One of the more common cancers, and one hardly anyone talks about. It can also appear anywhere the urinary tract is lined.
How it usually presents
Blood in the urine, often painless and often intermittent. Because it comes and goes, people frequently wait for it to happen again before mentioning it, and that delay costs time.
Irritative symptoms such as urgency and frequency without infection can also be a sign.
It is not only the bladder
The bladder is lined with urothelium, and so are the renal pelvis, the ureters and part of the urethra. The same cancer, urothelial carcinoma, historically called transitional cell carcinoma, can arise anywhere along that lining.
Upper tract urothelial carcinoma means disease in the renal pelvis or ureter. It is less common than bladder cancer but behaves similarly and is found the same way, usually through blood in the urine.
Urethral involvement is less common again but matters, particularly in men who have had bladder cancer.
This is why surveillance after a bladder cancer diagnosis is not limited to the bladder. Periodic imaging of the kidneys and ureters is part of it, because a tumor upstream would be missed by cystoscopy alone. If you have had bladder cancer and nobody has imaged your upper tracts, that is worth asking about.
Risk factors
Smoking is by far the largest, and it accounts for a substantial share of cases. Occupational exposure to certain chemicals, particularly in dye, rubber, leather and painting trades, matters. Risk rises with age, and it is more common in men.
Stopping smoking reduces future risk, which is worth saying to anyone already diagnosed.
Diagnosis and treatment
Cystoscopy is how it is found. Most bladder cancers are non muscle invasive at diagnosis, meaning they are confined to the inner lining, and those are typically removed under anesthetic, through the urethra without an incision.
Because non muscle invasive disease recurs frequently, surveillance cystoscopy on a schedule is part of care, sometimes with medication instilled into the bladder to reduce recurrence.
Muscle invasive disease is a different situation and is treated more aggressively.
The point
Blood in the urine that gets ignored is the single most common reason this is found late. It is usually a treatable cancer when caught early.