Bladder cancer risks, treatment, and medical malpractice

In my practice as a Houston, Texas medical malpractice attorney, I have represented a number of clients who missed an opportunity for prompt cancer treatment because of misdiagnosis.

Bladder cancer is the sixth most common type of cancer in the United States, with around 68,000 diagnoses every year.

Signs and symptoms of bladder cancer

The classic symptom for bladder cancer is blood in the urine, which is also called hematuria. As laypeople, we can spot potential blood in the urine by an appearance that is bright red or cola colored. Other symptoms include painful urination and pelvic pain.

Of course, all of the symptoms can be present as a result of other conditions, but it is important to see a doctor any time you notice blood in your urine. The standard of care then requires the physician to go through a differential diagnosis process to verify hematuria and then rule out all potential causes of it, including bladder cancer.

Who is at risk for bladder cancer?

Of course, bladder cancer can develop in anyone, but it occurs more frequently in men than women and in older adults.

In addition, experts recommend bladder cancer test for people who have a very high risk, including people who previously had bladder cancer, had birth defects of the bladder, and who have been exposed to certain chemicals.


According to the American Cancer Society, the five-year survival rate is about 70%, the 10-year survival rate is about 70%, and the 15-year survival rate is about 65%.

Fortunately, about 70% of bladder cancer cases are diagnosed at an early stage, when it is highly treatable. Even better, the five-year survival rate for patients with Stage 0 bladder cancer is about 98%, with Stage I is about 88%, Stage II is about 63%, and Stage III is about 46%.

As you probably surmised, for bladder cancer, as with other cancers, the higher the staging number, the more serious and advanced the cancer. This is shown by the five-year survival rate of 15% for Stage IV bladder cancer, which has spread to other parts of the body, and is difficult to treat.

Treatment options

The American Cancer Society describes five different treatment options for bladder cancer, depending on the stage. They include surgery, and intravesicle therapy, chemotherapy, radiation therapy, and immunotherapy.

Treatment of bladder cancer is often multidisciplinary, with physicians from various fields, including urology, radiation oncology, and medical oncology, being involved. Early, non-invasive bladder cancer is often treated endoscopically by surgically removing the cancerous tissue piece by piece through the urethra. For more aggressive tumors, a combination of surgery, radiation, and chemotherapy are often used. For more advanced bladder cancer, until recently, open surgery has been the only option, but now some surgeons have begun to use robotic bladder surgery.

Quality of care concerns

When doctors, physician assistants, and nurse practitioners rush through their evaluations or visits with patients, they can make an incorrect diagnosis. Sometimes busy healthcare providers skip important steps in the differential diagnosis process and instead settle on more common diagnoses, like a urinary tract infection or post-menopausal bleeding.

The standard of care requires healthcare providers to do a complete workup on patients who have blood in their urine, either visible to the naked eye (gross) or under a microscope. This is important because patients with bladder cancer may have blood in the urine for a short period of time, which resolves on its own. This can mislead doctors into thinking that it was caused by something insignificant.

Diagnostic tests for a full workup include a urine cytology test, as well as tests for one of several bladder cancer markers. These tests are extremely sensitive in detecting carcinoma in situ (CIS, or bladder cancer). Experts consider this to be the gold standard because relying on a visual, or even microscopic, assessment of the affected area can be inconclusive.

We are here to help

It is frightening to think that a responsible patient could go to the doctor quickly for evaluation, but because of medical malpractice a cancer diagnosis gets missed and the treatment window is lost. If you or someone you care for has been seriously injured as a result of cancer or other misdiagnosis and treatment, call Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.


Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical malpractice and wrongful death lawsuits against hospitals, doctors, surgeons, pharmacies, and other healthcare providers. He frequently speaks and writes about healthcare and medical negligence topics. He is a former editor-in-chief of The Houston Lawyer magazine and is a current member of the editorial board of the Texas Bar Journal.

Robert Painter
Article by

Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.