomography" may be used.

  • Ultrasound

    It is also an effective method for detecting tumors in the bladder. The doctor uses sound waves to get an image of the internal organs. The diagnosis of cancer made through this method allows the doctor to have a better description of the cancer. He can then easily perform a classification and staging.

What are the treatments for bladder cancer?

The treatment for bladder cancer depends on the stage of the disease. If the cancer is non-muscle-invasive, the recommended treatment is transurethral resection of the bladder. This is a one-day surgery, performed under general or spinal anesthesia.

This is the only recommended treatment when the tumor is limited to the superficial layer of the bladder. To get rid of the tumor, the doctor will insert a thin, rigid tube with a light source (cystoscope) into the urethra. With the optics connected to the cystoscope camera, the surgeon can see the bladder wall directly. A metal loop at the end of the instrument cuts the tumor away from the rest of the bladder. In the case of muscle-invasive cancer, a more radical solution (cystectomy) is chosen. This is a surgical procedure that removes the entire bladder in cases of major dysfunction such as cancer.

Ways to prevent bladder cancer

There are several actions that can be taken to prevent bladder cancer in the body. The main thing to do is to have a healthy lifestyle. It is also important to stop or refrain from smoking since tobacco is a major risk factor for the disease. It is also recommended to limit exposure to radiation and chemicals (solvents).




Here are the most common questions about bladder cancer.

  • Is bladder cancer serious?

    Bladder cancer is a serious disease with a very high mortality rate. According to statistics, 77% of people diagnosed with bladder cancer do not live beyond 5 years.

  • What is the right age for bladder cancer?

    Whether male or female, bladder cancer usually affects people between the ages of 5 and 70.

  • Is bladder cancer treatable?

    When the cancer has been diagnosed at the non-invasive stage, 80-90% of patients can survive another 5 years with appropriate treatment such as transurethral resection of the bladder. The survival rate drops to 50% if the tumor is muscle-invasive.

  • How to remove a tumor in the bladder?

    Transurethral resection and cystectomy are ways to remove a tumor in the bladder.

  • Are bladder polyps always cancerous?

    Polyps or tumors of the bladder can be benign, malignant or intermediate.