Bladder cancer

Bladder cancer is cancer that's found anywhere in your bladder. It's more common if you're over the age of 60.

What is bladder cancer?

• Bladder cancer is cancer that's found anywhere in your bladder. There are different types of bladder cancer depending on where in your bladder the cancer started.
• The bladder is an organ that collects and stores pee.
• How serious bladder cancer is depends on how big the cancer is, if the cancer has spread, and your general health.
• One of the main causes of bladder cancer is smoking.
• It's more common in men and people over the age of 60.

Symptoms of bladder cancer

Main symptoms of bladder cancer

The main symptom of bladder cancer is blood in your pee.

Other symptoms include:

• pain, burning, stinging or itching when you pee
• getting lots of urinary tract infections
• needing to pee more often
• needing to pee very suddenly
• losing your appetite and losing weight without trying to
• pain in your back and lower tummy
• aching, pain or tenderness in your bones
• feeling very tired for no reason and feeling generally unwell

See a GP if:

• you think you may have bladder cancer

Try not to be embarrassed. They'll be used to talking about these symptoms.

Important

Some of these symptoms are very common and can be caused by other conditions.

Having these symptoms does not definitely mean you have bladder cancer, but it's important to get checked by a GP.

If your symptoms are caused by cancer, finding it early may mean it's easier to treat.

What happens at your GP appointment

Depending on your symptoms, a GP may need to check inside your bottom (rectal examination) or vagina. This is where they put a gloved finger inside your bottom or vagina to check for lumps.

You'll be asked to undress from the waist down for a rectal or vaginal exam. You can ask for a male or female doctor.

You can ask for someone else to be in the room with you when the examination happens (a chaperone). This could be someone you know, a nurse or a trained member of staff.

You may also need to have a blood test or give a sample of your pee.

Referral to a specialist

The GP may refer you for more tests or to see a specialist in hospital if they think you have symptoms that need to be investigated.

This may be an urgent referral if you have certain symptoms. This does not definitely mean you have cancer.

Causes of bladder cancer

Who is more likely to get bladder cancer

It's not always known what causes bladder cancer.

You may be more likely to get bladder cancer if:

• you're over the age of 60
• you're a man
• you smoke or use chewing tobacco
• you've had a urinary catheter in for a long time
• you've had radiotherapy for cancer before
• you're overweight
• a close relative has had bladder cancer
• you have certain conditions, such as diabetes
• you've worked with chemicals, such as those used in the textile industry, or handling carbon or crude oil
• you've had an infection called schistosomiasis (bilharzia)

How to lower your risk of bladder cancer

You cannot always prevent bladder cancer, but there are things you can do to lower your chance of getting it.

Do

• try to quit smoking

• try to lose weight

• wear protective clothes and masks if you work in a job where you're exposed to harmful chemicals

It's important to get any symptoms of bladder cancer checked by a GP.

Tests and next steps for bladder cancer

Main tests for bladder cancer

If a GP refers you to a specialist (urologist) because they think you could have bladder cancer, you'll have tests to check for cancer. You may have another urine test.

The main test for bladder cancer is a cystoscopy, where a thin camera is passed through the tube that carries pee out of your body (urethra) to see inside your bladder.

It may be uncomfortable, but it should not be painful. You'll have painkilling medicine so you do not feel any discomfort or pain, or it may be done while you're asleep (general anaesthetic).

During the cystoscopy, a small sample of the lining of your bladder may be taken for testing (called a biopsy).

Treatment for bladder cancer

Main treatments for bladder cancer

Bladder cancer can often be treated.

The treatment you'll have depends on:

• the type of cancer you have
• the size of the cancer
• where it is
• if it has spread
• your general health

You'll usually be offered surgery to treat bladder cancer. You may also have chemotherapy, radiotherapy and targeted medicines.

Your specialist treatment team will:

• explain the treatments, the benefits and side effects
• work with you to make a treatment plan that's best for you
• help you to manage the side effects of treatment

You'll have regular check-ups during and after any treatments. You may also have tests and scans.

If you have any symptoms or side effects that you're worried about, talk to your specialists. You do not need to wait for your next check-up.

Surgery

Surgery is the main treatment for bladder cancer.

You may also need surgery if the cancer has spread to other areas of your body or if it has come back again after being removed.

Several types of surgery can be used to treat bladder cancer. For example, you may have surgery to:

• remove the cancer from your bladder lining
• remove all or part of your bladder and make a new way for you to pee
• unblock the tubes that carry pee from the kidneys to the bladder (ureters) or the tube that carries pee out of your body (urethra)

You'll be supported through surgery and recovery by your specialist treatment team.

Chemotherapy

Chemotherapy is medicine that kills cancer cells.

You may have chemotherapy for bladder cancer:

• before you have surgery or radiotherapy
• at the same time as radiotherapy (chemoradiotherapy)
• after surgery to stop the cancer coming back
• if the cancer has spread to other parts of your body

It can be given either into your bladder or into a vein (intravenously).

Targeted medicines and immunotherapy

Targeted medicines aim to stop the cancer growing.

Immunotherapy medicines help your immune system find and kill the cancer cells.

Targeted medicines or immunotherapy are sometimes used to treat bladder cancer if:

• there's a higher chance of the bladder cancer coming back after you have surgery
• you're having side effects from chemotherapy
• the tumour comes back while you're having chemotherapy
• the cancer has spread to other areas of your body

Radiotherapy

Radiotherapy uses rays of radiation to kill cancer cells.

You may have radiotherapy for bladder cancer instead of surgery or if the cancer has spread to other parts of your body.

You may have chemotherapy with radiotherapy (chemoradiotherapy).

What happens if you've been told your cancer cannot be cured

If you've been diagnosed with advanced bladder cancer, it may be hard to treat and not possible to cure.

The aim of treatment will be to slow down the growth and spread of the cancer to help with the symptoms and help you live longer.

Finding out cancer cannot be cured can be very hard news to take in.

You'll be referred to a team of doctors and nurses called a symptom control team or palliative care team.

They'll help you to manage your symptoms and make you feel more comfortable.

The palliative care team can also help you and your loved ones get any other support you need.