Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.


Bladder cancer happens when abnormal (cancerous) cells grow in the bladder. The bladder is a hollow organ in your abdomen shaped like a balloon. It stores and releases urine.

A cancerous growth (tumor) can:

  • Damage healthy bladder tissue.
  • Spread to other parts of the body if not caught early. 

We know it’s scary to be diagnosed with cancer. However, early bladder cancer can often be successfully treated. It’s important to recognize the symptoms early on.

Treatment depends on the stage of bladder cancer. You may have one or more of the following:

  • Surgery
  • Chemotherapy
  • Radiation
  • Medications that trigger your immune system to attack cancer cells (immunotherapy), either in the bladder or throughout your body
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The diagnosis depends on the type of cell we find where the cancer starts. There are 3 types of bladder cancer.

Urothelial carcinoma (transitional cell carcinoma) begins in the cells that line the bladder or ureter. This is the most common type in the United States. 

Squamous cell carcinoma begins in thin, flat squamous cells. These cells look similar to the flat cells found on the surface of the skin.

Adenocarcinoma begins in glandular cells that produce substances, such as mucus.

Bladder cancer may:

  • Develop only in the superficial (shallow) lining of the bladder (called noninvasive).
  • Break through the superficial lining and grow into the muscle layer of the bladder wall (called invasive).


It’s important to know the possible signs of bladder cancer so we can evaluate your symptoms early on.

The most common sign of bladder cancer is blood in the urine. The urine may appear rusty or dark red. 

Other symptoms may include:

  • Pain during urination
  • Frequent or urgent urination
  • An urge to urinate but not being able to
  • Low back pain

These symptoms are more often caused by other conditions, such as urinary tract infections or kidney stones.

Risk Factors

The risk of bladder cancer:

  • Increases with age.
  • Is more common in men.  

Other risk factors include:

  • Smoking
  • Exposure to chemicals, such as those used in rubber, textile, leather, dye, paint, and print industries
  • Family history
  • Certain cancer treatments, such as the chemotherapy drug cyclophosphamide and radiation therapy to the pelvis or abdomen

Just because you have one or more risk factors doesn’t mean you’ll get bladder cancer. Some people with no risk factors develop this cancer.

To lower your risk:

  • Follow good work safety practices to avoid chemical exposure.
  • Talk with us about ways to quit smoking.


To diagnose bladder cancer, we:

  • Ask about your medical history.
  • Perform a physical exam. 

We may order additional tests, such as:

  • Urine tests to look for blood and cancer cells.
  • Cystoscopy to examine the lining of the bladder and urethra. We insert a thin tube with a camera (cystoscopy) through the urethra. We may remove abnormal tissue samples to test for cancer.
  • Imaging scans (such as CT scan and ultrasound) to look for tumors in the bladder, kidneys, ureters, and urethra.


Staging is a process used to determine the severity of the cancer and how far it has spread. Your treatment is based on the stage of your cancer.

Early stage means the cancer is only in the bladder.

The cancer can also spread to:

  • Lymph nodes
  • Nearby organs, such as the prostate or uterus

Stage IV means the cancer has spread directly to the wall of the abdomen or traveled (metastasized) to distant parts of the body.

A number of tests can help determine how far the cancer has spread.

  • CT or MRI scans of the abdomen and pelvis can detect cancer in lymph nodes near the bladder and surrounding organs, such as the uterus, vagina, or prostate.
  • A chest X-ray or CT scan of the chest can show cancer that has spread to the lungs.


Once tests help us determine the extent of the cancer, we’ll talk about your treatment options. Together, we’ll develop a plan that is right for you.

Common treatments include surgery, chemotherapy, and radiation therapy.

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Follow-up Care

After you finish treatment, we’ll work with you to develop a plan for follow-up care. We’ll want to:

  • Watch for signs the cancer is coming back (recurrence).
  • Help you cope with possible long-term effects of treatment, such as living with a new bladder.

To check for cancer recurrence, we:

  • Regularly use some of the same tests we used to diagnose your cancer, such as urine tests and cystoscopy.
  • Typically test you every 3 to 6 months for several years. After this, you’re tested once each year.
  • Might order CT scans or other imaging tests, depending on the extent of your cancer.

Side effects usually go away once treatment ends. However, some may last for months or even years after treatment. 

Dealing with possible sexual problems and urine leakage (incontinence) may be particularly challenging. You can learn how to manage these symptoms as an important part of your recovery. We’ll talk together about any problems or concerns you have. 

Your survivorship plan includes:

  • Attending all of your follow-up appointments.
  • Eating a healthy diet.
  • Avoiding smoking or other tobacco use.
  • Getting regular physical activity.
  • Finding support to help you cope with life after cancer.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.