Bladder cancer

Condition

Bladder cancer arises from cells that line the bladder, and is one of the most common conditions treated by urologists.

Bladder cancer can vary from a small, non-aggressive growths on the surface of the bladder lining to an aggressive, invasive tumour, which invades through all the layers of the bladder, into the bladder muscle and sometimes beyond. Bladder cancer that has invaded into the muscle wall of the bladder is very serious and is most commonly treated by the removal of the bladder completely. Fortunately this aggressive form is not a common presentation, accounting for about 15% of first time cases.

Bladder cancer occurs most commonly in people between 50 and 70 years of age, and the most common symptom of bladder cancer is blood in the urine (haematuria). You may also have similar symptoms to having a urine infection, for example pain when you pass urine and the urge to pass urine more frequently.

Treatment

Treatment of bladder cancer involves removing the tumour with a urological endoscope via the urethra. This is done carefully as the bladder is very thin. The pieces of tissue are sent to the lab for analysis. This tells the surgeon what kind of tumour and how aggressive it is, and whether any further treatment is necessary.

Bladder cancer is characterised by its recurrent nature. This means that patients who have had one tumour are at high risk of getting another, even many years after the first episode. For this reason, patients are advised to get regular surveillance of the bladder, called check cystoscopies ("cysto" = bladder, "scope" = to look). This is initially done every 3 months for the first year, then less frequently, but at least annually in most cases. 

Some types of bladder cancer require extra treatment with chemicals that are placed inside the bladder. These can be a form of mild chemotherapy that remains in the bladder only, or a form of bladder immune therapy. These therapies can reduce the frequency of recurrence of bladder tumours, and delay progression to more aggressive forms. However they do not work for every patient and surveillance is still needed with regular checkups.