Muscle-Invasive Bladder Cancer

Reviewed by: HU Medical Review Board | Last review date: September 2017.

Urothelial bladder cancer is the most common form of bladder cancer in the United States.1 It affects about 90% of people who are diagnosed with bladder cancer. Cancer is diagnosed based on where the cancer cells began to form. In most people with bladder cancer, the cancer cells started forming in a part of the bladder called the urothelium.

The bladder is a hollow, flexible organ, and the walls of the bladder are mostly made up of muscle tissue. The lining of the inside of the bladder is a thin layer of cells called the urothelium, which is where most bladder cancer cells begin to grow. When bladder cancer cells continue to grow, they can gather together and form tumors.

What is muscle-invasive bladder cancer?

The type of bladder cancer can depend on how far the bladder cancer cells have spread from the urothelium. In people with muscle-invasive bladder cancer, the cancer cells have spread into the muscle of the bladder wall.

How is it diagnosed?

Common symptoms of bladder cancer include blood in the urine, frequency or difficulty urinating, and pain or burning during urination.2 These are not always symptoms of muscle-invasive bladder cancer, but it is important to let your healthcare provider know if you have any of these symptoms.

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If your healthcare provider thinks you may have bladder cancer after performing a physical examination and testing your urine, then a procedure called cystoscopy is used to help with the diagnosis. During the procedure, a thin, flexible tube is inserted into the urethra (the tube-like organ that allows urine to flow out of your bladder) so the healthcare provider can see the inside of the bladder and take tissue samples.

If the cystoscopy results show that there are cancer cells in the bladder, then the next step is to carry out further tests to check whether the cancer cells have spread into the bladder muscles or outside of the bladder. If the cystoscope testing shows that there are cancer cells in the bladder, then further tests may be used to measure how far the cancer cells have spread. This may involve a CT scan, MRI scanning, or X-rays. These tests help healthcare providers to create the best possible plan to treat the cancer. Some people may need to have the tumor—or a part of it—removed in order to learn more about the best way to treat their muscle-invasive bladder cancer.

What are treatment options?

Treatment for bladder cancer depends on the size of the tumor, the number of tumors, and where they are located in the bladder.1,2 Muscle-invasive bladder cancer cells tend to have a higher chance of spreading to other parts of the body. Depending on a person’s risk factors, healthcare providers may recommend an intensive treatment plan.

Common treatments for muscle-invasive bladder cancer include surgery, radiation therapy, and chemotherapy. For many people, treatment involves some form of combination of those treatments.

The type of surgery used to treat muscle-invasive bladder cancer depends on many different factors. Some people may have surgery to remove the part of the bladder affected by cancer (called partial cystectomy). Other people may need to have surgery to remove the entire bladder. If that type of surgery is required, then the surgeon will create a new way for the person to store and remove urine from the body.

Radiation therapy is a treatment that involves treating the area affected by cancer with a special type of energy to kill the cancer cells. External radiation therapy uses a machine to deliver radiation to the cancer cells. Chemotherapy also works by using powerful drugs that help kill cancer cells or keep them from growing. Chemotherapy medicines for bladder cancer are usually injected into the body, intravenously (into a vein) or intravesically (into the bladder through a catheter).

What is the prognosis?

Treatment can be effective for some people with muscle-invasive bladder cancer.1,2 However, in some people the cancer will recur, which means the bladder cancer cells start growing again after successful treatment.

After treatment for muscle-invasive bladder cancer, people are carefully monitored by their healthcare providers for signs that the cancer has recurred. Most people who die from bladder cancer do not die from tumors in the bladder muscles, but from cancer that has spread out of the bladder muscles and into other parts of the body.