Bladder Cancer

Bladder cancer usually arises from the inner lining of the bladder (the urothelium). It occurs more commonly in older males and smokers. Certain occupations such as painters are at more risk of developing bladder cancer.

What are the symptoms ?

Bladder cancers tend to bleed so the first indication of bladder cancer is usually the appearance of  blood in the urine. Sometimes more frequent or painful urination can be an early symptom of bladder cancer.

What is the treatment?

The first step will be to inspect the bladder with a small telescope. This can be done in the office under local anaesthetic. If a tumour is seen then a subsequent procedure to remove the tumour will be performed under a general anaesthetic. This is called a transurethral resection of bladder tumour (TURBT). A telescope is inserted along the urethra and into the bladder. The surgeon then carefully scrapes away the tumour using an electrocautery device. 

Will further treatment be required?

The pathologist will inspect the removed tumour and advise the surgeon about how aggressive the tumour is. Most bladder cancers can be adequately dealt with by a TURBT however some aggressive tumours may require a further course of medication delivered by catheter int the bladder (BCG therapy). If the cancer is deeply invading the bladder wall then a more aggressive approach may be indicated. This may entail major surgery to remove the entire bladder (cystectomy) and  replace it with either a neobladder or ileal conduit. Chemotherapy is often also given in this situation. Radiotherapy to the bladder is sometimes given instead of cystectomy. This approach is used in patients who may not be fit enough for bladder removal.