Plymouth Urology Partnership
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Bladder Cancer

Bladder Cancer is a common cancer. As with all cancers the causes are probably multiple. However there are known predisposing factors these include smoking and industrial chemicals.

The commonest presenting symptom of bladder cancer is blood in the urine. This is called haematuria. There are two kinds of haematuria.

  • Visible (also called frank, macroscopic or gross) haematuria where blood is seen in the urine by the patient. Patients with visible haematuria, with very few exceptions, need investigating.
  • Microscopic haematuria where blood is detected in the urine using chemical testing equipment but not seen by the patient. Patients with microscopic haematuria have less chance of having a serious cause for this although many will still need investigating.

How is bladder cancer detected?

Bladder cancer can sometimes be detected on imaging (such as ultrasound, x-ray or CT scan).

In most cases, however, tumours/cancers are detected (or confirmed) by an inspection of the bladder (cystoscopy). This can be done with the patient awake under local anaesthetic (flexible cystoscopy) or asleep under a general anaesthetic (rigid cystoscopy)

How is bladder cancer treated?

Bladder tumours can usually be removed by a procedure called a Trans-urethral resection of bladder tumour (TURBT), where instruments are passed into your bladder via the urethra. This is performed under general anaesthetic.

All pieces of tumour are sent to a laboratory for analysis and reviewed by an expert committee. The analysis will determine whether the tumour is cancerous, how aggressive the cancer is and whether the cancer has spread into the bladder wall.

In most cases, after removal of the first tumour, the bladder is inspected at regular intervals by cystoscopy and any recurrent tumours removed.

Sometimes additional treatments such as a course of chemical treatment in the bladder may be required to prevent further tumours developing.

Sometimes the results from the laboratory show that the cancer is invading the muscle of the wall of the bladder. In this case further scans will be required to assess the situation. Major treatments such as removing the entire bladder or radiotherapy may be appropriate. Plymouth is a designated centre offering these major treatments.