Bladder Cancer & Other Urinary Tract Tumors
Bladder cancer is a condition in which abnormal cells grow in the lining of the bladder. It is one of the most common cancers of the urinary system and is often highly treatable, especially when detected early.
The most common early sign is blood in the urine (hematuria), which may occur without pain or other symptoms. Because early symptoms can be subtle, prompt evaluation is essential.
At The Medical Group of New Jersey, our urology specialists provide comprehensive evaluation, timely diagnosis, and coordinated treatment, working closely with oncology and surgical teams to ensure the best possible outcomes.
Symptom Onset & Initial Evaluation
Bladder cancer may present with few or no symptoms in its early stages. When symptoms do occur, they are often related to changes in urination.
Common symptoms include:
- Blood in the urine (pink, red, or cola-colored)
- Frequent urination
- Urgency or feeling the need to urinate often
- Pain or burning with urination
- Pelvic discomfort (in more advanced cases)
It is important to note that these symptoms can also be caused by non-cancerous conditions such as infections or stones, but they should always be evaluated.
Evaluation
During your visit, your urologist will take a detailed history and perform a focused evaluation.
This includes:
- Reviewing when symptoms began and whether they are persistent
- Discussing risk factors such as smoking or chemical exposures
- Reviewing occupational history (e.g., exposure to dyes or industrial chemicals)
- Assessing prior urinary conditions or treatments
- Performing a physical exam
This initial step helps guide the urgency and type of diagnostic testing needed.
Diagnosis & Risk Assessment
Bladder cancer evaluation focuses on identifying abnormal cells, confirming the diagnosis, and determining the stage of the disease.
Urine Testing
- Urinalysis: Detects blood or signs of infection
- Urine cytology: Examines urine for abnormal or cancerous cells
- Urine-based tumor markers (in select cases): May help support diagnosis or monitoring
Imaging Studies
Imaging helps identify masses, evaluate the urinary tract, and assess for spread.
- CT urogram: Provides detailed imaging of the kidneys, ureters, and bladder
- Ultrasound: May be used in certain cases
Direct Visualization
- Cystoscopy: A small camera is inserted through the urethra to directly examine the bladder. Allows identification of tumors or abnormal areas
Biopsy & Tumor Resection
- Transurethral resection of bladder tumor (TURBT): Removes suspicious tissue for diagnosis and often serves as the initial treatment
Risk Assessment & Staging
This staging process is critical for guiding treatment decisions. If cancer is confirmed, further evaluation determines:
- Depth of tumor invasion (stage)
- Tumor grade (how aggressive the cells appear)
- Whether cancer has spread beyond the bladder
Treatment & Management
Treatment depends on the stage and grade of the tumor and is highly individualized.1
Early-Stage (Non–Muscle-Invasive) Bladder Cancer
This is the most common presentation and is often highly treatable. Treatment may include:
- TURBT (tumor removal): First-line treatment
- Intravesical therapy: Medication delivered directly into the bladder. Examples include BCG (immunotherapy) or chemotherapy
Muscle-Invasive or Advanced Bladder Cancer
If cancer has grown deeper into the bladder wall, treatment options may include:2
- Surgery (cystectomy): Removal of part or all of the bladder
- Urinary diversion: Creation of a new way for urine to leave the body
- Chemotherapy and/or immunotherapy
- Radiation therapy (in selected cases)
Treatment is coordinated across urology, oncology, and surgical teams.
1. Ahmadi, Hamed, et al. “Diagnosis and Staging of Bladder Cancer.” Hematology/Oncology Clinics of North America, vol. 35, no. 3, 1 June 2021, pp. 531–541.
2. Filon, Mikolaj, and Bogdana Schmidt. “New Treatment Options for Non-Muscle-Invasive Bladder Cancer.” American Society of Clinical Oncology Educational Book, vol. 45, no. 2, Jan. 2025, p. e471942.
Monitoring & Follow-Up
Bladder cancer requires ongoing surveillance, even after successful treatment, because recurrence is possible. The frequency of follow-up depends on the type and stage of cancer.
Prognosis & Preventive Care
When detected early, bladder cancer often has an excellent prognosis. Long-term outcomes depend on tumor stage, grade, and response to treatment.
At The Medical Group of New Jersey, we emphasize early detection, coordinated care, and long-term monitoring, ensuring patients feel supported and informed throughout their care journey.