Full Glossary of Terms
Beyond the basics of bladder cancer
Until now, bladder cancer treatment options have been slow to progress. But the last few years have brought advances that can give us hope toward a potential future without bladder cancer.
Whether you are newly diagnosed, years into your journey, or somewhere in between, this section is dedicated to supporting you.
Bladder cancer is the 6th most common cancer in the United States. But there’s nothing common about having to face the challenges of NMIBC each day. Understanding the nuances of bladder cancer can help you take control of it. It starts with knowing your specific NMIBC risk level.
Slide the bladder left or right to view the NMIBC risk levels.
Low-risk
Intermediate-risk
High-risk
People with low-risk NMIBC have a recurrence rate of
50% within 4
years
People with intermediate-risk NMIBC have a 38% recurrence rate at 3 years and a 50% recurrence rate at 5 years
People with newly diagnosed high-risk NMIBC have a 60%-70% of recurrence and a 10%-45% chance of progression to muscle-invasive or metastatic bladder cancer within 5 years
Not an actual patient-physician interaction.
There are a few factors that doctors use to determine your risk level. These can include staging, which describes how far the tumor has grown, and grading, which shows how abnormal and aggressive the cancer cells are.
Early stage, low-grade tumors often signify lower risk disease, while higher-stage or higher-grade cancers can be high-risk.
Being aware of your risk level and understanding the significance of recurrence and progression rates can help you and your care team come up with the best treatment plan for your life and desired outcomes for treatment.
Not an actual patient-physician interaction.
Recognizing gaps in bladder cancer care can help you receive support, information, and the right treatment every step of the way
While bladder cancer can affect anyone, certain factors can determine differences in care and outcomes:
- Socioeconomic status–including income and education levels
- Location–not having access to specialists and an inability to easily commute to a urologist for treatment and follow-up care
- Race–some ethnic groups may experience less favorable bladder cancer outcomes than others
- Gender–while men are more likely to be diagnosed, women may have less favorable outcomes overall
While this information may seem overwhelming, it’s provided to empower you. Here are some questions you can ask your care team that may help bridge the gap in care:
- Are there programs that can help cover the cost of my treatments?
- Can I speak with a financial counselor about my expenses?
- If insurance doesn’t cover everything, what other options do I have?
- Is there a foundation or a network that can help me get to appointments? What are my options if I can’t drive myself to treatments?
- Does the clinic/hospital offer rides or vouchers for travel or parking?
As always, continue to trust your intuition and your body. If something doesn’t feel right, don’t hesitate to bring it up to your doctor or ask for a second opinion. And don’t forget to visit the Resources section of this site for more content and groups that can offer additional information and support.
See our resources
No matter where you live, your race, gender, or background, staying engaged, understanding the
challenges, and asking questions about potential barriers to your care can help you move forward with
confidence
Understanding how therapies are evaluated
When considering whether a treatment may be right for you, it’s important to understand the language and terms that explain how well a therapy might work, its effect on the body, and any potential associated side effects. Here are some terms your urologist may use when discussing your treatment plan:
- Complete response: the disappearance of all signs of cancer in response to treatment. This does not always mean the cancer has been cured. It’s also sometimes referred to as complete remission.
- Duration of response: how long from the start of the first response from a medicine to the time the medicine stops working, or disease progression can be observed.
- Efficacy: the ability of a medicine to produce the desired beneficial effect.
- No evidence of disease (NED): at present, no signs of disease have been found on any tests.
- Progression-free survival (PFS): the length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse. In a clinical trial, measuring the progression-free survival is one way to see how well a new treatment works.
While efficacy is a priority in treatment, a therapy’s effect on the body should also be considered:
- Safety: while tolerability is subjective, safety is objective: it measures the medical risk to the patient of the drug’s side effects.
- Tolerability: the degree to which a patient can endure the side effects of a treatment. It is a measure of how patients feel and function while on treatment, which will determine their ability and desire to stay on a treatment course.
Not an actual patient-physician interaction.
It’s important to think about these key considerations together as you work with your doctor to decide
on a treatment that may be right for you
Glossary of bladder cancer terms and phrases
Select a letter to view the associated glossary words below.
Bacille Calmette-Guérin (BCG) solution a
form of biological
therapy for non-muscle
invasive bladder cancer. A catheter is used to place the BCG solution into the
bladder. The solution contains live, weakened bacteria BCG that activate the
immune
system. The BCG solution used for bladder cancer is not the same thing as BCG
vaccine, a vaccine for tuberculosis.
Biopsy the removal of cells or tissues for
examination under a
microscope. When
only a sample of tissue is removed, the procedure is called an incisional biopsy
or core biopsy. When an entire tumor or lesion is removed, the procedure is
called an excisional biopsy. When a sample of tissue or fluid is removed with a
needle, the procedure is called a needle biopsy or fine-needle aspiration.
