Doctors are now using a diagnostic tool to better find and eliminate this type of cancer.
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Liz Lytle of Upper Pottsgrove, Pa., thought she was having urinary tract infections. After several doctors, tests and medications, she got surprising news.
"It showed a tumor in my bladder," says Lytle.
Although other doctors didn't think it was cancerous, Lytle sought another opinion from Dr. Rosalia Viterbo, an oncologic surgeon at Fox Chase Cancer Center.
Because of her symptoms, Dr. Viterbo recommended a test with Cysview, a diagnostic dye.
Cysview goes into the bladder to show malignant cells the eye can't see.
"It collects in cancer cells, bladder cancer cells, and then when we look in the bladder with blue light," says Dr. Viterbo. "They glow bright pink," she continues.
Hidden cancers becomes very obvious.
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"There's this little sliver of tissue that has cancer in it, that's still there. You would have missed it with conventional lighting," Dr. Viterbo explains.
"Our goal is not only to see these lesions, but then to completely remove them," she adds.
Every year, there are about 81,000 new cases of bladder cancer in the U.S.
Lytle never smoked - one of the top risk factors for bladder cancer.
However, the environment can also be a factor.
"The water, drinking water, arsenic and water, or just heavy metals in your drinking water can increase your risk," says Dr. Viterbo.
On-the-job chemical exposures are also factors.
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Dr. Viterbo says Cysview isn't for every patient
It's designed for cancer that hasn't invaded the bladder muscle.
But it was the right course for Lytle.
"We wanted to reassure her that there were no other lesions," said Dr. Viterbo.
"I'm feeling really good, and I think my prognosis is good," Lytle says.
Cysview was first FDA approved in 2011, and received expanded approval for both rigid and flexible blue light cystoscopy in 2018.