Bladder Cancer

  • William Foster
  • Brian Lee
  • Joycelyn L. Speight


Risk factors: smoking, napthylamines, dyes, cytoxan exposure. Chronic irritation, i.e., bladder stones, chronic indwelling foley catheter Primary lymphatic drainage: hypogastric, obturator, iliac (internal and external), perivesical, sacral, presacral Secondary lymphatic drainage: common iliac Tumors tend to be multifocal in nature Transitional cell carcinoma (TCC) constitutes 93% of cases in the U.S.; TCC with squamous or glandular features behaves like pure TCC Squamous cell carcinoma (SCC) constitutes 5% of cases (primary histology seen in Egypt due to Schistosoma infections) Adenocarcinoma uncommon 1–2% (most often in dome of bladder; urachal remnant) Most common sites = trigone (inferiorly below ureterovesical junctions), lateral and posterior walls, and bladder neck Common presenting symptoms: hematuria (gross or microscopic; 75% of cases), irritative voiding (25–30%), pelvic pain, obstructive uropathy, hydronephrosis At presentation, 75% of cases are Ta, Tis, or T1 Probability of lymph node (LN) involvement (∼20% overall): pT1 5%, pT2-T3a 30%, pT3b 64%, pT4 50% (Skinner et al.) Incidence of distant metastases (DM) at diagnosis ∼8–10%; lung, bone, liver


Radical Cystectomy Transitional Cell Carcinoma Urethral Stricture Prostatic Urethra Bladder Preservation 
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Further Reading

  1. Milosevic MF, Gospodarowicz MK. The Urinary Bladder. In: Cox JD, Ang KK, editors. Radiation Oncology: Rationale, Technique, Results. 8th ed. St. Louis: Mosby; 2003. pp. 575-602.Google Scholar
  2. National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Bladder Cancer v.2.2008. Available at:
  3. Petrovich Z, Stein JP, Jozsef G, Formenti SC. Bladder. In: Perez CA, Brady LW, Halperin ED, editors. Principles and Practice of Radiation Oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 1412-1438.Google Scholar
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  6. Zelefsky MJ, Small EJ. Cancer of the Bladder. In Leibel SA, Phillips TL, editors. Textbook of Radiation Oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 939-957.Google Scholar

Copyright information

© Springer-Verlag New York 2010

Authors and Affiliations

  • William Foster
    • 1
  • Brian Lee
    • 2
  • Joycelyn L. Speight
    • 3
  1. 1.Radiation OncologyUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Radiation OncologySwedish HospitalSeattleUSA
  3. 3.Board Certified Radiation OncologistSan FranciscoUSA

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