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A single type of cell in the lining of the bladder is responsible for most cases of deadly bladder cancer, according to a new research. 

The study is first to pinpoint the specific normal cell type that can give rise into invasive bladder cancers. The study also explains why many human bladder cancer recur after therapy. 

"We've learned that, at an intermediate stage during cancer progression, a single cancer stem cell and its progeny can quickly and completely replace the entire bladder lining," said Philip Beachy, PhD, professor of biochemistry and of developmental biology in the press release. "All of these cells have already taken several steps along the path to becoming an aggressive tumor. Thus, even when invasive carcinomas are successfully removed through surgery, this corrupted lining remains in place and has a high probability of progression."

The study noted that despite the cancer stem cells and the precancerous lesions formed in bladder lining universally expressed an important signaling protein called sonic hedgehog, the cells of subsequent harmful cancers invariably do not. Instead, a critical switch appears vital for invasion and metastasis. 

"This could be a game changer in terms of therapeutic and diagnostic approaches," said Michael Hsieh, MD, PhD, assistant professor of urology and a co-author of the study in the press release. "Until now, it's not been clear whether bladder cancers arise as the result of cancerous mutations in many cells in the bladder lining as the result of ongoing exposure to toxins excreted in the urine, or if it's due instead to a defect in one cell or cell type. If we can better understand how bladder cancers begin and progress, we may be able to target the cancer stem cell, or to find molecular markers to enable earlier diagnosis and disease monitoring."

The study has been published online in the journal Nature Cell Biology.