Bladder cancer is the tenth leading cause of cancer-related deaths in the United States, with approximately 85,000 new cases diagnosed each year. While several factors contribute to the development of bladder cancer, smoking is a major risk factor. Fortunately, both the incidence and mortality rates of bladder cancer have been steadily improving. This positive trend is partly due to a decrease in smoking, greater public awareness, and advancements in treatment. Early detection continues to play a vital role in improving survival outcomes and is believed to be a key factor in these encouraging developments1. This article will examine the symptoms, progression, diagnosis, stages, and types of bladder cancer while exploring the critical role of early detection.
Early Symptoms of Bladder Cancer
Common Signs to Watch For
There are many common signs of bladder cancer, though it’s important to understand that many of these symptoms can be caused by other issues. Common signs to watch out for include2:
- Blood in urine - This symptom, known as hematuria, is a primary indicator of bladder cancer and may cause the urine to appear discolored rather than bright red.
- Frequent urination - This can involve feeling the urge to urinate frequently, even when little or no urine is passed.
- Painful urination - This can also appear later on when bladder cancer is more advanced.
- Urgency to urinate or a weak stream
Early-stage symptoms are often mistaken for minor problems, but it's important to talk to your healthcare provider if they appear.
When Symptoms Become Serious
As bladder cancer advances, symptoms can become more severe. Advanced symptoms include2:
- Fatigue
- Pelvic pain3
- Back pain
- Weight loss
- Loss of appetite
Why Early Recognition Matters
Bladder cancer survival rates have gradually improved over recent years. While there are many contributing factors to this, improvements in education and early detection are thought to play a significant role1. Early detection leads to better outcomes partly because it provides healthcare providers with more treatment options and identifies cancer before it spreads to other parts of the body, where it becomes more challenging to treat. For instance, localized bladder cancer that has not spread has a 5-year survival rate of 72 percent, while the rate for distant (metastasized) bladder cancer is 7 percent4.
Understanding the Types and Stages of Bladder Cancer
Types of Bladder Cancer
There are several different types of bladder cancer, and each has unique characteristics, risk factors, and treatment approaches5.
- Urothelial carcinoma - This is by far the most common type of bladder cancer and is also known as transitional cell carcinoma.
- Squamous cell carcinoma - These cancers develop from squamous cells, a type of cell that lines many surfaces in the body, and account for up to 5 percent of bladder cancer cases.
- Adenocarcinoma - These cancers emerge from cells that secrete mucus in the bladder and occur in about 1 percent of cases.
Stages of Bladder Cancer
Clinicians use bladder cancer staging to determine how far the cancer has spread and to guide treatment planning. There are five main stages of bladder cancer6.
- Stage 0 - Non-invasive cancer confined to the inner bladder lining. It hasn't invaded deeper tissues or spread elsewhere.
- Stage I - Cancer has invaded the connective tissue beneath the bladder lining but not the muscle layer. No lymph node or distant spread.
- Stage II - Cancer has spread into the muscle layer of the bladder wall. It hasn’t reached surrounding fat or distant sites.
- Stage III - Cancer has grown into surrounding fatty tissue or nearby organs and/or spread to nearby lymph nodes. It hasn’t reached distant organs.
- Stage IV - Cancer has invaded the pelvic/abdominal wall and/or spread to distant lymph nodes or organs such as the bones, lungs, or liver.
How Fast Does Bladder Cancer Progress?
How fast bladder cancers progress depends on many factors, including the type of cancer, the stage, and patient health7.
Different types of bladder cancer usually grow at different rates. For example, small cell carcinoma, an even rarer type than those previously mentioned, is known to grow quickly and often requires more aggressive treatment5.
Diagnosing Bladder Cancer
How Is Bladder Cancer Diagnosed?
Diagnosing bladder cancer typically involves removing part or all of a suspected tumor and analyzing it in a laboratory to determine if cancer is present. When a patient shows symptoms, healthcare providers often order additional tests to closely examine bladder health. These tests assist in both diagnosing bladder cancer and determining its stage. Common diagnostic methods include:
- Cystoscopy - This is a procedure where a thin tube with a camera is inserted through the urethra to examine the inside of the bladder8.
