Bladder cancer

Bladder cancer mostly affects people who are over 50 and is twice as likely to occur in men as in women. In the UK, over 10,000 new cases of bladder cancer are diagnosed each year, making it the fourth most common cancer in men and the 12th most common in women. Nearly 5000 people die from bladder cancer each year.

Bladder cancer occurs when cells in the bladder divide and grow in an abnormal way. These extra cells can form a mass of tissue called a growth or tumour, affecting how the bladder works.

CLICK HERE TO DOWNLOAD OUR BITESIZE GUIDE (PDF)

Learn more about Bladder cancer

Bladder cancer symptoms

  • Blood in the urine (the most common symptom, known as haematuria).
    • Rarely any pain.
    • Urine varies from rusty brown to deep red. This may not be the case every time you urinate and can sometimes disappear for weeks or months.
    • The amount of blood is not related to the extent of the cancer.
    • Can also indicate other conditions, such as an infection or kidney stones.
  • Pain or obstruction to the flow of urine if blood clots form.
  • Increased frequency of urination.
  • Feeling the need to urinate but without any urine coming through.

If you have any of the symptoms mentioned above, you should see your GP as soon as possible for a full diagnosis.

Bladder cancer

Bladder cancer diagnosis

The symptoms of bladder cancer are very similar to many other conditions, so it's very important that your doctor identifies the exact cause of your symptoms. Initial diagnosis includes:

Urinalysis

  • A urine sample to test for blood and infection.

Physical examination of the abdomen and pelvis

  • May also include an internal examination of the rectum in men or the vagina in women.
  • Depending on the results of the examinations, your GP may then refer you to a urologist at your local hospital for further tests, including:

Blood tests

  • Give an idea of your general health and how well your kidneys are working.

Ultrasound scan

  • Uses sound waves to produce a picture of the inside of the abdomen.
  • Before the scan you will be asked to drink plenty of fluids so that your bladder is full and the picture is clear.
  • Takes about 15 minutes and is completely painless.

Intravenous pyelography (IVP)

  • X-ray examination of your kidneys, ureters and bladder.

Cystoscopy

  • Allows the urologist to look at the inside of your bladder, using a small tube with a camera on the end, which is inserted into your urethra. If tissue samples are required, you may need to have a general anaesthetic

Chest X-ray

  • Examines your heart and lungs to check that they are healthy.

CT or CAT scan (computed tomography)

  • A type of X-ray examination, in which a large number of cross-sectional pictures of your body are created. These make up a 3D image of your internal organs.

Radioactive bone scans

  • May be performed to check whether any cancer has spread to the bones.
  • A tiny amount of radioactive liquid is injected into a vein, and then you will have a scan 2 to 3 hours later. Abnormal areas show up in the scan.

Bladder cancer treatment

Treatment depends on the type of bladder cancer, the stage of the disease (how far it has spread) and the grade of the tumour. The doctor will also take into consideration your age and general health.

Treatment for early (superficial) bladder cancer

Usually removed surgically by a cystoscope (a tiny camera that allows the doctor to look inside your bladder). The cancerous growths are simply cut off at the stem. This procedure is known as a transurethral resection of a bladder tumour (TURBT).

Following this, you'll need cystoscopies every 3 to 4 months. Most follow-up cystoscopies can be carried out under local anaesthetic in your hospital's outpatient department.

If the cancer comes back, the tumours can usually be surgically removed while they are still in the early stages. However, you may also be offered anticancer drug treatment, including:

Intravesical chemotherapy

  • Chemotherapy given directly into the bladder - targeting cancer cells in the bladder lining.
  • Can be a one-off treatment, or over the course of six weeks.
  • Limited side effects, though cystitis common (inflammation of the bladder).

Intravesical immunotherapy

  • A vaccine called BCG (bacille Calmette-Guérin) is inserted directly into the bladder.
  • This triggers the body's immune system to attack the cancer cells.
  • Side effects of treatment include feeling unwell, pain when you pass urine and skin rashes.

Treatment for invasive bladder cancer

Surgery is the most common treatment for invasive cancers. Radiotherapy and chemotherapy may be used in addition (adjunctive therapy).

Cystectomy

  • Large or invasive tumours may mean that the bladder has to be removed.
  • If the whole bladder is removed, the operation is called a total cystectomy.
  • You will still be able to pass urine after this operation, but your bladder will hold less urine, and you may need to pass urine more often.

Urostomy

  • A urostomy is a new storage place for urine. Under general anaesthetic, both ureters are redirected through a small hole (stoma) in your abdomen leading to a watertight bag. You'll need to empty this when needed.

Continent urinary diversion

  • An alternative to urostomy. Urine is removed through the stoma - but you do not need an external bag.
  • Urine collects in a pouch formed in the abdomen using a piece of bowel - known as self-catheterisation.

Bladder reconstruction

  • Surgeons make a completely new bladder out of a piece of the small or large intestine.
  • Unlike your old bladder, you will need to tense your stomach to empty it. You will have lost the nerves that tell your brain when your bladder is full.

Radiotherapy

  • An alternative to surgery, radiotherapy uses high-energy rays to destroy cancer cells, while avoiding damage to the surrounding normal cells.
  • Usually given as a series of daily treatments at your hospital. The number of treatments depends on the size and type of cancer, but each treatment takes 10 to 15 minutes and usually continues for up to six weeks.

Chemotherapy

  • Chemotherapy drugs are injected into the bloodstream, reaching cancer cells anywhere in the body.
  • Other cells in the body can also be affected, resulting in side effects such as sickness and hair loss.
  • A course of several drugs is given over a few days. The course may then be repeated every few weeks for several months.

Treatment for advanced bladder cancer

If the cancer has spread outside the bladder, or comes back after the initial treatment, the main treatment is chemotherapy. This is known as palliative chemotherapy. The aim is to try to slow the growth of the cancer. It can also help maintain a good quality of life for as long as possible.

Unfortunately, once cancer has spread to other parts of the body, the chance of a cure is rare. If you have been offered chemotherapy, discuss the pros and cons with your doctor. There are other options available to you to control your symptoms of cancer. These vary depending on your symptoms.

Need more information?

Speak to your GP for advice about bladder cancer, especially if you have specific concerns about your symptoms and treatment options. You can also find useful websites via our links section.

Kidney

Read more

Bladder

Read more

Prostate

Read more

Male reproductive organs

Read more

Your stories

Headmaster runs multiple marathons post-surgery for TUF

Read Andy Conlon’s story Read all stories