Bladder Cancer

Around 60% of cases are among those aged 75 and over, with the condition being more prevalent in men.

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

BLADDER CANCER IN OUR AREA

Bladder cancer is the ninth most common cancer in North West England and the eighth top cancer by total deaths in North Wales. 

This means it's among some of the most prevalent cancers in our region.

Overall, incidences in the North West are 8% higher than in the rest of England. Key areas of concern are Merseyside, which over-indexes by 25% and Lancashire, which over-indexes by 14% above the English average. 

TYPES

Once diagnosed, bladder cancer can be classified by how far it has spread. For example, suppose the cancerous cells live inside the bladder's lining. In that case, doctors describe it as non-muscle-invasive bladder cancer, the most common type. 

Most people don't die due to this type of bladder cancer.

When the cancerous cells spread beyond the lining into the surrounding bladder muscle, it's called muscle-invasive bladder cancer. This is less common but has a higher chance of spreading to other body parts. If bladder cancer has spread to other body parts, it's known as advanced or metastatic. 

SYMPTOMS

Blood in your urine is the most common symptom of bladder cancer. You may notice streaks of blood in your wee, or the blood may turn your wee brown. 

However, the blood is only sometimes noticeable and may come and go.

If you ever have blood in your wee – even if it comes and goes – you should visit your GP so they can investigate the cause.

Having blood in your wee doesn't necessarily mean you have bladder cancer.

Other, more common, causes include:

• a urinary tract infection
• a kidney infection
• kidney stones
• urethritis
• an enlarged prostate gland (in men)

Less common symptoms of bladder cancer include:

• a need to wee on a more frequent basis
• sudden urges to wee
• a burning sensation when weeing

If bladder cancer reaches an advanced stage and begins to spread, symptoms can include the following:

• pelvic pain
• bone pain
• unintentional weight loss
• swelling of the legs

CAUSES

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.

DIAGNOSIS

Suppose you get a referral to a hospital specialist, and they think you might have bladder cancer. In that case, they should first offer you 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 or MRI scan if the specialist feels you 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 are complete, it should be possible to tell you the grade of the cancer and what stage it is. 

TREATMENT

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, followed by a dose of chemotherapy medication directly into the bladder to reduce the risk of 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 choose 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 the bowel, with the process undertaken 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.

If you have any concerns about the signs and symptoms of bladder cancer, please visit your GP.