Bladder Cancer
(Cancer of the Urinary Bladder)

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What is the bladder?

The urinary bladder, or the bladder, is a hollow organ present in the pelvis. Most of it lies behind the pubic bone of the pelvis but when full it can extend up into the lower part of the abdomen. Its primary function is to store urine that drains into it from the kidney through tube-like structures called the ureters. The ureters from both the kidneys open into the urinary bladder. The bladder forms a low-pressure reservoir which gradually stretches out as urine fills into it. In males, the prostate gland is located adjacent to the base of the bladder where urethra joins the bladder. From time to time, the muscular wall of the bladder contracts to expel urine through the urinary passage (urethra) into the outside world.

What are the layers of the bladder?

The bladder consists of three layers of tissue. The innermost layer of the bladder which comes into contact with the urine stored inside the bladder is called the "mucosa" and consists of several layers of specialized cells called "transitional cells," which are almost exclusively found in the urinary system of the body. These same cells also form the inner lining of the ureters, kidneys, and a part of the urethra. These cells form a waterproof lining within these organs to prevent the urine from going into the deeper tissue layers.

The middle layer is a thin lining known as the "lamina propria" and forms the boundary between the inner "mucosa" and the outer muscular layer. This layer has a network of blood vessels and nerves and is an important landmark in terms of the staging of bladder cancer (described in detail below in the bladder cancer staging section).

The outer layer of the bladder comprises of the "detrusor" muscle and is called the "muscularis." This is the thickest layer of the bladder wall. Its main function is to relax slowly as the bladder fills up to provide low-pressure urine storage and then to contract to compress the bladder and expel the urine out during the act of passing urine. Outside these three layers is a variable amount of fat which lines and protects the bladder like a soft cushion and separates it from the surrounding organs such as the rectum and the muscles and bones of the pelvis.

Picture of the urinary system: kidneys, ureters, and bladder
Picture of the urinary system: kidneys, ureters, and bladder


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Know the signs and symptoms of bladder cancer.

Bladder Cancer

Bladder Cancer Causes, Symptoms, and Signs

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Jay W. Marks, MD

Cancerof the urinary bladder develops in over 70,000 Americans each year, leading to over 14,000 deaths. According to the American Cancer Society, the chance of a man developing this cancer at any time during his life is about one in 30; for a woman, the chance is one in 90. Since bladder cancer that is detected in the early stages has a good chance of cure, awareness of the signs and symptoms of this malignancyare critical. Anyone experiencing the signs or symptoms of bladder cancer should be checked by a urologist, who can perform tests to diagnose bladder cancer even in its early stages.

The cause of bladder cancer is not understood, but certain risk factors are known to increase an individual's risk of getting bladder cancer. Men are about three times more likely than women to develop bladder cancer, and older people are more likely to be affected. Up to 90% of those affected are over 55 years of age. Smokersare at an increased risk for development of bladder cancer. Exposure to certain chemicals used in manufacturing and industry (including paints and paint thinners, some hairdressing supplies, and certain dyes) are associated with a higher risk of bladder cancer, so people who work in certain occupations (workers in the rubber, chemical, and leather industries; hairdressers; machinists; metal workers; printers; painters; textile workers; and truck drivers) are at increased risk. Being infected with certain parasites that are common in tropical areas also increases the risk for bladder cancer.

The following are signs and symptoms of bladder cancer:

  • Blood in the urine: This is the most common symptom of bladder cancer and occurs in the vast majority of people with bladder cancer. Having blood in the urine does not necessarily mean a person has cancer, since other conditions (including infections) can lead to bloody urine, but blood in the urine is never normal and should always be evaluated by a doctor.
  • Urinary urgencyor pain on urination
  • Backor abdominal pain
  • Loss of appetiteand weight

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