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you are here: Medical dictionary » Conditions » Bladder cancer

The urinary bladder is a hollow, muscular bag located on top of the pelvic floor. Urine drains into the bladder from the kidneys through two tubes (ureters) and can be stored there or expelled by muscular contractions through a tube (urethra) to the outside of the body.

Bladder cancer is the fifth commonest cancer in the UK after breast, prostate, lung and colorectal (colon) cancer ⁽¹⁾.

What are the symptoms of bladder cancer?

The commonest symptom of bladder cancer is blood in the urine (haematuria), as the bladder tumour may be bleeding.

There are other health conditions, such as a bladder infection, that can also cause blood in the urine. The other less common symptoms, such as frequency of urination, pain when urinating, pelvic pain and swollen legs can also have other causes.

If you have blood in your urine, see your doctor.

Diagnosis of bladder cancer

A doctor will examine you and ask for a urine sample which will be sent off for testing at a laboratory.

You may also need to have the following tests:

• Cystoscopy - a flexible, narrow tube with a light and camera on the end (cystoscope) is passed up the urethra and into the bladder to examine the lining. Small tissue samples (biopsies) can be taken by small instruments passed down the cystoscope which are then sent off to be tested for cancer
• Intravenous Urogram/ Pyelogram (IVU/ IVP) - a dye that shows up on X-rays is injected into a vein in your arm or hand. As it travels from the kidneys to the bladder, it shows up any abnormalities of the urinary system
• Abdominal ultrasound, CT scan or an MRI scan - may be necessary to measure the size of any cancer and help determine whether it has spread outside of the bladder to other parts of the body

There are three types of bladder cancer:

• Transitional cell cancer - accounts for the majority of bladder cancers in the UK ⁽²⁾. It develops in cells that form the lining of the bladder
• Squamous cell cancers - develops from one of the types of cell in the bladder lining. Approximately two per cent ⁽²⁾ of bladder cancers in the UK are of this type
• Adenocarcinoma - a cancer of the mucous-producing cells in the bladder lining. It is rare and makes up only one to two per cent of bladder cancer cases ⁽²⁾

What are the treatments for bladder cancer?

The way your bladder cancer is treated will depend on the size and depth of your tumour (if it has invaded the muscle of the bladder or not) or if it has spread (metastasised) to other parts of your body.

Your age, general health and personal wishes will also dictate how your treatment progresses.

1) Non-invasive bladder cancer: many bladder cancers are superficial and don’t extend into the main muscle wall of the bladder. These can often be treated with a cystoscopy, where the abnormal area is resected (removed surgically) ⁽³⁾.

The operation to remove superficial bladder cancer is called a transurethral resection of bladder tumour (TURBT).

A TURBT can be followed by introducing types of chemotherapy or BCG (like the TB vaccine) directly into the bladder, which reduces the frequency of further cancers forming ⁽³⁾.

2) Invasive bladder cancer: when the cancer is invading muscle it cannot be treated using the above techniques.

To try to cure invasive tumours there are the options of surgical removal of the bladder (radical cystectomy) and a course of radiotherapy (X-ray treatment) over a number of weeks ⁽³⁾.

Chemotherapy drugs injected into a vein are also sometimes used before a cystectomy to try to shrink down the tumours prior to the main treatment ⁽³⁾.

Chemotherapy is used in this manner before radiotherapy treatment also ⁽³⁾.

If the disease has spread outside the pelvis so that it cannot be cured, chemotherapy into a vein is also an option to try to shrink the secondary tumours and hold the disease for a while ⁽³⁾.

Infolinks

• Bladder and Bowel Foundation
• Macmillan Cancer Support

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