Types of bladder cancer

The type of bladder cancer means the type of cell the cancer started in. Knowing this helps your doctor decide which treatment you need.

The most common type of bladder cancer is urothelial bladder cancer. This is also called transitional cell bladder cancer. There are some rarer types. These include squamous cell bladder cancer, adenocarcinoma, sarcoma and small cell bladder cancer. 

Doctors also describe your bladder cancer based on how far it has spread into the bladder wall. You can have either:

  • non muscle invasive bladder cancer
  • muscle invasive bladder cancer 

The different types of bladder cancer

There are different types of bladder cancer that begin in the lining of the bladder. The name of each cancer type depends on the type of cells that becomes cancerous:

About 90 out of 100 bladder cancers in the UK (about 90%) are urothelial cancer. These are also called transitional cell cancer. 

Urothelial cancer develops from the cells of the bladder lining (urothelium). These are called transitional or urothelial cells.

When the bladder is empty, these cells are all bunched together. As the bladder fills with urine the cells stretch out into a single layer. These cells come into contact with waste products in the urine that may cause cancer. For example, chemicals from cigarette smoke.

Urothelial bladder cancers can behave in different ways. There are non muscle invasive cancers. These have not invaded the deeper layers of the bladder.  And there are muscle invasive bladder cancers. These have grown into the deeper muscle layer of the bladder wall or beyond.  The treatments are different, so it is important to know which kind you have.

About 5 out of every 100 (5%) bladder cancers are squamous cell cancers. It is usually invasive.

Squamous cells are flat cells that make up the moist, skin-like tissues that line your body organs. This type of bladder cancer develops from these cells.

It is more common in some parts of the world, including Africa and Asia. This is because an infection called bilharzia increases the risk of squamous cell bladder cancer. Bilharzia is caused by a parasitic worm that lives in fresh water in some parts of the world. But this parasitic infection is extremely rare in the UK.

This is a very rare type of bladder cancer. Between 1 and 2 out of every 100 people (1 to 2%) diagnosed with bladder cancer have it. It is usually invasive.

All the moist, skin-like tissues lining your body organs have some gland cells. These produce mucus. Adenocarcinoma develops from these cells in the lining of the bladder.

Sarcomas

Very rarely, some people get a cancer that starts in the bladder muscle or other structural tissues. These are different to cancers that start in the bladder lining. Cancers that start in the bladder muscle are called sarcomas. Doctors treat these differently to bladder cancer.

Small cell cancer of the bladder

This is a very rare type of bladder cancer. If you have it, you may have some of the treatments described in this section. For example, surgery and chemotherapy. But the chemotherapy drugs you have may be different. You must ask your own specialist how your treatment may differ.

Non muscle invasive and muscle invasive bladder cancers

Doctors describe your bladder cancer based on how far it has spread into the bladder wall. You can have either:

  • non muscle invasive bladder cancer
  • muscle invasive bladder cancer

Non muscle invasive bladder cancer

This means the cancer is only in the lining of the bladder. It has not grown into the deeper layers of the bladder wall. There are different types:

Papillary bladder cancer

Non muscle invasive bladder cancer usually appears as small growths, shaped like mushrooms. These grow out of the bladder lining. This is called papillary bladder cancer.  Your surgeon can remove these growths and they may never come back.

Carcinoma in situ (CIS)

Unlike other non muscle invasive bladder cancers, areas of CIS are flat. They do not grow 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 non muscle invasive bladder cancer.

High grade T1 tumours

T1 tumours are early cancers that have grown from the bladder lining into a layer underneath. This layer is called the lamina propria. High grade T1 tumours are early cancers, but they can grow very quickly. 

Muscle invasive bladder cancer

Transitional or urothelial cell bladder cancer can become invasive. This means it has grown into a deeper (muscle) layer of the bladder, or beyond. 

Muscle invasive bladder cancer needs more intensive treatment than non muscle invasive bladder cancer. This is because there is a risk that it could spread to other parts of the body.

Metastatic bladder cancer

Metastatic bladder cancer means the cancer has spread from the bladder to another part of the body. It is also called advanced bladder cancer.

Your cancer might be metastatic when it is first diagnosed. Or it may have come back some time after you finished treatment. This is called recurrent or relapsed cancer.

Cancer that has spread to the bladder (secondary cancer)

Sometimes cancer that has started elsewhere in the body can spread to the bladder. This can happen with prostate, rectum, ovary, cervix and womb cancer for example.

Cancers that have spread from somewhere else in the body are called secondary cancers. The cancer cells are the same type as the first (primary) cancer. So is the treatment.

If you have cancer that has spread to the bladder, you need to go to the section about your primary cancer. 

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  • AJCC Cancer Staging Manuel (8th Edition)
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  • Bladder cancer: diagnosis and management of bladder cancer
    National Institute of Health and Clinical Excellence, 2015

  • EAU Guideline on Muscle-invasive and Metastatic Bladder Cancer
    J A Witjes and others
    European Association of Urology, 2022

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
22 Sep 2022
Next review due: 
22 Sep 2025

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