If you or someone in your family has been diagnosed with bladder cancer, it’s natural to wonder if it runs in families. Could your children be at risk? What if your parent or sibling was just diagnosed? Does this mean you might get it, too?

In this article, we’ll discuss how bladder cancer can sometimes be passed down through families. We’ll explain how certain inherited genes can raise the risk of bladder cancer and some other cancers. We’ll also dive into outside factors — like chemicals and lifestyle choices — that strongly affect your risk. To learn more about your risk of this cancer, talk to your doctor or bladder cancer specialist.

The Role of Genetics in Bladder Cancer Risk

Your genes help decide your height, hair color, and your chance of getting certain diseases. Some mutations (gene changes) are passed down from your parents, while others happen during your lifetime. These mutations affect how your cells work, grow, and divide. Some mutations in bladder cells cause them to grow uncontrollably, which can lead to cancer.

According to the American Cancer Society (ACS), most people with bladder cancer have mutations that developed during their lives. They often develop from environmental exposure to certain chemicals or even treatments for previous cancers. Some people randomly get mutations without any known cause.

You can also inherit cancer-causing genes from your parents. Research studies have shown that people with close relatives who have bladder cancer are at a higher risk of this type of cancer themselves. But it’s not common for bladder cancer to run in families.

If you have a parent or sibling with bladder cancer, your risk nearly doubles compared to those without a family history. In a 2023 study, the authors found that having a first-degree relative with a history of certain other cancers raises the risk of bladder cancer. Examples include the skin cancer melanoma, female genital cancer, and tobacco-associated cancers, according to the International Journal of Cancer.

Genetic Mutations Associated With Bladder Cancer

Bladder cancer develops in people with gene mutations that affect their bladder cells. There are a few ways you can inherit or acquire these changes.

Genetic Cancer Syndromes and Bladder Cancer Risk

In most cases, bladder cancer isn’t hereditary. However, some genetic syndromes raise the risk of bladder cancer in certain families. People with these syndromes have specific gene changes associated with certain types of cancer.

For example, if you have Lynch syndrome — an inherited condition that affects how your body repairs damaged DNA — you’re more likely to develop endometrial and colon cancer. This is because the condition affects genes involved in repairing broken DNA. More mutations build up in your cells over time and eventually lead to cancer. The ACS notes that Lynch syndrome may also raise your risk of bladder cancer and other urinary tract cancers.

Cowden syndrome is a rare inherited condition that increases the risk of several types of cancer.

People with Cowden syndrome have changes in the PTEN gene. This gene is known as a tumor suppressor, meaning it stops cells from growing and dividing uncontrollably. Problems with the PTEN gene are associated with bladder cancer risk. Cowden syndrome can lead to thyroid and breast cancer as well.

The RB1 (retinoblastoma) tumor suppressor gene also controls cell growth and division. Mutations in the RB1 gene usually lead to a rare type of eye cancer called retinoblastoma. Mutations in this gene are also seen in some cases of bladder cancer.

Many genetic syndromes are inherited in very specific ways. For example, Lynch syndrome is an autosomal dominant disorder. This means if one parent has the syndrome, there is a 50 percent chance they will pass it on to their children.

It’s not clear whether bladder cancer tends to run in families if you have other types of cancer. However, some studies have found family links between bladder cancer and cancers of the blood, prostate, kidney, thyroid, stomach, lungs, cervix, uterus (endometrium), and brain.

Acquired Genetic Mutations Associated With Bladder Cancer

Acquired mutations are commonly found in bladder cancer. These gene changes develop during your lifetime in your bladder cells. The mutations usually affect genes that control cell growth and gene activity. When your cells grow too quickly, they eventually form tumors.

Examples of acquired gene mutations seen in bladder cancer include:

• TP53 — This gene is a tumor suppressor that helps repair damaged DNA to prevent more mutations and stop damaged DNA cells from dividing. When TP53 is not working properly, it can lead to Li-Fraumeni syndrome, a condition that increases the risk of several early-onset cancers.
• Fibroblast growth factor receptor 3 (FGFR3) — This receptor encodes a protein that sends growth signals inside cells, telling them to grow and divide. Changes in the FGFR3 gene have been found in some cases of bladder cancer.
• KDM6A — This gene provides instructions for making a protein that controls chromosome shape and gene activity. KDM6A is often mutated in several types of cancer, especially urothelial cancer.
• PIK3CA — This gene produces a protein that activates growth signals in cells. Mutations in PIK3CA can make the PI3K enzyme overactive, which may cause cancer cells to grow. These mutations have been found in many types of cancer.

Environmental Factors Linked to Bladder Cancer

Although genetics can play a role in your bladder cancer risk, environmental factors are much more likely to contribute. Examples include exposure to chemicals that cause cancer and previous cancer treatment.

Cigarette Smoking

Cigarette smoking is a major risk factor for bladder cancer. The ACS explains that smoking is responsible for about 50 percent of bladder cancer cases. Tobacco smoke contains hundreds of cancer-causing chemicals called carcinogens. The body processes these chemicals in the kidneys. They filter into the urine, where they can affect bladder cells.

Occupational Exposure to Chemicals

If you work in an industry with high exposure to harmful chemicals, you’re at risk of developing bladder cancer. Jobs with a higher risk of exposure to bladder cancer-linked chemicals include:

• Truck drivers who regularly breathe in diesel fumes
• Hairdressers who handle chemicals found in hair dyes
• Workers in leather, textile, rubber, and paint manufacturing who are exposed to industrial chemicals
• Firefighters who may breathe in harmful chemicals from smoke, burning materials, and firefighting foam

Using Certain Cancer Treatments

Many cancer treatments work by harming cancer cells beyond repair. Chemotherapy drugs stop cells from growing and dividing by damaging DNA. However, these medications can also raise the risk of other cancers. If you take the chemotherapy drug cyclophosphamide for a long time, it can irritate your bladder. This may eventually lead to bladder cancer.

Radiation therapy may also lead to an increased risk of bladder cancer. The treatment technique uses concentrated beams of radiation to target and destroy tumors. Radiation therapy for cancers in the pelvis raises the risk of bladder cancer as well.

Drinking Contaminated Water

Drinking water contaminated with arsenic contributes to your bladder cancer risk. Most Americans getting their water from public systems don’t need to worry. However, people who get their drinking water from wells in certain parts of the country are at a higher risk of arsenic exposure.

Medications and Supplements

The ACS notes that some medications and herbal supplements may raise the risk of bladder cancer. For example:

• The diabetes drug pioglitazone may be linked to higher bladder cancer risk.
• Herbal products with aristolochic acid have been linked to bladder and urinary tract cancers.

Always check with your doctor before starting new medications or supplements.

Talk To Your Doctor About Your Bladder Cancer Risk

If you’re concerned about how the risk of bladder cancer may affect your family, talk to your doctor. They can help explain your risk based on specific factors. For example, you or your relatives may get genetic testing to look for cancer syndromes or other gene changes. Your doctor can also assess other risks, like chemical exposure.

Remember, people inherit certain genes associated with cancer, but not the disease itself. Even if you do have high-risk genetic changes linked to bladder cancer, it doesn’t mean you’re guaranteed to develop it. Understanding your risk will help you make healthier choices to lower your chances of cancer. Your doctor can make recommendations for quitting smoking and reducing your exposure to other chemicals.

Find Your Team

On MyBladderCancerTeam, the social network for people with bladder cancer and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with bladder cancer.

Are you or a family member living with bladder cancer? Do you have any hereditary risk factors? Share your experience in the comments below, or start a conversation by posting on your Activities page.