Introduction

Bladder Cancer

The bladder collects and stores urine made by the kidneys. The outer part of the bladder is muscle, which stretches as the bladder fills and contracts to empty the bladder. The bladder also has a lining of Mucosa made of urothelial cells inside the muscle.

Bladder cancer starts when cells in the lining of the bladder become abnormal. The cells then divide and grow to form a cancer

The most common type of bladder cancer is urothelial cell carcinoma (also known as transitional cell carcinoma). 

Less common types are:

  • Squamous cell carcinoma 
  • Adenocarcinoma.
  • Small cell cancer 

In 2016, there were 1019 deaths caused by bladder cancer in Australia. The chances of surviving this cancer for five years is 54%.

Causes of bladder cancer

Factors that can increase your risk include:

  • Smoking
  • Workplace exposure to certain chemicals used in dyeing in the textile, petrochemical and rubber industries
  • Use of the chemotherapy drug cyclophosphamide
  • Diabetes
  • Chronic inflammation of the bladder.

Bladder cancer symptoms

Blood in urine: The most common sign of bladder cancer is blood in the urine without any pain. This is the most important sign. Do not neglect presence of  blood in urine. Contact your GP or us urgently.

Other symptoms include:

  • Trouble emptying the bladder when you go to the toilet
  • Burning feeling when you’re trying to pass urine
  • Frequent Urination
  • Urgency of urination 

Diagnosis

  • Urine Test (MSU)
  • Urine cytology (3 consecutive urine samples)
  • CT IVP (CT scan with and without intravenous contrast)
  • Cystoscopy and Biopsy – Camera check of bladder to remove any visible tumour which is sent for Microscopic examination to determine the aggressiveness of the tumour. This will help determine further treatment options.

Treatment 

Depends on :

  • Nonmuscle-invasive bladder cancer, also called superficial bladder cancer, occurs when cancerous cells are contained in the lining of the bladder and have not invaded the bladder muscle. This is considered early stage and represents about 70 to 75 percent of all diagnoses. 
  • Muscle-invasive bladder cancer occurs when the cancer invades the bladder wall. This is considered advanced stage and represents the other 25 to 30 percent of diagnoses. 

Nonmuscle-invasive bladder cancer

  • Cystoscopy, removal of tumour and send for Analysis for type and grade of tumour 
  • Intravesical Chemotherapy
  • Intravesical BCG

Muscle-invasive bladder cancer

  • Robotic Cystectomy (removal of bladder )and ileal conduit (Forming stoma on abdominal wall from small part of intestine )or Neobladder 
  • Radiation
  • Chemotherapy 
  • Multimodal Approach