Caught Early, Highly Treatable
Bladder Cancer
Bladder cancer is one of the most common cancers in the United States, and when it is found early — usually because someone acted on blood in the urine — it is highly treatable. Our board-certified urologists provide diagnosis, surgery, and long-term surveillance at our offices in The Woodlands, Tomball, and Kingwood.
What is Bladder Cancer?
Understanding Bladder Cancer
Bladder cancer begins in the cells lining the inside of the bladder, most often as urothelial carcinoma. The critical distinction is depth: non-muscle-invasive cancers are confined to the inner lining and are treated by removing them through the urethra with no external incision, while muscle-invasive cancers have grown into the bladder wall and require more aggressive treatment. The large majority of newly diagnosed bladder cancers are non-muscle-invasive. Smoking is by far the leading risk factor, responsible for roughly half of cases, and risk remains elevated for years after quitting. Occupational exposure to chemicals used in painting, dye, rubber, leather, and chemical manufacturing also contributes, along with age, male sex, chronic bladder irritation, and prior pelvic radiation.
How Would I Know if I Had Bladder Cancer?
Symptoms of Bladder Cancer
Blood in the urine is the most common presenting sign, and it is characteristically painless and intermittent — appearing once, then disappearing for weeks. That disappearance is the reason bladder cancer is so often diagnosed late, because people reasonably conclude the problem resolved. It did not. Other symptoms include urinary frequency and urgency, burning with urination without an infection present, and difficulty urinating. Pelvic or flank pain, bone pain, and weight loss suggest more advanced disease. Any episode of visible blood in the urine warrants a complete evaluation, and so does microscopic blood found on a routine urinalysis.
How is Bladder Cancer Diagnosed?
How We Diagnose Bladder Cancer
Cystoscopy is the cornerstone: a small scope passed through the urethra allows the urologist to see the bladder lining directly, and it detects tumors that imaging misses. It is performed in the office with numbing gel and takes only a few minutes. Urine cytology examines cells shed into the urine for cancerous changes, and CT urography images the kidneys, ureters, and bladder to identify tumors and assess the upper tracts. When a tumor is found, transurethral resection removes it and provides tissue for pathology, which establishes both the grade and — critically — whether the muscle layer is involved. Additional imaging is used to stage the disease when the tumor proves invasive.
Why Choose Texas Regional Urology for Bladder Cancer Care?
Why Patients Choose TRU
Here is what we can do
Bladder Cancer Treatment Options at Texas Regional Urology
Treatment depends almost entirely on whether the cancer has invaded the bladder muscle. Non-muscle-invasive disease is managed by removing the tumor endoscopically, frequently followed by medication instilled directly into the bladder to reduce recurrence, and then by regular surveillance. Muscle-invasive disease requires more aggressive treatment and a multidisciplinary approach. Bladder cancer recurs more often than most cancers, which makes long-term follow-up an integral part of treatment rather than an afterthought.
Transurethral Resection (TURBT)
The tumor is removed through the urethra using a resectoscope, with no external incision. This is both the treatment for non-muscle-invasive disease and the procedure that establishes accurate staging.
Intravesical Therapy
Medication placed directly into the bladder — most commonly BCG immunotherapy, sometimes chemotherapy — reduces the risk of recurrence and progression after resection. It is delivered in a series of office visits through a catheter.
Surveillance Cystoscopy
Because recurrence is common, patients undergo periodic cystoscopy on a defined schedule for years after treatment. Recurrences found early are usually managed with another endoscopic resection.
Treatment for Muscle-Invasive Disease
Invasive bladder cancer typically requires bladder removal, often preceded by chemotherapy, or in selected patients a bladder-preserving combination of chemotherapy and radiation. We coordinate these cases with medical and radiation oncology at our affiliated hospital systems.
Answers to your Bladder Cancer Questions
Frequently Asked Questions
No — that's the dangerous assumption.
Bleeding from a bladder tumor characteristically stops on its own and returns later, so resolution provides no reassurance whatsoever. A single episode of visible blood warrants a full evaluation.
Usually not — most cases are superficial.
The large majority of bladder cancers are non-muscle-invasive and are treated by removing the tumor endoscopically while keeping the bladder. Bladder removal is reserved for muscle-invasive disease.
Bladder cancer recurs frequently.
Recurrence rates are high even after successful treatment, and repeat tumors are usually caught early and handled easily when surveillance is maintained. Skipping scheduled cystoscopy is the most common way a manageable recurrence becomes a serious one.
Yes — meaningfully so.
Continued smoking increases the risk of recurrence and progression, so quitting after diagnosis measurably improves outcomes. It is one of the few things fully within your control.
Uncomfortable briefly, but not painful.
The procedure uses numbing gel and takes a few minutes, with most patients describing pressure rather than pain. Mild burning with urination for a day afterward is normal.
Noticed blood in your urine?
