BladDer Cancer

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Most bladder cancers arise from urothelial cells that make up the inner lining of the bladder. Bladder cancers may cause bleeding in the urine, which may be visible or only detected under the microscope. Other symptoms include urinary irritation, such as urgency or burning sensation with urination. 

Who is at risk of bladder cancer?

Smoking is by far the strongest risk factor for bladder cancer. This risk may be increased by up to 4 times compared to a non-smoker. Other risks include occupational hazards, such as exposure to dyes, industrial fumes, chemicals and pesticides at your workplace.  Chronic irritation and bladder infection, if left untreated, may also be a risk factor for different forms of bladder cancer. 

How do we investigate for bladder cancers?

There are a few ways to investigate. This can be done with a combination of imaging and a cystoscopy. A cystoscopy is an examination of your bladder with a camera.  Where there is convincing evidence of bladder cancer from the investigations, a discussion will be had with you to undergo a Transurethral Resection of Bladder Tumour (TURBT).  

A TURBT is first needed to work out the stage and grade of the cancer. Where possible, removal of the tumour will occur at the same time. You may require a catheter and a slow irrigation for one night. This catheter will usually be removed before you are discharged. 

Not all cancers are the same. Where do we go from here?

This depends on the stage and grade of the bladder cancer. Most bladder cancers are superficial and non-invasive (75% of cases). Superficial low-grade cancers, once fully removed, can be safely monitored with regular cystoscopies and imaging. 

For higher grade cancers, Mr Aw may discuss a repeat removal of the tumour, to ensure there are no residual cancers which may only be visible at a microscopic level. Even with complete removal, we know that there is a risk of tumour recurrence and progression in the future. Some patients may require some immune therapy in the bladder. If left untreated or if the cancer has invaded into the muscle layer of the bladder, the entire bladder may need to be removed surgically or you may require radiotherapy. As part of a multidisciplinary team, Mr Aw works closely with experienced medical and radiation oncologists to offer you a comprehensive cancer treatment plan.