The first signs of bladder cancer

There are approximately 10,000 new cases of bladder cancer in the UK every year. Although the incidence of bladder cancer has reduced in recent years, despite this 28 patients are diagnosed with bladder cancer every day. Bladder cancer is more common in men and tends to be a condition associated with people over 60 years of age.

Urologist Mr Chris Blick talks about the most common types of bladder cancer, the risks and who is most likely to develop it.

There are three main types of bladder cancer, the first and most common being urothelial carcinoma, also known as transitional cell bladder cancer which accounts for approximately 90% of bladder cancers. The second most common type is squamous cell carcinoma, affecting on average 5% of people with bladder cancer. The third most common; adenocarcinoma, only accounts for 2% of all bladder cancers.

What are the risk factors for bladder cancer?

The main risk factors for bladder cancer are preventable. 45% of all bladder cancer cases in the UK are caused by smoking. Chemicals called arylamines in cigarette smoke may be the cause of the increased risk. Being male slightly increases the risk and other less common risk factors include work place exposure to chemicals and radiation, which could affect anyone working in the manufacture of rubber and plastics for example.

How common is bladder cancer and what age group does it affect?

Bladder cancer is the 10^th most common cancer in the UK, being slightly more common in men than in women and is most common in people aged between 70 and 80 years of age.

What are the first signs of bladder cancer?

There are a number of signs or symptoms for bladder cancer, some of which might be:

• The presence of blood or blood clots in the urine
• Pain or burning when passing urine
• Frequent need to urinate and the need to urinate many times throughout the night
• A sensation of needing to pass urine but with great difficulty

Occasionally bladder cancer can present as pain around the kidney region or pubic region.

It is important to realise that there could be a number of other possible causes for these symptoms, so the presence of the above symptoms doesn’t always indicate that you have bladder cancer and further investigating of your symptoms may be required.

Different types of bladder cancer and treatment

There are two main subgroups or types of bladder cancer. Low grade bladder cancer tends to be localised to the lining of the bladder, although this type of bladder cancer has excellent survival rates it has a relatively high recurrence rate. The other type of bladder cancer is high grade bladder cancer, this is more dangerous and has the potential to involve the muscle layer of the bladder and spread beyond the bladder.

Low grade bladder cancer is usually treated by a procedure under anaesthetic to remove the abnormal cells from the bladder. This is often followed by the single installation of a chemical into the bladder to reduce the risk of recurrence. Following this treatment patients will undergo surveillance via a cystoscopy (inserting a camera into the bladder) and may not require any further treatment.

High grade bladder cancer is again treated by removing the bladder tumour during a procedure under anaesthetic and depending on whether or not the muscle layer has been infiltrated, various methods of treatment will follow.

If the muscle hasn’t been infiltrated, patients may require a course of treatment using BCG (Bacillius Calmette-Guerin), a form of immunotherapy which is given into the bladder. If the cancer has grown into the muscle of the bladder, patients may require more radical treatment which may be in the form of surgery to remove the bladder or radiotherapy.

Having bladder trouble and afraid it might be a sign of something more serious? Book an appointment with Mr Chris Blick for peace of mind.