Bladder Cancer is the seventh most common cancer in the UK. Its most common presentation is with blood in the urine (haematuria). The main risk factors are age, smoking and being male.Over 10,000 new people are diagnosed with bladder cancer ever year; making it the seventh most common cancer in the UK. In addition just over 5,000 people will die of bladder cancer ever year. It is more common in the older age group, men and smokers but can affect both sexes at any age. It is also associated with exposure to some hazardous chemicals although this is less common as these substances have now been banned.
Bladder cancer most commonly presents with Haematuria (micro or macroscopic), but can often be detected as a result of other symptoms such as, a change in voiding symptoms or urinary tract infection. If you have any of the above symptoms then you should consult your doctor who should refer you to an urologist if they are concerned.
Whilst the majority of bladder cancers are very curable, the earlier they are detected the better the chance of a good outcome.
Some of the later symptoms of advanced bladder cancer include pelvic pain, weight loss, oedema (swelling of the legs), fatigue and anaemia.
Approximately 70 % of all bladder cancers in the UK are regarded as ‘superficial’. This means that they are confined to the lining of the bladder and have not started to invade into the bladder muscle or spread elsewhere. These tumours are normally curable by performing keyhole surgery via the penis to remove the growth, TURBT.
Unfortunately these types of tumours frequently recur and therefore patients need to be kept under regular surveillance (flexible cystoscopy) to ensure any recurrence is captured at an early stage. On occasions where these tumours keep recurring then addition chemical treatment within the bladder is required to try and keep them under control (BCG or Mitomycin therapy).
The remaining 30% are made up predominantly of muscle invasive or more aggressive types of bladder cancer. These cases are more dangerous and if not treated in an aggressive manor can be fatal. If a bladder cancer is invading the muscle of the bladder then suitable patients are offered major surgery in the form of removal the bladder (Cystectomy) or radiotherapy as the main mode of treatment. In both cases the treatment is often preceded with a course of chemotherapy.
Unfortunately in some cases the bladder cancer will have progressed to an incurable stage at the time of presentation. In these cases treatment is aimed at keeping the symptoms under controlled to the best of everyone’s ability.
Should you or your Doctor be concerned about symptoms then you should be seen by a Consultant Urologist.
Your initial consultation will consist of a detailed capture of your symptoms, relevant risk factors and an over view of your general health and previous medical conditions.
You will also need a physical examination which is likely to include a rectal examination in men and a vaginal examination in women. This examination is aimed to pick up any warning signs, but also to look for other causes of your symptoms.
Following on from your initial consultation your clinician is likely to request some blood tests to asses you blood count and you kidney function. For patients who have presented with just haematuria then they are likely to require a detailed CT scan to assess the whole their urinary system. Some patients who present with more complex symptoms may however require additional targeted investigations. These will all be discussed with you at the time of your consultation.
Finally almost all patients will require a camera test to allow a full inspection of the inside of your bladder (cystoscopy). This is almost always performed initially as an out-patient procedure with the use of topical local anaesthetic. A small fibre-optic camera (flexible cystoscopy) is passed into your bladder via your urethra (the tube you passerine through) and then the bladder is filled with sterile water to allow a full inspection of its lining. In some cases this may be performed under general anaesthetic.
Once your clinician has all your result then they will discuss how best to manage your bladder cancer in a time appropriate manor. You will also be given all the relevant bladder cancer booklets to enable you to approach your situation in a fully informed manor. Finally of all your investigations have failed to demonstrate any sign of bladder cancer then the Manchester Urology team will be able to provide all the necessary care and attention to treat your underlying symptoms.
British Association of Urology Information (including video)