Bladder cancer

Overview

Most bladder cancers start in the urothelial cells that line the bladder. Many are found while still confined to the lining, when treatment options are broadest. Smoking is the largest single risk factor; certain workplace chemical exposures also increase risk.

Symptoms

The main symptom is blood in the urine. Some people also have urinary urgency, frequency, or discomfort passing urine. These symptoms overlap with infection and other conditions, so testing is needed to find the cause.

How it is diagnosed

Assessment may include urinalysis, urine tests for abnormal cells, imaging of the urinary tract, and cystoscopy, which lets a clinician look directly inside the bladder and take a sample if needed.

Treatment options

Treatment depends on the depth and grade of the cancer and overall health. Options may include removing the tumour through the urethra, treatments placed inside the bladder, and, for deeper cancers, surgery, chemotherapy, radiation, or newer therapies — usually coordinated by a multidisciplinary team.

Questions to ask a clinician

• What did my tests show about the type and depth of the cancer?
• Do I need a cystoscopy or further imaging?
• What are my treatment options and their trade-offs?
• What follow-up will I need, since bladder cancer can recur?
• Would stopping smoking change my outlook?