Bladder cancer

Bladder cancer overview

The bladder cancer team at Fred Hutchinson Cancer Center treats every type and stage of bladder cancer, from early to advanced. This includes rare variants that other doctors may never see. People with bladder cancer have better outcomes if they receive care at a center, like ours, where experienced doctors treat many people with this disease.

We bring the same expertise to related cancers of the upper urinary tract. These include cancer of the ureter or renal pelvis. Much of the information on our bladder cancer webpage applies to these cancers, too.

Our patients with bladder or other urothelial cancer often join clinical trials — led by world-renowned doctors from Fred Hutch and UW Medicine — to get access to promising therapies that are not available everywhere.

Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body.
Confirming your bladder cancer diagnosis

A biopsy shows if you have cancer. It will also give details about the type of cancer you have. Most bladder cancers are a type called urothelial cancer. But there are many rare histologic types, called variants. Some examples are squamous cell carcinoma, adenocarcinoma, micropapillary, sarcomatoid, nested, plasmacytoid and neuroendocrine variants. 

The extent of the cancer — how far it has spread — matters, too. Your care team needs to know if your cancer sits on or in the first lining of your bladder (non-muscle invasive), if it goes into the bladder muscle wall (muscle-invasive) or if it has spread to distant parts of your body (metastatic).

We also compare the cancer cells to normal cells to tell the cancer grade. The grade helps your doctors predict how your bladder cancer will behave (how aggressive it is).

At Fred Hutch, we have a great deal of experience with all forms of bladder cancer. We have pathologists and radiologists who specialize in diagnosing these cancers. They will give your treating doctors the details needed to tailor your care to you.

We often take another look at the test results and imaging that patients have had elsewhere. This allows us to update your exact diagnosis and disease stage in important ways that can affect your treatment choices.
 

Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Grade In cancer, a grade is a description of a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. In cancer, a grade is a description of a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. Low-grade cancer cells look more like normal cells and tend to grow and spread more slowly than high-grade cancer cells. Grading systems are different for each type of cancer. They are used to help plan treatment and determine prognosis. Also called histologic grade and tumor grade. Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Adenocarcinoma Cancer that forms in the glandular tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices or other fluids.

Cancer that forms in the glandular tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices or other fluids. Most cancers of the breast, pancreas, lung, prostate, colon, esophagus and stomach are adenocarcinomas.

Confirming your bladder cancer diagnosis

Our experts begin by checking details about your disease, including the type, extent and grade of the cancer, so we can provide the right treatment for you.

Bladder cancer second opinions

Fred Hutch has the region’s first Bladder Cancer Multispecialty Clinic. At this clinic, a team of doctors comes together to plan care for people with bladder or other urothelial cancers. During a single visit, you get a second opinion from an entire group of doctors. They include urologic oncologists, medical oncologists, radiation oncologists, pathologists and radiologists.

You can talk with cancer experts who understand your disease and treatment options in greater depth than the general oncologists in your local community. We will share information with your local doctors based on your wishes and be a resource for you and them.

Call us at (855) 557-0555 to request an appointment for a second opinion.

How a second opinion can help

Getting a second opinion from specialists can help you:

  • Find out as much as possible about your exact diagnosis and cancer stage. These affect your treatment plan and prognosis.
  • Learn about the benefits of team-based care that is well coordinated.
  • Start with the best possible course of treatment for you. (It is not always easy or possible to change course.)
  • Think about advanced and recently approved treatment options that not all doctors may know about. These may include robot-assisted surgery to speed up your recovery, bladder reconstruction to help maintain your quality of life and faster access to many new treatments. 

If you were diagnosed through Fred Hutch, ask your care team about getting a second opinion. They will be happy to give you names of doctors we recommend.
 

 

Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Prognosis A statement about the likely outcome of a disease in a patient. Radiation oncologist A physician who has special training in using radiation to treat cancer. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Bladder cancer second opinions

If you have been diagnosed with bladder cancer or another urothelial cancer, we recommend getting a second opinion before choosing where you will be treated. 

