Types of Bladder Cancer

Approximately 80,000 people in the United States are diagnosed with bladder cancer every year, according to the American Cancer Society, making bladder cancer the fourth most common type of cancer in men and the ninth in women.

There are multiple kinds of bladder cancer, each with different risk factors and outlooks. A patient's specific type of cancer is determined by the type of cell from which the cancer originated, as well as how the tumor cells look under a microscope.

There are four main types of bladder cancer:

  • Urothelial or transitional cell carcinoma
  • Squamous cell carcinoma
  • Adenocarcinoma
  • Small cell carcinoma

Bladder cancer can be invasive or non-invasive, and the type of bladder cancer you have may affect the likelihood of cancer cells traveling to other parts of the body or recurring after treatment.

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What Is the Most Common Type of Bladder Cancer?

Each type of bladder cancer depends on how tumor cells look under a microscope. Urothelial Carcinoma, also called transitional cell carcinoma, is the most common type of bladder cancer, accounting for more than 90% of all bladder cancers.

Though the vast majority of bladder cancers are urothelial, other types of the disease do occur. Let's take a broad look at four of the common types of bladder cancer.

Urothelial carcinoma

Urothelial carcinoma — also known as transitional cell carcinoma — is a type of bladder cancer that starts in the surface of the bladder's lining. It can also be referred to as Non-Muscle Invasive Bladder Cancer, or NMIBC. This type of cancer can generally be broken down into two categories: papillary and flat.

Papillary carcinomas grow out into the hollow center of the bladder and are usually noninvasive, while flat carcinomas remain flat against the surface of the bladder lining.

The following facts can provide a larger picture of urothelial carcinoma:

  • Almost all bladder cancers start in the urothelium.
  • When the bladder is empty, urothelial cells bunch together. When full, the cells stretch out. The cells can then be reached by urinary chemicals (e.g. from cigarette smoke) that may cause bladder cancer.
  • If bladder cancer affects only the urothelium it is called superficial or non-invasive.
  • Bladder cancers may spread into deeper bladder layers, becoming more difficult to treat.
  • If bladder cancer spreads from the urothelium to the muscle layer it is called invasive.

Superficial or Non-Invasive Bladder Cancer

Bladder cancers are called superficial, or non-invasive, if they stay confined to the bladder tissue in which they began. For example, Urothelial cancer is considered superficial if it has not spread anywhere outside of the bladder lining. Typically, non-invasive cancers are easier to treat and less likely to recur.

Other helpful information about superficial bladder cancer includes:

  • Superficial bladder cancer is an early-stage disease that affects the bladder lining (urothelium) only.
  • Small, ‘finger-like’ growths project from the inside surface of the bladder towards its hollow center. This is called papillary bladder cancer. These growths (e.g. Ta tumors) can be removed quite easily by your surgeon, and they may never come back (recur).
  • Some types of early-stage bladder cancer are more likely to recur. These include carcinoma in situ (CIS or Tis) and high-grade T1 tumors.

Types of tumors and their treatment include:

  • CIS or Tis tumors: Unlike other superficial bladder cancers, these tumors are flat and do not grow out of the bladder lining. These tumor cells look irregular and can grow rapidly. This is called high-grade disease. It is more likely to recur than other types of superficial bladder cancer.
  • T1 tumors: These tumors are superficial bladder cancers that have spread from the bladder lining (urothelium) to the layer of connective tissue underneath (the lamina propria). High-grade T1 tumors can grow rapidly. About 30–40% of all T1 tumors will recur.
  • Treatment: If you have a Tis or T1 rather than Ta tumor, your doctor may suggest that you need additional treatment. You will also require regular follow-up visits so that your doctor can detect the cancer early, if it recurs.

Invasive Bladder Cancer

Bladder cancers are considered invasive when they spread outside their original place of origin. Typically, invasive cancers are more difficult to treat and more likely to recur, though this isn't always the case.

Additional helpful information about invasive bladder cancer includes:

  • Urothelial cancer can become invasive and spread to deeper layers of the bladder wall.
  • In some cases, bladder cancer may be invasive when first detected.
  • Invasive bladder cancer requires more aggressive treatment.
  • Invasive bladder cancer can spread or metastasize to other parts of the body.
  • The stages of bladder cancer that are invasive are T2, T3 and T4 tumors.

Muscle Invasive Bladder Cancer

Muscle invasive bladder cancer (MIBC) is a bladder cancer that has spread to the muscle wall of the bladder. Like other invasive forms of cancer, MIBC has unique properties that make it more difficult to treat:

  • Muscle invasive bladder cancer is a more advanced stage of cancer than non-muscle invasive bladder cancers
  • Once cancer cells reach the muscle layer of the bladder, it becomes easier for them to spread beyond the bladder into other parts of the body
  • About one-quarter of people with MIBC who had surgery to remove the bladder were later found to have cancer cells in the lymph nodes
  • Cancer that has spread to the lymph nodes may be more difficult to treat
  • Cancer that has spread to the lymph nodes generally increases the chances of recurrence

Diagnosing Bladder Cancer

If you've received treatment for bladder cancer in the past, or if your doctor thinks you might currently have bladder cancer, he or she may recommend CxbladderThis accurate, easy-to-use bladder cancer urine test can rule out bladder cancer and help your doctor decide whether you need to complete further testing.

Whether you're a clinician recommending a method of testing or a patient concerned about symptoms of bladder cancer, Cxbladder can give you confidence, reassurance and peace of mind. For more information, reach out to us today.

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