What is Bladder Cancer?
Bladder cancer begins when cells in the bladder lining start to grow out of control and form a tumor. Most bladder cancers start in the urothelial cells that line the inside of the bladder, which is why it is often called urothelial carcinoma. It is one of the most common cancers in the United States, with an estimated 84,530 new cases expected in 2026, and it affects men about three times as often as women.¹
The good news: when bladder cancer is found early, it is highly treatable. Most cases are diagnosed while the cancer is still confined to the inner lining of the bladder. So, what causes bladder cancer? What are the warning signs? And what can you do?
What Causes Bladder Cancer?
There is no single cause, but certain factors raise your risk. Smoking is the biggest one.¹ Harmful chemicals from tobacco are filtered by the kidneys, collect in the urine and sit in contact with the bladder lining for hours at a time. Other risk factors include:
- Smoking or other tobacco use, now or in the past
- Workplace exposure to certain chemicals, such as those used by painters, metal and leather workers, miners, plastics manufacturers and firefighters
- Older age (most people diagnosed are over 55)
- Being male
- Chronic bladder irritation, including long-term catheter use or repeated bladder infections
- Past treatment with certain chemotherapy drugs or pelvic radiation
- A personal or family history of bladder cancer
- Arsenic in drinking water
Having a risk factor does not mean you will get bladder cancer, and some people with no known risk factors still develop it. Quitting smoking at any age lowers your risk.
What are the Symptoms?
The most common early sign is blood in the urine (hematuria). It is often painless and may come and go, so it is easy to ignore. Any blood in the urine, even once, should be checked by a urologist. Watch for:
- Blood in the urine, making it look pink, red, orange or cola-colored
- Blood found on a routine urine test, even if you can’t see it
- Needing to urinate more often than usual
- Pain or burning during urination
- Feeling an urgent need to go, even when your bladder isn’t full
- Trouble urinating or a weak urine stream
- Lower back pain on one side, pelvic pain or bone pain (in more advanced cases)
- Unexplained weight loss, fatigue or loss of appetite (in more advanced cases)
These symptoms are more often caused by conditions such as a urinary tract infection, kidney stones or an enlarged prostate. Only a medical evaluation can tell the difference. Learn more about hematuria.
How is Bladder Cancer Diagnosed?
Your urologist will start with your health history and a physical exam, then recommend one or more tests:
- Urine tests: a urinalysis, urine cytology to look for cancer cells, and in some cases urine tumor marker tests
- Cystoscopy: a thin, lighted scope is passed through the urethra so your urologist can see inside the bladder; this is usually done in the office with local numbing gel
- Imaging: a CT urogram, MRI or ultrasound to look at the bladder, kidneys and ureters
- Biopsy (TURBT): if an abnormal area is found, it is removed or sampled through the scope so a pathologist can confirm the diagnosis and see how deeply the tumor has grown
The results tell your care team the cancer’s stage (how far it has grown) and grade (how aggressive the cells look). Both guide your treatment plan.
Treatments Available at Unio Specialty Care
Treatment options range from minimally invasive procedures to medications placed directly in the bladder, surgery, radiation and systemic therapies. Which is best for you? It depends on the stage and grade of the cancer, your overall health, your age and your personal goals for treatment and quality of life.
Early-stage (non-muscle-invasive) bladder cancer is often treated with transurethral resection of bladder tumor (TURBT), which removes the tumor through a scope with no incisions. This is frequently followed by intravesical therapy, in which BCG immunotherapy or chemotherapy is placed directly into the bladder to lower the chance of the cancer returning. Cancer that has grown into the bladder muscle may be treated with radical cystectomy (removal of the bladder) with urinary diversion, bladder-sparing trimodality therapy that combines TURBT, chemotherapy and radiation, or chemotherapy, immunotherapy or targeted therapy.
- Transurethral Resection of Bladder Tumor (TURBT)
- Intravesical BCG Immunotherapy and Chemotherapy
- Radical Cystectomy and Urinary Diversion
- Bladder-Sparing Therapy with Radiation Oncology
- Systemic Chemotherapy, Immunotherapy and Targeted Therapy
Our urologic oncology team works alongside radiation oncologists and medical oncologists to build a coordinated plan for each patient. Because bladder cancer can come back, regular follow-up cystoscopy is an important part of care after treatment.
How Does Bladder Cancer Affect Your Life?
A bladder cancer diagnosis can feel overwhelming. Beyond the physical effects, many patients worry about frequent follow-up visits, changes to urinary or sexual function after treatment, and the chance that the cancer could return. It all adds up.
You don’t have to navigate it alone. Death rates from bladder cancer have been falling in recent years, a trend linked to earlier detection and better treatments.¹ With early diagnosis, a clear follow-up plan and a care team that supports you through every step, many people with bladder cancer go on to live full, active lives. If you have blood in your urine or other symptoms, schedule an appointment with a Unio Specialty Care urologist.
- American Cancer Society. Key Statistics for Bladder Cancer. Last revised January 13, 2026. cancer.org