About 10,000 people are diagnosed with bladder cancer every year and it's the tenth most common cancer in the UK.
The condition is more common in older adults. Almost 60% of new cases are in people aged 75 and over, and the condition is more common in men than in women. Bladder cancer is where a growth of abnormal tissue, known as a tumour, develops in the bladder lining. In some cases, the tumour spreads into the bladder muscle.
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 non-muscle-invasive bladder cancer. This is the most common type of bladder cancer. Most people don't die as a result of this type of bladder cancer.
When the cancerous cells spread beyond the lining, into the surrounding bladder muscle, 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. If bladder cancer has spread to other parts of the body, it's known as advanced or metastatic bladder cancer.
Blood in your urine is the most common symptom of bladder cancer. You may notice streaks of blood in your urine or the blood may turn your urine brown. The blood isn't always noticeable and it may come and go.
If you ever have blood in your urine – even if it comes and goes – you should visit your GP, so the cause can be investigated.
Having blood in your urine doesn't mean you definitely have bladder cancer.
There are other, more common, causes including:
- a urinary tract infection
- a kidney infection
- kidney stones
- an enlarged prostate gland (in men)
Less common symptoms of bladder cancer include:
- a need to urinate on a more frequent basis
- sudden urges to urinate
- a burning sensation when passing urine
If bladder cancer reaches an advanced stage and begins to spread, symptoms can include:
- pelvic pain
- bone pain
- unintentional weight loss
- swelling of the legs
Most cases of bladder cancer appear to be caused by exposure to harmful substances, which lead to abnormal changes in the bladder's cells over many years. Tobacco smoke is a common cause.
Contact with certain chemicals previously used in manufacturing is also known to cause bladder cancer. However, these substances have since been banned.
If you're referred to a hospital specialist and they think you might have bladder cancer, you should first be offered a cystoscopy. This procedure allows the specialist to examine the inside of your bladder by passing a cystoscope through your urethra (the tube through which you urinate). A cystoscope is a thin tube with a camera and light at the end. The procedure usually takes about 5 minutes.
You may also have a CT scan or an MRI scan if the specialist feels they need a more detailed picture of your bladder.
An intravenous (IV) urogram may also be used to look at your whole urinary system before or after treatment for bladder cancer.
Once these tests have been completed, it should be possible to tell you the grade of the cancer and what stage it is.
In cases of non-muscle-invasive bladder cancer, it's 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. This is followed by a dose of chemotherapy medication directly into the bladder, to reduce the risk of the cancer returning.
Treatment for high-risk non-muscle-invasive bladder cancer, or muscle-invasive bladder cancer may involve surgically removing the bladder in an operation known as a cystectomy.
Most patients will have a choice of either surgery or a course of radiotherapy.
When the bladder is removed, you'll 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 cystectomy.
After treatment for all types of bladder cancer, you'll have regular follow-up tests to check for signs of recurrence.