In this video, Dr. Petros Grivas and Dr. Jonathan Wright discuss what people diagnosed with bladder cancer should know, including questions to ask their doctor, current treatment options, and the latest research in bladder cancer. · Cancer.Net

Your First Appointment

Based on your exact needs, your first appointment will be either with the team in our Bladder Cancer Multispecialty Clinic or with a urologic oncologist or medical oncologist who specializes in bladder and other urinary tract cancers.   

From the first time you come to see us, your specialized cancer team will begin getting to know you and your family to best address your needs. We also have nurse navigators. They are here to help schedule your appointments, help you navigate smoothly through our system and make sure that we answer all your questions and concerns.

At your first appointment, your care team will explain your disease. They will tell you how it is treated and which tests you need to help plan your care. Before you leave, your team will make sure you understand the next steps. 

Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.

Care at Fred Hutch

How Does Fred Hutch Approach Treatment?

The safest, most effective and most widely accepted therapies for cancer are known as the “standard of care.” For many patients, these therapies will be a large part of their treatment. At Fred Hutch, we provide all standard therapies for urinary tract cancers. We know how to choose the right ones for you and how to deliver them to give you the best chance at a full recovery.

Our doctors and researchers are always asking how we can make cancer treatments more effective and reduce side effects as much as possible. This is why we do clinical trials (also called clinical studies). Through these studies, we are able to offer you therapies that aren’t offered everywhere. A trial therapy today may become the new standard of care tomorrow.

Along with treating your cancer, a group of world-class professionals is here to support you. This team includes nurses, dietitians, physical therapists, social workers and psychologists. We also bring in supportive care services for your physical, mental and emotional well-being. 
 

Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies.

Treatment Plan and Process

You are unique, and your care team will design a treatment plan specifically for — and with — you. Fred Hutch doctors with knowledge and experience in bladder and other urothelial cancers will design your personalized treatment plan and provide your care. 

Many people with bladder cancer have surgery to remove just their tumor or sometimes their entire bladder. But surgery is not always needed or possible. Other treatments may be used along with, or instead of, surgery. They include chemotherapy, radiation therapy, immunotherapy and targeted therapy, among others. We offer all these options based on your needs. 

As you go through treatment, your needs may change. Your care team at Fred Hutch is with you each step of the way. For example, we will help you deal with any side effects you may have. We may suggest adding a new therapy that was just approved by the U.S. Food and Drug Administration. Even after your bladder cancer treatment is done, we will keep seeing you to protect your health over the long term, which we call “survivorship care.”

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
“We’re not treating a disease. We’re treating a person, and we figure out which treatments fit best for each individual.”
— Jonathan L. Wright, MD, MS, FACS, urologic oncologist

For Caregivers

Caregiver icon

When someone close to you needs treatment for bladder or another urothelial cancer, you might step into the role of caregiver. Being a caregiver can mean many things, from lending a hand with daily living tasks to helping with medical decisions. It can also mean dealing with your own emotions, thoughts and stress.

At Fred Hutch, caregivers are valuable members of a patient’s care team. We see every day that your presence and your support make a difference. We know that what your friend or family member is going through affects you, too.

Part of our mission is to help you take care of yourself. Caring for yourself is good for your physical, mental, spiritual and emotional health. It also helps you give your best to your loved one. Our social workers, Spiritual Health team and Patient and Family Resource Center staff are here to help support you.

Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting.

Other Resources

Care team
Care team

At Fred Hutch, a team of dedicated people surrounds you and your family to give you the highest level of care and support. You are the most important person on your care team. Our patients are at the center of everything we do.

Research
Research

Fred Hutch is a national leader in urothelial cancer research. Our scientists and doctors are working hard all the time to improve current treatments for urinary tract cancer and develop new ones so every person with this disease may live a long, healthy life. 

Resources
Resources

There are many resources for learning about your disease, as well as organizations that provide support. Health educators at the Fred Hutch Patient and Family Resource Center have put together a list of trusted sources to help you get started.