- Urine cytology - This lab test looks for abnormal or cancerous cells in a urine sample9.
- Biopsy - This involves taking a small sample of tissue from the body to examine it under a microscope for signs of disease, such as cancer. Abnormal growths in the bladder are often removed using a method called transurethral resection of bladder tumor (TURBT)10.
- Imaging tests: Computed tomography (CT) and magnetic resonance imaging (MRI) scans are imaging tests that create detailed pictures of the inside of the body and help to detect tumors and other abnormalities in the bladder11,12.
The Role of Imaging in Early Detection
While imaging tests alone cannot diagnose bladder cancer, they are useful for detecting tumors early, which can guide the decision to perform a biopsy or TURBT. They also play a key role in cancer staging by helping visualize whether the cancer has spread locally or to distant sites.
Ezra full body MRI scans can play an important role in assessing bladder cancer. This can include:
- Identifying tumors and other abnormalities in the bladder
- Assessing the spread of tumors to different organs
- Monitoring disease progression
- Monitoring treatment efficacy
- Follow-up screening to test for recurrence
How Fast Does Bladder Cancer Spread Without Treatment?
Bladder cancers can spread at different rates depending on factors such as the cancer's stage, type, and the patient’s overall health. Early detection and timely treatment are crucial for preventing cancer from spreading to areas like the lymph nodes, bones, and liver.
Prognosis, Survival Rates, and Treatment Outlook
Bladder Cancer Prognosis Factors
Bladder cancer prognosis depends on many factors:
- Age - Older bladder cancer patients generally have a poorer prognosis13.
- Stage - Early-stage cancers have a better outlook than advanced-stage cancers that have spread4.
- Type - Urothelial carcinomas generally come with a better prognosis than other types14.
- Response to treatment - Tumors that respond well to treatment typically have better outcomes.
- Genetics - Genetic mutations can influence cancer behavior and treatment effectiveness15.
- Lifestyle factors - Smoking, diet, and overall health can impact both progression and recovery and may also be linked to bladder cancer recurrence16,17.
Bladder Cancer Survival Rates
The 5-year survival rate for bladder cancer differs greatly depending on whether the cancer is caught early or late. As we have discussed above, early-stage bladder cancer has a 5-year survival rate of 72 percent, while the survival rate for late-stage bladder cancer is 7 percent. These statistics highlight the sharp decline in survival rates for late-stage bladder cancer and emphasize the critical importance of early detection4.
What to Expect from Treatment
There are several treatment options for bladder cancer, and the choice of treatment depends on various factors, including the cancer’s stage and type, as well as the patient’s age and medical history.
- Surgery - This can include TURBT or cystectomy, which is the removal of part or all of the bladder. These approaches are most effective when the cancer is still localized to the bladder18.
- Chemotherapy - This type of therapy can be administered systemically or directly to the bladder (intravesical therapy). Chemotherapy is used before and after surgery and also to manage more advanced bladder cancers19.
- Immunotherapy - Clinicians use these therapies primarily to treat earlier stages of bladder cancer20.
Even after successful treatment, bladder cancer can return. That’s why regular follow-up checks are essential to monitor for any signs of recurrence in the bladder or other parts of the body21.
Summary: Bladder Cancer Symptoms and Early Detection
Bladder cancer often begins with symptoms that may appear minor, like blood in the urine or frequent urination. However, recognizing these signs and seeking medical attention can significantly improve the chances of early detection. Since survival rates drop significantly once cancer spreads, catching it early can dramatically improve outcomes. Proactive health screening, particularly for high-risk individuals like smokers and adults over 50, is essential. Timely action can save lives and lead to better treatment success.
If you want to be proactive about your health, why not book an Ezra full body MRI? Our annual scan catches potential cancer earlier, leveraging AI through the screening process to make it more efficient, affordable and faster.
