Bladder cancer starts in the tissues of the bladder. It can cause urinary and other symptoms such as back pain and fatigue. Treatment can depend on your cancer stage and type.

Bladder cancer occurs when abnormal bladder cells begin to divide and grow out of control. They may form a tumor and, with time, spread to surrounding muscles and organs.

While other types of cancer may spread to the bladder, cancer is named for the location where it starts.

In the United States, doctors diagnose approximately 60,000 males and 18,000 females per year with the disease. Worldwide, it is the 7th most common type of cancer.

Keep reading to learn the symptoms, risk factors, treatment options, and survival rates for bladder cancer.

Bladder cancer can cause symptoms that vary from person to person. These may include:

Bladder cancer may also cause symptoms that affect other parts of the body, particularly if the cancer has spread beyond the bladder. These can include:

Cancer occurs when cell mutations cause abnormal cells to grow and multiply quickly and uncontrollably. They then spread to other tissues.

While certain factors can increase your risk for the kind of DNA damage that causes these mutations, mutations may also occur at random. People can develop bladder cancer without having known risk factors, while others who have multiple bladder cancer risk factors may not develop bladder cancer at all.

Some factors may increase your risk of developing bladder cancer. These can include:

  • smoking cigarettes
  • exposure to cancer-causing chemicals (carcinogens), such as petroleum, rubber, metals, paint products, dyes, or diesel fumes
  • a family history of bladder cancer
  • having certain genetic changes
  • having schistosomiasis, a bladder infection caused by a specific parasite
  • drinking water contaminated with arsenic or chlorine
  • certain herbal medicines and supplements
  • previous treatment with the chemotherapy drugs cyclophosphamide (Cytoxan) or ifosfamide (Ifex)
  • prior radiation therapy to treat cancer in the pelvic area
  • chronic bladder infections or long-term use of urinary catheters
  • not drinking enough fluids
  • having a bladder defect

People who smoke cigarettes may be at least three times more likely to develop bladder cancer than people who do not smoke.

Bladder cancer also tends to occur more often in certain groups of people. You may have a higher risk of developing it if you are:

  • assigned male at birth
  • age 55 or older
  • white

Doctors refer to the types of bladder cancer based on which cells become abnormal. These can include:

Transitional cell carcinoma

Transitional cell carcinoma or urothelial carcinoma is the most common type of bladder cancer. It begins in the transitional cells in the inner layer of the bladder. Transitional cells are cells that change shape without becoming damaged when the tissue is stretched.

Squamous cell carcinoma

Squamous cell carcinoma begins when thin, flat squamous cells form in the bladder after long-term infection or irritation in the bladder.


Adenocarcinoma begins when glandular cells form in the bladder after long-term bladder irritation and inflammation. Glandular cells make up the mucus-secreting glands in the body.

Small cell carcinoma

Small cell carcinoma begins in the neuroendocrine cells. These cells release hormones into the bloodstream following signals from your nervous system.

If you have symptoms or lab results, such as urinalysis results, that suggest bladder cancer, a doctor will typically take your medical history and conduct a physical examination. This may involve feeling in your vagina or rectum for lumps. They may also order tests to diagnose bladder cancer. Tests can include:

A doctor may diagnose bladder cancer using one or more of the following methods:

  • a cystoscopy, which involves inserting a narrow tube that has a small camera on it through your urethra to see inside your bladder
  • a biopsy, which involves taking a small sample of tissue from your bladder to test for cancer
  • a computed tomography (CT) scan or an intravenous pyelogram (IVP) to view the bladder
  • a urine tumor marker test, which can detect some types of bladder cancer

The doctor typically orders additional tests to stage bladder cancer. These tests look for signs of cancer in other areas of the body. These tests may include:

Doctors use a staging system to communicate how far the cancer has spread within your bladder, lymph nodes, and other organs. There are multiple staging systems for bladder cancer. Stages can include:

  • Stage 0: The cancer hasn’t spread past the lining of the bladder
  • Stage 1: The cancer has spread past the lining of the bladder, but it hasn’t reached the layer of muscle in the bladder
  • Stage 2: The cancer has spread to the layer of muscle in the bladder
  • Stage 3: The cancer has spread into the tissues that surround the bladder
  • Stage 4: The cancer has spread past the bladder to the neighboring areas of the body

The stage may also be subdivided to more specifically describe the cancer’s spread.

