Bladder Cancer: Causes, Risks, Symptoms

September 8, 2021

Bladder cancer is one of the most common cancers in the United States. It affects approximately 68,000 adults in the United States each year. It begins in the cells that line the inside of the bladder called urothelial cells. It’s most commonly found in the bladder, but this same type of cancer can be found in other parts of the urinary tract.

Bladder cancer is highly treatable at an early stage. Approximately seven out of every ten bladder cancer diagnoses starts out at an early stage. Even though it can be caught early, it can reoccur. Typically, those diagnosed with bladder cancer have follow-up tests regularly after treatment to ensure they stay cancer free.

Researchers do not know exactly what causes most bladder cancers but they have found some risk factors. These risk factors can cause cells in the bladder to change and become cancerous. While some risk factors can be changed along with lifestyle choices, others cannot.

Top risk factors for bladder cancer include: 

  • Smoking and tobacco use. This includes cigarettes and pipes. The use of “vaping” and marijuana are not well-researched to determine whether or not they are a risk factor.
  • Exposure to chemicals, especially on the job. Chemicals linked to bladder cancer risk include arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products.
  • Past radiation exposure, especially to the abdomen or pelvis.
  • Chronic irritation of the bladder lining due to bladder stones, long term catheter use or frequent bladder infections.
  • Chronic parasitic infections. Schistosoma haematobium (S. haematobium) is a parasitic worm that infects the bladder. This is most often seen in developing countries and is very rare in the U.S.
  • Per the FDA, the use of a diabetes medication Actos (pioglitazone) for longer than one year might be linked to an increased risk of bladder cancer. This is still an area of active research.
  • Dietary supplements containing aristolochic acid (mainly in herbs from the Aristolochia family) have been linked with an increased risk of bladder cancer.
  • Long-term use of the chemotherapy drug cyclophosphamide (Cytoxan, Procytox) with poor hydration may increase bladder cancer risk.
  • The risk of bladder cancer increases with age. It is estimated that nine out of ten diagnosed with bladder cancer are older than 55.
  • Caucasians are two times as likely to develop bladder cancer as African Americans and Hispanics.
  • Bladder cancer is more common in men than women.
  • Personal history of other cancers: Having a cancer in the lining of any part of the urinary tract allows for higher risk of having another cancer.
  • Bladder birth defects including exstrophy or a remaining urachus even if surgically corrected.
  • Family history/genetics: People who have family members with bladder cancer have a higher risk of getting it themselves. This could be because the family members are exposed to the same cancer-causing chemicals or may also share changes in some genes that make it hard for their bodies to break down certain toxins, causing them to be more susceptible to bladder cancer. A small number of people inherit a gene syndrome that increases their risk for bladder cancer.
  • Cowden disease, caused by a gene mutation, is linked mainly to cancers of the breast and thyroid, but may also cause a higher risk of bladder cancer.
  • Lynch syndrome (hereditary non-polyposis colorectal cancer) is linked mainly to colon and endometrial cancer, but it does increase the risk of bladder cancer.

Although no screening tests are recommended for people at average risk, bladder cancer can often be found early because it causes blood in the urine or other urinary symptoms. Oftentimes, many of these symptoms have less serious causes, but it’s important to have them checked by a doctor.

Possible symptoms of bladder cancer include:

  • Visible blood in the urine (hematuria) with or without pain. Often the first sign of bladder cancer is blood in the urine. A small amount of blood can change the color of the urine to appear orange, pink, or, less commonly darker red. Blood can come and go, but eventually will reappear and worsen.
  • Repeated episodes of microscopic blood in the urine found by your doctor (microscopic hematuria). The color of the urine may appear normal, however microscopic amounts of blood are found when a urine test, called a urinalysis, is done either routinely or because of other symptoms.
  • Chronic irritative bladder symptoms. Frequency, urgency and bladder irritation can sometimes be a symptom of bladder cancer, however, there are many possibilities that may cause these symptoms that are not at all cancerous.

Again, many of these symptoms are likely to be caused by something other than bladder cancer. However, it’s important to have them checked so the cause can be found and treated.

If you have any questions or concerns about bladder cancer, contact Austin Urology Institute to make an appointment with a provider at 512.694.8888.