Bladder the organ that stores urine.
Bladder cancer cancer that forms in
tissues of the bladder (the
organ that stores urine). Most bladder cancers are transitional cell carcinomas
(cancer that begins in cells that normally make up the inner lining of the
bladder). Other types include squamous cell carcinoma (cancer that begins in
thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and
release mucus and other fluids). The cells that form squamous cell carcinoma and
adenocarcinoma develop in the inner lining of the bladder as a result of chronic
irritation and inflammation.
Carcinogen any substance that causes
cancer.
Carcinoma in situ cancer that involves
only the cells in which it
began and that has not spread to neighboring tissues.
Catheter a tube placed in the body to
drain and collect urine from
the bladder.
Chemotherapy treatment with anticancer
drugs.
Clinical trial a research study that tests
how well new medical
treatments or other interventions work in people. Each study is designed to test
new methods of screening, prevention, diagnosis, or treatment of a disease.
Comorbidity the condition of having 2 or
more diseases at the same
time.
Complete response the disappearance of all
signs of cancer in
response to treatment. This does not always mean the cancer has been cured. Also
called complete remission.
Cystectomy surgery to remove all or part
of the bladder.
Cystoscope a thin, lighted instrument used
to look inside the
bladder and remove tissue samples or small tumors.
Cystoscopy examination of the bladder and
urethra using a thin,
lighted instrument (called a cytoscope) inserted into the urethra. Tissue
samples can be removed and examined under a microscope to determine whether
disease is present.
Duration of response the length of time
from the patient’s first
medication response to the time disease progression can be observed (meaning the
medication is no longer working).
Dysuria another word for painful
urination, defined as feeling
trouble or burning while passing urine. This is often felt in the tube that
carries urine out of the bladder or around the genitals. In women, it’s often
caused by urinary tract infections. In men, it’s often caused by urethritis and
prostate problems.
Efficacy the ability of a medicine to
produce the desired
beneficial effect.
Grade the grade of a tumor depends on how
abnormal the cancer
cells look under a microscope and how quickly the tumor is likely to grow and
spread. Grading systems are different for each type of cancer.
Hematuria blood in the urine. Hematuria is
either gross, meaning
that the blood can be seen with the naked eye, or microscopic, meaning that
blood can only be detected in the urine when examined under a microscope.
Imaging tests that produce pictures of
areas inside the body.
Immune system the complex group of organs
and cells that defends
the body against infection or disease.
Immunotherapy treatment that uses your
body’s own immune system to
help fight cancer, infection, and other diseases.
Intravesical therapy treatment that is
placed directly into the
bladder.
Invasive bladder cancer a bladder cancer
that invades the
structures that lie beneath the lining cells. These tumors have
characteristically bad biological behavior and are capable of spreading to other
parts of the body without much warning. Accordingly, physicians are constantly
on the lookout for evidence of disease spread in patients with invasive bladder
carcinomas. Invasive cancers are less common than superficial ones, but they
unfortunately spread to other parts of the body in about half of the patients
who have this invasive disease.
Local recurrence cancer that has come back
in the same place it
first started.
Local therapy treatment that is directed
to a specific organ or
limited area of the body.
Macrohematuria blood that can be seen in
the urine.
Metastasis the spread of cancer from one
part of the body to
another. Tumors formed from cells that have spread are called “secondary tumors”
and contain cells that are like those in the original (primary) tumor. The
plural is metastases.
Metastasize to spread from one part of the
body to another. When
cancer cells metastasize and form secondary tumors, the cells in the metastatic
tumor are like those in the original (primary) tumor.
Metastatic bladder cancer cancer that
starts in the bladder and
has spread to another part of the body.
Microhematuria blood in the urine that
can’t be seen with the
naked eye but can be detected when the urine is viewed under a microscope.
Muscle-invasive bladder cancer
(MIBC)
cancer that has spread
through the lining of the bladder and into the muscle wall of the bladder or
beyond it.
Monotherapy treatment of a disorder with a
single drug.
No evidence of disease (NED) at present,
no signs of disease have
been found on any test results.
Non-muscle invasive bladder cancer
(NMIBC)
cancer which is
confined to the bladder wall.
Oncology the area of medical
specialization that deals with the
treatment of cancer.
Oncolytic immunotherapy a virus designed
to selectively replicate
in and break down cancer cells while simultaneously amplifying the immune
response against bladder tumors.
Papillary tumor a tumor that looks like
long, thin “finger-like”
growths. These tumors grow from tissue that lines the inside of an organ.
Papillary tumors may be benign (not cancer) or malignant (cancer). Papillary
tumors occur most often in the bladder, thyroid, and breast, but they may occur
in other parts of the body as well.
