What causes bladder cancer?
What are the symptoms of bladder cancer?
How is bladder cancer treated?
TURBT for bladder cancer treatment
Radical cystectomy for bladder cancer treatment
Immunotherapy and chemotherapy for non-invasive bladder cancer
Patient outcomes
Preventing bladder cancer
Bladder cancer is a condition in which the cells on the inner lining of the bladder begin to grow and divide in an abnormal and uncontrolled way.
There are different types of bladder cancer:
- Urothelial carcinoma accounts for over 90% of bladder cancers
- Squamous cell carcinoma accounts for 1-2% of cases
- Adenocarcinoma is a rare form of bladder cancer (less than 1% of cases) that starts in the glandular cells of the bladder
Bladder cancer is classified as being either non-muscle invasive (superficial) or muscle-invasive. Most bladder cancer is superficial, which means that it is contained to the inner lining of the bladder or in the next layer of tissue, but not in the deeper layers of the bladder wall. Muscle-invasive bladder cancer occurs when the tumour has invaded the muscle wall of the bladder. This has the potential to spread to nearby organs and lymph nodes.
Doctors Shekib Shahbaz and Tony De Sousa of Melbourne Urology Centre are experts in managing bladder cancer. They work closely with medical oncologists and radiation oncologists to provide a multi-disciplinary approach to ensure that you receive the most up-to-date and effective treatments.
What causes bladder cancer?
There are certain risk factors that can increase a person’s risk of developing bladder cancer:
- Smoking
- Increasing age
- Bladder cancer is more common in men
- Occupational exposure to certain chemicals in the textile, petrochemical and rubber industries
- Chronic inflammation or infections of the bladder
- Family history of bladder cancer (genetic causes)
- Previous treatment with cyclophosphamide (chemotherapy drug)
What are the symptoms of bladder cancer?
The most common symptom of bladder cancer is blood in the urine (haematuria) which is often painless. Other symptoms may include:
- The urge to urinate more frequently
- Inability to pass urine
- Burning or pain while urinating
- Pain in one side of the lower back or abdomen
- Loss of weight and lethargy in advanced cases
Sometimes, bladder cancer does not cause symptoms and is discovered incidentally when microscopic blood is detected on a urine test, or the bladder is inspected (cystoscopy) for another condition.
How is bladder cancer treated?
The treatment for bladder cancer depends on the type of bladder cancer and the extent of the cancer (referred to as the stage).
- TURBT (transurethral resection of bladder tumour) is the most common treatment for non-invasive bladder cancer
- Radical cystectomy (entire bladder removal) is the most common treatment for muscle-invasive bladder cancer
- Immunotherapy, chemotherapy and radiation therapy may also be used in advanced disease
TURBT for bladder cancer treatment
- Surgical treatment option for early stage bladder cancer or non-invasive bladder cancer
- Performed under general or spinal anaesthesia
- A small telescope (cystoscope) is inserted through to the bladder via the urethra
- A wire loop on the cystoscope is used to remove the tumour
- No skin incisions are required
- Most patients will have a catheter for 1-2 nights
- A follow-up procedure may be required to ensure that all the cancer has been removed
- Low risk of infection or injury to the bladder
Radical cystectomy for bladder cancer treatment
- Treatment option for muscle-invasive bladder cancer
- Performed under general anaesthetic
- May be performed as an ‘open’ procedure (one incision) or keyhole procedure (robotic)
- The entire bladder is removed, along with pelvic lymph nodes
- In men, the prostate, urethra and seminal vesicles must also be removed
- In women, the urethra, uterus and part of the vagina are often removed; the ovaries may be spared in young women
- Once the bladder is removed, urine will drain either via an ileal conduit or a neobladder may be created, in order to collect and store the urine
Immunotherapy and chemotherapy for non-invasive bladder cancer
- Immunotherapy is a treatment aimed at boosting the body’s immune system to delay or stop cancer growth
- Chemotherapy drugs may also be instilled directly into the bladder to damage or destroy cancer cells.
Patient outcomes
Following a diagnosis of bladder cancer, your urologist may give you a prognosis (predicted outcome) based on a number of individual factors, such as the type of cancer you have and the rate of its growth, your age and medical history.
Preventing bladder cancer
Whilst it is not possible to prevent bladder cancer, you can minimise your risk of developing the disease by not smoking, or quitting smoking and limiting your exposure to hazardous carcinogenic chemicals.
Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa
Urological Society of Australia and New Zealand, (2021), Bladder Cancer Patient Guidebook, [https://www.usanz.org.au/info-resources/position-statements-guidelines#BLADDER], accessed 18/02/21.
Cancer Council, (2020), Bladder Cancer, [https://www.cancer.org.au/cancer-information/types-of-cancer/bladder-cancer], accessed 19/02/21.