The bladder is a hollow organ in the pelvis with flexible, muscular walls. Its main function is to store urine before it leaves the body. Urine is made by the kidneys and is then carried to the bladder through tubes called ureters. When you urinate, the muscles in the bladder contract, and urine is forced out of the bladder through a tube called the urethra. Bladder cancer begins when cells in the urinary bladder start to grow uncontrollably. As more cancer cells develop, they can form a tumor and spread to other areas of the body.
The wall of the bladder has several layers, which are made up of different types of cells. Most bladder cancers start in the innermost lining of the bladder, which is called the urothelium or transitional epithelium. As the cancer grows into or through the other layers in the bladder wall, it becomes more advanced and can be harder to treat. Over time, the cancer might grow outside the bladder and into nearby structures. It might spread to nearby lymph nodes, or to other parts of the body. If bladder cancer spreads, it often goes first to distant lymph nodes, the bones, the lungs, or the liver.
Most common type of cancer that start in the bladder is Urothelial carcinoma, also known as transitional cell carcinoma (TCC). These cancers start in the urothelial cells that line the inside of the bladder. There are other type of bladder cancers.
Bladder cancers are often described based on how far they have invaded into the wall of the bladder:
- Non-invasive cancers are still in the inner layer of cells and have not grown into the deeper layers.
- Invasive cancers have grown into deeper layers of the bladder wall. These cancers are more likely to spread and are harder to treat.
The stage of a bladder cancer describes how far it has spread. Itís one of the most important factors in choosing treatment options and predicting a personís prognosis (outlook). If you have bladder cancer, ask your cancer care team to explain its stage. This can help you make informed choices about your treatment.
There are actually 2 types of stages for bladder cancer.
- The clinical stage is the doctorís best estimate of the extent of the cancer, based on the results of physical exams, cystoscopy, biopsies, and any imaging tests that are done (such as CT scans).
- If surgery is done to treat the cancer, the pathologic stage can be determined using the same factors as the clinical stage, plus what is found during surgery.
The clinical stage is used to help plan treatment. Sometimes, though, the cancer has spread farther than the clinical stage estimates. Pathologic staging is likely to be more accurate, because it gives your doctor a firsthand impression of the extent of your cancer.
Depending on the stage of the cancer and other factors, treatment options for people with bladder cancer can include Surgery, Intravesical Therapy, Chemotherapy and Radiation Therapy. Doctor will start treating after due discussion with the patient and the need.