Phase I trial Phase I studies of a new
drug are usually the first
that involve people. Phase I studies are done to find the highest dose of the
new treatment that can be given safely without causing severe side effects.
Phase II trial if a new treatment is found
to be safe in Phase I
clinical trials, a Phase II clinical trial is done to see if it works in certain
types of cancer. Usually in a Phase II clinical trial, everyone gets the same
dose. Placebos (inactive treatments) are not used in Phase II trials.
Phase III trial Phase III clinical trials
compare the safety and
effectiveness of the new treatment against the current standard treatment.
Phase IV trial drugs approved by the FDA
are often watched over a
long period of time in Phase IV studies. This is often the safest type of
clinical trial because the treatment has already been studied a lot and has
likely been given to many people. Phase IV studies look at safety over time.
Prognosis the likely outcome or course of
a disease; the chance of
recovery or recurrence.
Progression-free survival (PFS) the length
of time during and
after the treatment of a disease, such as cancer, that a patient lives with the
disease but it does not get worse.
Quality of life the overall enjoyment of
life. Many clinical
trials measure aspects of an individual’s sense of well-being and ability to
perform various tasks to assess the effects of cancer and its treatment on the
quality of life.
Radical cystectomy surgery to remove the
bladder as well as nearby
tissues and organs.
Recur/Recurrence to occur again.
Recurrence is the return of
cancer, at the same site as the original (primary) tumor or in another location,
after the tumor had disappeared.
Risk factor a habit, trait, condition, or
genetic alteration that
increases a person’s chance of developing a disease.
Safety an objective measure of the medical
risk to the patient.
Side effects problems that occur when
treatment affects healthy
cells. Common side effects of cancer treatment are fatigue, nausea, vomiting,
decreased blood cell counts, hair loss, and mouth sores.
Staging performing exams and tests to
learn the extent of the
cancer within the body, especially whether the disease has spread from the
original site to other parts in the body.
Symptom an indication that a person may
have a condition or
disease. Some examples of symptoms are headache, fever, fatigue, nausea,
vomiting, and/or pain.
Systemic therapy treatment that travels
through the blood,
reaching and affecting cells throughout the body.
T1 the cancer has grown into the layer of
connective tissue under
the lining layer of the bladder, but it has not reached the layer of muscle in
the bladder wall.
Ta
the cancer is a non-invasive papillary
carcinoma, which grows
in like a mushroom on a stalk from the inner wall of the bladder toward the
hollow center.
Tolerability the degree to which a patient
can endure the side
effects of a treatment. It is a measure of how patients feel and function while
on treatment, which will determine their ability and desire to stay on a
treatment course.
Transurethral resection (TURBT) surgery
performed with a special
instrument inserted through the urethra.
Tumor an abnormal mass of tissue that
results from excessive cell
division. Tumors perform no useful body function. They may be benign (not
cancerous) or malignant (cancerous).
Ureter the tube that carries urine from
the kidney to the bladder.
Urethra the tube through which urine
leaves the body. It empties
urine from the bladder.
Urine fluid containing water and waste
products. Urine is made by
the kidneys, stored in the bladder, and leaves the body through the urethra.
Urologic oncologist a doctor who
specializes in treating cancers
of the urinary system.
Urologist a doctor who specializes in
diseases of the urinary
organs in females and the urinary and reproductive organs in males.
Urology the area of medical specialization
that deals with the
urinary tract, bladder cancer diagnosis, and bladder cancer treatment.
Urothelial carcinoma previously called
transitional cell
carcinoma, occurs in the cells that line the inside of the bladder. Urothelial
cells expand when your bladder is full and contract when your bladder is empty.
These same cells line the inside of the ureters and the urethra, and cancers can
form in those places as well. Urothelial carcinoma is the most common type of
bladder cancer in the United States.
Urinalysis a urinalysis is a test of your
urine. It’s used to
detect and manage a wide range of disorders, such as urinary tract infections,
kidney disease, and diabetes. It involves checking the appearance,
concentration, and content of urine.
Urinary tract the organs that make urine
and remove it from the
body. The urinary tract is divided into 2 parts: 1) the upper urinary tract,
which includes the kidneys and ureters, and 2) the lower urinary tract, which
includes the bladder and urethra. The kidneys remove waste and extra fluid from
the blood to make urine. The urine flows from the kidneys through the ureters to
the bladder. It is stored in the bladder until it leaves the body through the
urethra. Also called urinary system.
Urothelium the lining of the urinary
tract, including the renal
pelvis, ureters, bladder, and urethra.
Video Resources
Bladder Cancer Advocacy Network: Driven by and for patients
-Sima Porten
BCAN Patient Resources
-Sima Porten
Support & Advocacy
