What Vinod Khanna's Story Can Help Us Understand About Bladder Cancer

What was announced

Vinod Khanna died on 27 April 2017 at the age of 70. He was a leading Bollywood actor of the 1970s and later a member of India's parliament.

CNN reported the cause from a hospital statement: Tushar Pania of the HN Reliance Foundation and Research Centre in Mumbai said Khanna died of advanced bladder cancer.

That is the record. His stage, his treatments and his decisions were his own and were not made public, so this page says nothing about them. What is worth saying is what "advanced bladder cancer" describes, because bladder cancer gets far less public attention than its numbers deserve.

A cancer that starts in the lining

The urinary tract runs from the kidneys, down the ureters, into the bladder, and out through the urethra. NCI's clinical summary notes that this whole path is lined with the same tissue, called urothelium.

More than 90% of bladder cancers begin in that lining. They are called urothelial carcinomas, or transitional cell carcinomas. About 2% to 7% are squamous cell carcinomas and about 2% are adenocarcinomas.

Because the lining is continuous, these tumors are often multifocal — more than one spot at once. NCI says that when a tumor is found, the entire urothelium has to be checked, not just the bladder.

The two divisions that decide everything

Doctors sort bladder cancer twice, and both sorts matter more than the word "cancer" on its own.

The first is grade. NCI states that people rarely die of low-grade bladder cancer. High-grade disease recurs in the bladder, tends to invade, and accounts for almost all bladder cancer deaths.

The second is depth. Deep in the bladder wall is a thick muscle called the muscularis propria, or detrusor. If the tumor has not reached it, the disease is non-muscle-invasive. If it has, it is muscle-invasive.

Non-muscle-invasive disease is the more common situation, and it is usually managed through the urethra without any outside incision. Muscle-invasive disease is far more likely to spread, and is treated much more aggressively.

When to get checked

There is one symptom that matters more than the rest.

NCI says bladder cancer typically shows up as hematuria — blood in the urine. It may be visible, turning the urine pink, red or cola-colored, or it may be found only on a urine test.

Visible blood in the urine, even once, even painless, even if it clears up by itself, is a reason to book an appointment. It is very often something else: an infection, a stone, an enlarged prostate. Sorting that out is a short, ordinary piece of medicine, and it is the single most useful thing on this page.

Less commonly, NCI notes, people report needing to urinate often, waking at night to urinate, or pain on urinating. Those symptoms are more typical of carcinoma in situ, a flat high-grade cancer confined to the lining.

One practical point about the workup. NCI is explicit that CT scans and ultrasound are not sensitive enough to rule bladder cancer out. The useful test is cystoscopy, in which a thin camera is passed into the bladder in a urology clinic. If someone tells you a scan was clear but the bleeding continues, that is a fair thing to raise. Our page on cancer diagnosis walks through how these steps fit together.

What treatment involves

For non-muscle-invasive disease, NCI describes transurethral resection of the tumor, followed by a single immediate dose of chemotherapy put straight into the bladder. In the United States that drug is usually mitomycin.

What comes next depends on risk. Low-risk tumors may simply be watched. Tumors at intermediate or high risk of becoming muscle-invasive are usually given at least a year of BCG — bacillus Calmette-Guérin, a live weakened bacterium, instilled into the bladder to provoke an immune response against the tumor. Some tumors get more chemotherapy into the bladder instead.

For muscle-invasive disease treated with the aim of cure, NCI lists two standard routes: cisplatin-based chemotherapy first, then removal of the bladder with a new way to drain urine; or radiation given together with chemotherapy.

What raises the risk

NCI names cigarette smoking as the most common risk factor for bladder cancer in the United States. It estimates that smoking causes up to half of all bladder cancers, and raises risk two to four times.

Other links NCI lists include certain workplace chemical exposures, the chemotherapy drug cyclophosphamide, arsenic in drinking water, long-running urinary infections, and infection with the parasite Schistosoma haematobium, which is tied to squamous cell bladder cancers. Cancer risk factors covers how to read a list like this one without over-reading it.

The numbers, and their limits

SEER, the federal cancer surveillance program, publishes American Cancer Society projections of about 84,530 new bladder cancer diagnoses and 17,870 deaths in the United States in 2026. The median age at diagnosis is 73.

Among people diagnosed from 2016 through 2022, five-year relative survival is 98.0% for cancer still in situ, 73.0% when localized, 41.8% once it has reached nearby lymph nodes, and 9.6% once it has spread to distant sites. Across all stages it is 79.1%. Half of cases are found in situ.

Those are averages across tens of thousands of people diagnosed years ago. They describe a group, not a person, and they cannot be applied to any individual — including anyone reading this.

What this does not mean

Khanna was 70, and no public detail explains why his cancer was advanced when it became known. Nothing about his case predicts anyone else's.

"Advanced" in a hospital statement is not a stage. It is a plain-language word, and it does not tell us where the disease had spread or what had been tried.

And the survival figures above lag current care by years. A person diagnosed today, at a different depth and grade, is not the group in that table.

Sources

• CNN: Bollywood's 'original heartthrob' Vinod Khanna dies at 70
• NCI PDQ: Bladder Cancer Treatment (Health Professional Version)
• NCI SEER Cancer Stat Facts: Bladder Cancer

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

Cancer Explained is published by the National Cancer Information Foundation. It is not medical advice and does not suggest a test or treatment.

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