What is bladder cancer?

Bladder cancer develops when abnormal cells in the bladder grow and divide in an uncontrolled way.

The bladder is a small organ in the lower part of the abdomen (tummy area) that stores urine. Most bladder cancers start in the inner lining of the bladder. When cancer affects only the inner bladder lining, it is called non-invasive cancer. If the cancer spreads into the deeper layers of the bladder lining or the bladder wall, it is harder to treat and more likely to spread.

The cancer cells can spread to the muscle wall of the bladder, or even further to lymph nodes or other organs.

Bladder cancer is usually easier to treat if it is found at an early stage.

What are the types of bladder cancer?

The most common form of bladder cancer is called urothelial carcinoma (or transitional carcinoma). This starts in the urothelial cells in the inner lining of the bladder.

There are other types of bladder cancer, which are more rare:

• Squamous cell carcinoma starts in thin, flat cells that line the bladder.
• Adenocarcinoma starts in a type of cell that produces mucus in the bladder.

What are the symptoms of bladder cancer?

The most common sign of bladder cancer is blood in your urine. It usually happens suddenly but isn't painful. If you notice blood in your urine, you should always see your doctor.

Other symptoms of bladder cancer include:

• having trouble emptying your bladder when you go to the toilet
• a burning feeling or pain when you're trying to pass urine
• needing to pass urine often
• pain in your lower stomach or back

What causes bladder cancer?

Doctors and researchers don't fully understand why bladder cancer develops in some people.

Smoking is the key risk factor in many cases of bladder cancer.

Some other factors that can increase the risk include:

• being male
• exposure to certain chemicals
• family history of bladder cancer
• chronic urinary tract infections
• some types of chemotherapy
• previous radiotherapy treatment to the pelvic area

When should I see my doctor?

See your doctor promptly if you experience any ongoing or unusual changes in how you urinate. Even symptoms that start and stop or are mild should be checked by a health professional.

Bladder cancer is most treatable when found early. Timely medical assessment is important — do not delay seeking care if something does not feel normal.

How is bladder cancer diagnosed?

Your doctor will examine you and may refer you for some tests, including:

• blood tests
• urine tests
• imaging scans such as a computed tomography (CT), ultrasound or magnetic resonance imaging (MRI)

A common test used to diagnose bladder cancer is called a cystoscopy. During a cystoscopy, the doctor — usually a specialist doctor called a urologist — looks inside your bladder with a small camera. If they see anything worrying, they will take a biopsy (a small sample of tissue) to be checked in a laboratory.

How is bladder cancer treated?

Your treatment will depend on the type of bladder cancer and how far it has spread.

You may need a type of surgery called a transurethral resection. The cancer cells can also be removed or destroyed with a laser during surgery.

Some types of bladder cancer can be treated with immunotherapy. This is a type of medicine that stimulates your own immune system to fight the cancer.

Chemotherapy is a type of medicine that is sometimes used, and can be delivered into the bladder through a catheter. Some people can also have radiotherapy to treat bladder cancer.

If the cancer has spread, part or all of your bladder may need to be removed with surgery.

Your doctor may also remove some lymph nodes and any other affected organs. If your bladder is removed, a new 'bladder' for urine to be stored may be made for you using part of your bowel. In other cases, urine may pass through an opening in your abdomen to collect in a bag outside your body. This is known as a urostomy.

Living with bladder cancer

If your bladder is removed and you have a urostomy, it can take time to adjust. Help and support is available from your doctor, urology nurses, stomal therapists and physiotherapists.

Read more on living with a stoma.

Bladder cancer and its treatment may also affect your bowel function, sexual function and mental health. Ask your healthcare team about what you can do to relieve your symptoms and cope with the changes.

Many people feel anxious or distressed after being diagnosed with cancer. If you are struggling, it is important to seek support from your doctor, a therapist or other people who have been through cancer.

What are the complications of bladder cancer?

Bladder cancer can lead to a range of complications if not detected and treated early. As the disease progresses, it may spread beyond the bladder to nearby tissues or distant organs such as the lungs, liver or bones. This can make treatment more complex and reduce the chances of recovery.

Sometimes, cancer can block the normal flow of urine, leading to kidney damage. Ongoing bleeding from the bladder may also cause anaemia.

Treatment can bring its own challenges. Surgery to remove the bladder may mean you need a new way for urine to leave your body, which can affect day-to-day activities. Chemotherapy or radiotherapy may also cause side effects, such as infections, urinary problems, or changes in kidney function.

Managing these complications often requires long-term follow-up and supportive care to help maintain quality of life.

Can bladder cancer be prevented?

There is no sure way to prevent bladder cancer, but some lifestyle choices can help lower your risk. The most important step is to avoid tobacco and e-cigarettes, as smoking is the leading cause of bladder cancer. Harmful chemicals from cigarettes are absorbed into the bloodstream and pass through the kidneys into the urine, where they can damage the bladder lining over time.

You can reduce your risk by making the following choices:

• Avoid smoking, vaping or using tobacco products.
• Limit your exposure to harmful chemicals, including in the workplace, and use protective gear and follow safety guidelines.
• Drink enough water to stay hydrated.
• Eat a balanced diet.
• Talk to your doctor if you have a family history of bladder cancer or other known risk factors.

While these steps can't completely prevent bladder cancer, they can help lower your risk and support your overall health.

Resources and support

For more information and support, try these resources:

• Continence Health Australia provides information about bladder control. Call the National Continence Helpline on 1800 33 00 66.
• The National Public Toilet Map helps you find the location of the nearest public toilet. You can also download it as an app.
• Cancer Council Australia provides services and support to all people affected by cancer. Call 13 11 20.

Information for Aboriginal and/or Torres Strait Islander peoples

• Read all about cancer for Aboriginal and/or Torres Strait Islander people.
• Watch the video Our Mob and Cancer.

Languages other than English

• Beat Bladder Cancer Australia has online resources in several community languages.
• General information from NSW Health about cancer is available online in many community languages.