A doctor will work with you to determine the best treatment based on the type and stage of your cancer, your symptoms, and your overall health.

Treatment for stage 0 and stage 1

Treatment for stage 0 and stage 1 bladder cancer may include:

  • surgery to remove the tumor
  • chemotherapy
  • immunotherapy, which involves taking a medication that causes your immune system to attack the cancer cells

Treatment for stage 2 and stage 3

Treatment for stage 2 and stage 3 bladder cancer may include:

  • removal of part of the bladder
  • removal of the whole bladder (radical cystectomy) followed by surgery to create a new way for urine to exit the body
  • chemotherapy
  • radiation therapy
  • immunotherapy

A doctor may recommend chemotherapy, radiation therapy, and immunotherapy for multiple purposes, including to:

  • shrink the tumor before surgery
  • treat cancer when surgery isn’t an option
  • treat remaining cancer cells after surgery
  • prevent cancer from recurring

Treatment for stage 4 bladder cancer

Treatment for stage 4 bladder cancer may include:

  • radical cystectomy and removal of the surrounding lymph nodes, followed by surgery to create a new way for urine to exit the body
  • chemotherapy
  • radiation therapy
  • immunotherapy
  • clinical trial drugs

Depending on your overall health, treatment may focus on removing cancer cells or relieving your symptoms and extending your life.

You may also choose to participate in a clinical trial to test new treatments and new combinations of existing treatments.

Your outlook depends on a lot of variables, including:

  • cancer type and stage
  • your age
  • your overall health, including any other health conditions you have
  • how your cancer responds to treatment

According to the National Cancer Institute (NCI), the five-year survival rates for bladder cancer are:

  • 97% for carcinoma in situ that hasn’t spread past the lining of the bladder
  • 71% for cancer that hasn’t spread past the bladder
  • 39% for cancer that has spread to nearby lymph nodes or organs
  • 8% for metastatic bladder cancer that has spread to a distant part of the body

What is a 5-year survival rate?

Health professionals often use 5-year survival rate as a measure of a disease’s outlook. It refers to the percentage of people with the disease who are still alive at least 5 years after their diagnosis.

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Survival ratings are based on averages and may not reflect an individual’s life expectancy. In addition, as treatments improve, the outlook for people with bladder cancer may improve. The numbers in a 5-year survival rate are based on people who were diagnosed and treated at least 5 years before.

Because doctors don’t yet know what causes bladder cancer, it may not be preventable in all cases. The following factors and behaviors may help reduce your risk of getting bladder cancer:

  • not smoking, or quitting smoking if you smoke
  • avoiding secondhand cigarette smoke
  • avoiding exposure to carcinogenic chemicals and wearing appropriate safety equipment when working with carcinogenic chemicals
  • drinking plenty of water

How long can you have bladder cancer and not know?

Blood in your urine is usually the first sign of bladder cancer. That said, this can also have other causes and can often be misdiagnosed until there are other symptoms more clearly pointing to cancer. In addition, blood in the urine can come and go, which can make the cause hard to pinpoint initially. These factors can often delay diagnosis by a year or longer.

How quickly does bladder cancer progress?

How fast bladder cancer spreads depends on the type of cancer. The types that spread the fastest are small cell carcinoma, adenocarcinoma, and squamous cell carcinoma.

Learn more: Does bladder cancer spread quickly?

Is bladder cancer curable?

In the very early stages, bladder cancer is very treatable and may even be curable. However, this does depend on the type of cancer. Different bladder cancers also have different likelihoods of recurrence.

What are the symptoms of bladder cancer in females vs males?

The symptoms of bladder cancer are the same regardless of biological sex. They include blood in your urine, frequent urination, and pain during urination. That said, bladder cancer is nearly three times more common in males assigned at birth (MAAB) than in females assigned at birth (FAAB).

What happens in the final stages of bladder cancer?

In addition to the typical symptoms of bladder cancer, in the advanced stages, you can also experience weight loss, bone pain, foot swelling, lower back pain on one side, loss of appetite, and more.

Bladder cancer begins in the tissue of the bladder. It can cause urinary symptoms, such as urgency and frequency, and systemic symptoms, such as fatigue.

Treatment and outlook can depend on the stage of your bladder cancer and other factors, including your age and overall health.