Bladder cancer is roughly twice as prevalent in men as in women and, as with prostate cancer, it is more likely to occur with increasing age. It is believed to be more common in people who smoke, as the chemical products of smoking travel via the lungs and bloodstream into the bladder before being passed out of the body. It is also more common in those who have worked in the dye or rubber industries.
Bladder cancer can be non-invasive or invasive. The non-invasive form does not grow deep into the wall of the bladder. The invasive form can cover a large area of the inner surface of the bladder as well as invading deeper into the bladder wall. If this occurs, the cancer can also spread to the lymph nodes and later progress to distant sites such as the lungs, liver and bones.
The symptom you are most likely to notice is blood in your urine (haematuria). You may also be aware of a need to pass urine more often than usual and experience discomfort or pain on passing urine (dysuria). It’s important to remember that both symptoms can often be caused by a non-cancerous problem – such as a readily treatable infection – but this is no reason to delay a check-up with your doctor.
You will undergo various tests to establish whether cancer is present, and these may include urine tests and an internal examination of the bladder with a cystoscope. This is a means of looking inside the bladder with a thin tube containing a type of telescope and may be done under either general or local anaesthetic. You may also have X-rays and scans of the kidneys, abdomen and the pelvis.
The treatment for the non-invasive type of bladder cancer involves cystoscopy, with cauterization or removal by laser of any tumour and then regular follow-up cystoscopy. Drugs may also be instilled into the bladder. The more invasive type of cancer may involve more extensive surgery, possibly with the removal of the whole bladder (cystectomy). This also involves the requirement to reconstruct the bladder or to divert the flow of urine, and you will need to discuss this in detail with your doctors so that you fully understand the impact that the surgery will have on your life. Radiotherapy may be an option to consider instead of surgery, but this will depend upon your particular circumstances. Chemotherapy may be proposed. Although its role is not yet fully defined, bladder cancer (including secondary disease) can respond well to chemotherapy.
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