Bladder Cancers begin on the inner surface of the bladder, in the lining cells called the transitional cells. Bladder cancer is most often a transitional cell carcinoma. 

Bladder cancers most often grow as a polyp on the surface of the bladder or as a flat tumor called a “sessile” tumor. Bladder cancers can invade the deeper layers of the bladder and they becomes much more likely to spread if they become invasive. Bladder cancers can also grow along the surface of the bladder into something called carcinoma in situ.

Bladder cancers can be low grade (slower growing) or high grade (faster growing and more aggressive). 

Cigarette smoking is the number one risk factor for forming bladder cancer and blood in the urine is the most common sign or symptom.

Tumors that form along the surface of the bladder can be lopped off under anesthesia using a transurethral (through the urethra) resection technique. For many patients this is the only treatment they will need. Patients with invasive tumors or carcinoma in situ need more aggressive treatment. 

Bladder cancer is a disease with a high recurrence rate. Even small low grade tumors resected completely have a high risk of recurrent tumors in a relatively short period of time either in the area of resection or in any part of the urinary system where we find transitional cells, most often the bladder but also the renal pelvis draining the kidney, the ureters that transport urine down to the bladder and the urethra.

Even the slow growing bladder cancer grow quickly enough that if not caught early enough they will cause complications such as bleeding and pain, or, worse, they can convert to high grade tumors that become invasive.

Bladder cancers take constant surveillance to make sure the cancer has not come back.