Bladder Cancer Explained

Bladder cancer is where a growth of abnormal tissue known as a tumour develops in the lining of the bladder. In some cases the tumour spreads into the surrounding muscles.

The most common symptom of bladder cancer is blood in your urine, which is usually painless.

If you notice blood in your urine, even if it comes and goes, you should visit your GP so the cause can be investigated.

Types of bladder cancer

Once diagnosed, bladder cancer can be classified by how far it has spread.

If the cancerous cells are contained inside the lining of the bladder, doctors describe it as superficial or non-muscle-invasive bladder cancer. This is the most common type of bladder cancer, accounting for 7 out of 10 cases. Most people do not die as a result of this type of bladder cancer.

When the cancerous cells spread beyond the lining into the surrounding muscles of the bladder, it’s referred to as muscle-invasive bladder cancer. This is less common, but has a higher chance of spreading to other parts of the body and can be fatal.

Why does bladder cancer happen?

Most cases of bladder cancer appear to be caused by exposure to harmful substances that lead to abnormal changes in the bladder’s cells over the course of many years.

Tobacco smoke is a common cause and it is estimated that half of all cases of bladder cancer are caused by smoking.

Contact with certain chemicals previously used in manufacturing is also known to cause bladder cancer. However, these substances have since been banned.

Treating bladder cancer

In cases of non-muscle-invasive bladder cancer, it is usually possible to remove the cancerous cells while leaving the rest of the bladder intact.

This is done using a surgical technique called transurethral resection of a bladder tumour (TURBT). This may be followed by a dose of chemotherapy medication directly into the bladder to reduce the risk of the cancer returning.

In cases with a higher risk of recurrence, a medication known as Bacillus Calmette-Guérin (BCG) may be injected into the bladder to reduce the risk of the cancer returning.

Treatment for muscle-invasive bladder cancer may involve surgically removing the bladder in an operation known as a radical cystectomy.

When the bladder is removed, you will need another way of collecting your urine. Possible options include making an opening in the abdomen so urine can be passed into an external bag, or constructing a new bladder out of a section of bowel. This will be done at the same time as a radical cystectomy.

If it’s possible to avoid removing the bladder or if surgery is not suitable, a course of radiotherapy and chemotherapy may be recommended. Chemotherapy may sometimes be used on its own before surgery or before being combined with radiotherapy.

After treatment for all types of bladder cancer, you will have regular follow-up tests to check for signs of recurrence.

Who is affected?

About 10,000 people are diagnosed with bladder cancer every year.

The condition is more common in older adults, with the average age at diagnosis being 68 years old.

Rates of bladder cancer are four times higher in men than in women, possibly because in the past men were more likely to smoke and work in the manufacturing industry.