What to Know About Bladder Cancer in Children

Pediatric bladder cancer is a disease in which malignant (cancer) cells form in the tissues of the bladder in children. Bladder cancer typically affects older people and is not common in children. It is very rare in the first 20 years of life, with an incidence of 0.1%–0.4%.

The bladder is a hollow, balloon-shaped organ in the lower pelvis with flexible, muscular walls. The bladder’s main job is to store urine, liquid waste made by the two kidneys. When you urinate, the muscles in the bladder tense, and urine is pushed out of the bladder through a tube called the urethra.

Bladder cancer starts when cells that make up the bladder start to grow out of control. As more cancer cells form, they can turn into a tumor. Read on to learn more about bladder cancer in children, including symptoms, treatment, and how it is diagnosed.

Ultrasound scanning performed by healthcare professional

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Genitourinary Cancers

Genitourinary cancers affect the reproductive and urinary systems. These cancers are rare in children—only about 10% of childhood cancers are genitourinary.

Cancer in the urinary system can affect a child’s:

  • Kidneys: Nearly 90% of children who have kidney cancer have Wilms tumor (also called nephroblastoma). There are about 500 to 600 new cases of Wilms tumor diagnosed in the United States annually.
  • Bladder: Bladder cancer in children is extremely rare. Published reviews and national cancer databases spanning up to 30 years can only find a small number of cases of bladder cancer in pediatric patients.

Symptoms of cancers affecting the urinary system include blood in the urine (hematuria), lower back pain (not caused by injury), and abdominal swelling.

Childhood cancer in the reproductive organs can include:

  • Ovaries: These female reproductive organs produce and release eggs. Ovarian malignancies (cancer in the ovaries) are uncommon in children, with an average of 2.6 cases per 100,000 girls per year. Abdominal pain is the most common symptom of ovarian tumors, followed by a noticeable abdominal or pelvic mass.
  • Testicles (testes): These male reproductive glands create and store sperm. Testicular tumors rarely happen in boys before puberty. The odds of a boy having a testicular tumor are about one in 100,000. Signs of a testicular tumor in children include a painless lump in the testicle and swelling of the testicle (with or without pain).

Symptoms

Bladder cancer may cause any of the following signs and symptoms:

  • Blood in the urine (slightly rusty to bright red in color)
  • Burning, pain, or discomfort when urinating
  • Having to urinate more frequently than usual during the daytime and/or at night
  • Having an urge to urinate even when the bladder is not full
  • Losing urine involuntarily (incontinence)

Check with your child’s doctor if your child has any of the above.

Many of these symptoms are more likely to be caused by something other than bladder cancer, such as a urinary tract infection, kidney stones, or an overactive bladder, but it’s important to have them checked out.

Causes

The causes of most childhood cancers are not known. Current data suggest that about 10% of all children with cancer have a predisposition because of genetic factors—that is, a genetic mutation that can be passed from parents to their children.

In adults, the causes of bladder cancer reflect the effects of aging and long-term exposure to cancer-causing substances such as cigarette smoke. However, figuring out what environmental causes are connected to childhood cancer has been difficult, partly because bladder cancer in children is rare. It is also difficult to determine what children might have been exposed to early in their life.

It is thought that the risk of bladder cancer is higher in children who have been treated for cancer with certain anticancer drugs, called alkylating agents, given for other childhood tumors or leukemia.

Diagnosis

A diagnosis of bladder cancer begins with a discussion between you, your child, and their doctor about the symptoms they have been experiencing. Tests that examine the bladder are used to help diagnose or rule out bladder cancer.

The following tests and procedures may be used:

Physical exam and health history: This exam of the body is used to check general signs of health, including checking for lumps or anything else that seems odd. A history of your child’s health and past illnesses and treatments will also be taken, and a urinalysis and urine culture are done to make sure symptoms are not from an infection, which is more common than bladder cancer.

Ultrasound exam: Ultrasounds can show the doctor if there has been a change (such as size or shape) in organs, tissues, or blood vessels, and may also show if there is an abnormal mass present, such as a tumor.

Cystoscopy: This procedure allows healthcare providers to look inside the bladder and urethra to check for abnormal areas. A cystoscope—a thin, tube-like instrument with a light and a lens for viewing—is inserted through the urethra into the bladder. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. Your child will be given general anesthesia to keep them asleep and pain-free during the procedure.

Differential Diagnosis

Before determining if a bladder tumor is present, your child’s doctor will rule out the following conditions, which have similar symptoms to bladder cancer:

Staging

The process used to find out if cancer has spread from the bladder to nearby areas or to other parts of the body is called staging. There is no standard system for staging childhood bladder cancer. The results of tests and procedures done to diagnose bladder cancer are used to help make decisions about treatment.

Treatment

In children, bladder cancer is usually low grade (not likely to spread) and the prognosis (likely course of the disease) is usually excellent after surgery to remove the tumor.

Treatment of bladder cancer in children generally includes a transurethral resection. During this procedure, a urologist places a rigid, thin instrument with a light and camera on it (resectoscope) through a person’s urethra into the bladder. The resectoscope contains a wire loop that allows the doctor to remove the tumor.

Treatment of recurrent bladder cancer in children may include participation in a clinical trial that checks a sample of the patient’s tumor for certain gene changes. The type of targeted therapy that will be given to the patient depends on the type of gene change.

Summary

Bladder cancer is very rare in children, but it can happen. The symptoms of bladder cancer are blood in the urine, a burning sensation while urinating, a frequent urge to urinate, and incontinence. Because these are also symptoms of other conditions, like a urinary tract infection, it is best to talk to your child’s doctor about getting them tested. The doctor will conduct a physical exam and take your child’s health history. They may also do an ultrasound exam and/or cystoscopy.

A Word From Verywell

Bladder cancer in children is incredibly rare, but also very amenable to treatment. If your child is experiencing blood in their urine, it’s likely to be from a benign source, but talk to your primary care physician who can order tests to rule out anything worse. This can also help you and your family have some peace of mind.

Frequently Asked Questions 

What’s the average age of a bladder cancer diagnosis?

Around 90% of people with bladder cancer are over the age of 55. The average age of bladder cancer diagnosis is 73.

Is bladder cancer in children treatable? 

Bladder cancer in children tends to be low grade, which means it is not likely to spread and is highly treatable. The most common problem with bladder tumors in children is that there are not any standardized follow-up protocols.

In adults, chemotherapy or immunotherapy are common after tumor resection, depending on the stage and grade. This remains under debate in children, mainly due to the rarity and the low malignant potential of bladder tumors in younger patients.

Can bladder cancer in children be misdiagnosed?

Due to the rarity of bladder cancer in children, there is a chance it could be misdiagnosed as a urinary tract infection, kidney stones, or an overactive bladder.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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