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Transitional cell bladder cancer

About 9 out of 10 (90%) bladder cancers in the UK are transitional cell cancers. Transitional cells line the bladder. There are two main types of transitional cell cancer. They behave in quite different ways. The two types are non muscle invasive (superficial) bladder cancer and invasive bladder cancer. It is important to know which one you have, because the treatment is quite different.

Non muscle invasive (superficial) bladder cancer

This is early cancer that has not grown beyond the bladder lining. It usually appears as small growths, like little mushrooms. Your surgeon can remove these and they may never come back. But some types of superficial bladder cancer are more likely to come back. These are called carcinoma in situ (CIS) and high grade T1 tumours. High grade T1 tumours are superficial cancers, but they can grow very quickly. If you have one of these, you may need more treatment than for a lower risk bladder cancer. You will also need regular checkups to make sure your doctor picks the cancer up early, if it does come back.

Invasive bladder cancer

This is cancer that has grown into the muscle layer of the bladder, or beyond. It needs more intensive treatment than superficial cancer.

Other types of bladder cancer

About 8 out of every 100 (8%) bladder cancers in the UK are squamous cell cancers. They start in the flat cells that make up the lining of the bladder. Between 1 and 2 out of every 100 bladder cancers are adenocarcinoma (1 to 2%). This is a very rare type of bladder cancer that develops from cells that produce mucus.

 

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Transitional cell bladder cancer

About 9 out of 10 bladder cancers in the UK (90%) are the transitional cell type, which is sometimes called urothelial cancer. It is a cancer that develops from the cells of the bladder lining (urothelium). The cells are called transitional cells. When the bladder is empty, they are all bunched together. When the bladder is full, they are stretched out into a single layer. Because they line the bladder, these cells come into contact with waste products in the urine that may cause cancer, such as chemicals in cigarette smoke.

Transitional cell cancers can behave in different ways. They can be

In the section about treating bladder cancer, there are separate pages on treating non muscle invasive (superficial) bladder cancer and on treating invasive bladder cancer. The treatment is quite different. So you need to know which one you are dealing with to get the right information.

 

Non muscle invasive (superficial) bladder cancer

Superficial bladder cancers are early stage transitional cell bladder cancer. The cancer is only in the lining of the bladder and hasn't grown into the deeper layers of the bladder wall. It usually appears as small growths, shaped like mushrooms, growing out of the bladder lining. This is called papillary bladder cancer. Your surgeon can remove these growths and they may never come back.

But some types of non muscle invasive (superficial) bladder cancer are more likely to come back. They are carcinoma in situ (CIS) and high grade T1 tumours.

Unlike other superficial bladder cancers, areas of carcinoma in situ are flat and not growing out of the bladder wall. In CIS the cancer cells look very abnormal and are likely to grow quickly. This is called high grade. It is more likely to come back than other types of superficial bladder cancer.

T1 tumours are superficial cancers that have grown from the bladder lining into a layer underneath, called the lamina propria. High grade T1 tumours are superficial cancers, but they can grow very quickly. About 30 to 40 out of every 100 (30 to 40%) T1 bladder cancers come back.

If you have CIS or T1 superficial bladder cancer, your doctor may suggest more treatment than for other superficial bladder cancers. And the specialist will keep a close eye on you to make sure the cancer is picked up as early as possible if it does come back.

CIS and T1 are stages of bladder cancer. You can read about staging in the section about treating early bladder cancer.

 

Invasive bladder cancer

Transitional cell bladder cancer can become invasive. This means it has grown into the muscle layer of the bladder, or beyond. Some people have invasive bladder cancer when they are first diagnosed. Invasive bladder cancer needs more intensive treatment than superficial bladder cancer. This is because there is a risk that it could spread to other parts of the body. Invasive bladder cancers are divided into T2, T3 or T4. This is part of the staging of bladder cancer. There is more about the stages of bladder cancer in the section about treating invasive bladder cancer.

 

Squamous cell bladder cancer

Squamous cells are flat cells that make up the moist, skin like, tissues lining the body organs. About 5 out of every 100 (5%) bladder cancers in the UK are squamous cell cancers. They are more common in developing countries where a worm infection called bilharzia or schistosomiasis is widespread.

 

Adenocarcinoma of the bladder

This is a very rare type of bladder cancer. Between 1 and 2 out of every 100 people diagnosed with bladder cancer have this type (1 to 2%). It is a cancer that develops from the cells in the lining of the bladder that produce mucus. All the moist, skin like, tissues lining the body have some gland cells that produce mucus.

 

Rare types of bladder cancer

It is possible to get a cancer of the bladder muscle or other structural tissues, rather than the bladder lining. Cancers that start in the bladder muscle are called sarcomas and are very rare. If you are looking for information about sarcoma of the bladder, you need to go to the section about soft tissue sarcoma.

There is another type of bladder cancer called small cell cancer of the bladder, but it is very rare. If you have this type of bladder cancer, some of the information in this section will be useful to you. You may have your bladder removed and you may have chemotherapy. But the chemotherapy drugs you have may be different from other people with bladder cancer. You need to ask your own specialist about how your treatment may be different to make sure you have the right information. There is information about many individual chemotherapy drugs in the cancer drugs section.

 

Cancer that has spread to the bladder

Sometimes, a cancer that has started elsewhere in the body can spread to the bladder. For example

These cancers are called secondary cancer. This section is only about primary bladder cancer. Secondary cancer cells are the same type as the primary cancer. So the treatment will be the same as for the primary cancer. If you have a cancer that has spread to the bladder, you need to look at the section for your type of primary cancer to get the right information.

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Updated: 23 October 2013