Bladder cancer

Bladder cancer is when cells in the lining of your bladder start to grow abnormally and multiply in an uncontrolled way to form a tumour.

Around 70% of cases of bladder cancer are non-muscle-invasive (superficial), which means the cancerous cells have stayed in the lining of your bladder. At this stage, half of people diagnosed with non-muscle-invasive bladder cancer have a good chance of successfully managing it with regular surveillance and treatment for 10 years or more.

Other bladder cancer tumours grow into the muscle wall of the bladder – this is called invasive bladder cancer.

Sometimes bladder cancer spreads to other parts of the body – this is called advanced or metastatic bladder cancer.

There's no national screening programme in the UK for bladder cancer, but earlier detection can improve your prognosis.

The main bladder cancer symptom is blood in your urine (pee) which is usually bright red but not painful.

It’s important to see your GP if you notice blood in your urine. Even if it’s not there all the time, it’s important to find out the cause.

Other bladder cancer symptoms include:

• Pain when peeing
• Needing to pee urgently
• Needing to pee frequently

However, these are often symptoms of other conditions, such as a bladder infection or enlarged prostate.

If you have any of these symptoms you should see your GP. They will:

• Ask about your symptoms and risk factors
• Take a urine sample to see if you have an infection
• Perform an internal examination to make sure the problem isn’t your womb or prostate gland – which can cause similar symptoms

You may be referred to a urologist, a consultant specialising in the urinary system. Bladder cancer is usually diagnosed with a cystoscopy – a procedure to look inside your bladder. This may also be with a biopsy and is performed under a local or general anaesthetic.

Other diagnostic tests are:

• Intravenous urogram – a contrast agent is used to highlight your urinary tract on an X-ray
• Ultrasound scan
• CT scan
• MRI scan

If you’re diagnosed with bladder cancer, your doctor will tell you the type, stage and the grade of your cancer. They'll also tell you if there's any metastasis (spreading) to other parts of your body. This is important to help them decide the most effective treatment options for you.

Bladder cancer is usually diagnosed in people over 60. It's also more common in men than women.

There are other risk factors that increase your risk of developing bladder cancer. These are:

• A close relative with bladder or upper urinary tract cancer
• If you’re a smoker
• Exposure to chemicals used in the textile, rubber, leather, dye, paint and print industries – usually through your workplace
• A chronic bladder infection or a neurological condition that affects your bladder control (neurogenic bladder)
• Previous radiotherapy to your pelvis

Treatment depends on the type of bladder cancer, the stage and the grade. Generally, treatments offered will be:

• If your bladder cancer is in the non-muscle-invasive stage it can be removed with a surgical procedure called Transurethral Resection of Bladder Tumour (TURBT) – this may be followed by chemotherapy directly to your bladder
• Higher risk tumours are treated with a chemotherapy drug injected into your bladder
• Muscle-invasive cancers may require complete removal of your bladder (cystectomy) followed by radiotherapy

Bladder cancer sometimes recurs in the months and years following treatment so you’ll need regular follow-up appointments and cystoscopies.