Non-Muscle Invasive Bladder Cancer

What is non-muscle invasive bladder cancer?

There are several different types of bladder cancer, but the most common type is called urothelial carcinoma.1,2 In the United States, nine out of ten adults diagnosed with bladder cancer have this type of disease.

The type of cancer a person is diagnosed with depends on where in the body the cancer cells started to form. As the number of cancer cells grows, they can gather together and form a tumor.

Urothelial carcinoma starts in a part of the bladder called the urothelium. The bladder is a hollow, flexible organ that is mostly made of muscle, which allows it to expand to hold urine. The urothelium is a thin layer of cells that line the inside of the bladder walls. This is the most common place for cancer cells to begin growing in the bladder.

Around three-quarters of people diagnosed with urothelial carcinoma have what is called non-muscle-invasive bladder cancer. This means that the cancer cells are all still located in the urothelium layer of cells, and have not spread into the muscle of the bladder walls. Bladder cancer that has spread into the muscle is called muscle-invasive cancer.

In some people with non-muscle-invasive bladder cancer, the cancer cells have also spread into the lamina propria. The lamina propria is another very thin layer of cells that lies between the urothelium and the bladder muscles.

If you are diagnosed with urothelial carcinoma, your healthcare providers will carry out tests to find out where the bladder cancer cells have formed in the bladder, and whether they have spread beyond the bladder to other parts of the body. This will help to identify the best way to treat the cancer. Treatment for non-muscle-invasive bladder cancer is effective for many people.

How is it diagnosed?

The most common symptom of bladder cancer is blood in the urine.2 Other common symptoms include the need to urinate frequently and pain or burning during urination. These are not always symptoms of bladder cancer, and not all people with non-muscle invasive bladder cancer have these symptoms. It is very important to speak with your healthcare provider if you do have symptoms like these, because treatment for bladder cancer is more effective if the cancer is diagnosed early.

If your healthcare providers are concerned that you have symptoms that may be caused by bladder cancer, they will carry out a physical examination and test your urine for signs of bladder cancer. They may then use a test called cystoscopy to help make a diagnosis. This test is carried out using a cystoscope, which is a very thin, flexible tube with a tiny light and a viewing lens on the tip of the tube. It is inserted into the bladder through the urethra (the thin tube-like organ that carries urine from the bladder out of the body). This allows the healthcare provider to view the inside of the bladder and take tissue samples if needed.

How is it treated?

Treatment for non-muscle invasive bladder cancer is based on how widely the cancer cells have spread within the urothelium and the lamina propria.1,2,3 It also depends on other types of risk factors the person may have. Your healthcare providers will advise you about the best possible plan for treating your bladder cancer.

Many people who are diagnosed with non-muscle invasive bladder cancer will have surgery to remove the tumor (or tumors) that have formed in the bladder lining. This surgery is called transurethral resection of the bladder. During this surgery, a tiny telescope is inserted through the urethra and into the bladder, allowing the surgeon to trim away the tumor and use an electrical current to destroy the surface where the tumor was removed. After surgery, some patients will have a special type of chemotherapy injected into the bladder to help prevent the cancer cells from growing back (recurring).

After completing treatment for non-muscle invasive bladder cancer, patients have regular checkups. Healthcare providers will be checking for early signs of possible cancer cell recurrence, so that they can be treated as early as possible.

What is the prognosis?

Non-muscle invasive bladder cancer can be treated effectively in many people, and it is quite rare for people to die from this type of bladder cancer after they have gone through treatment.1

However, it is not uncommon for this type of bladder cancer to recur later in a person’s life. This is why it is important to maintain regular check-ups after treatment. If this type of bladder cancer does recur, it usually occurs in the same place (the urothelium).

Written by Anna Nicholson | Last review date: September 2017.
View References
  1. Bladder Cancer Treatment. National Cancer Institute. https://www.cancer.gov/types/bladder/hp/bladder-treatment-pdq#link/_21_toc. Accessed September 2017.
  2. Anastasiadis A, de Reijke TM. Best practice in the treatment of nonmuscle invasive bladder cancer. Therapeutic Advances in Urology. 2012;4(1):13-32. doi:10.1177/1756287211431976.
  3. Bladder Cancer. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/facts-about-bladder-cancer. Accessed September 2017.