Bladder cancer is the presence of a malignant tumour or multiple tumours in the bladder. The most common presenting symptom of bladder cancer is the presence of blood in urine. The blood can either be visible (macroscopic) or invisible (microscopic).

Investigations

When a patient presents with blood in the urine investigations need to be done to determine the origin of the blood and whether it is caused by a malignancy (cancer). These investigations include urine tests (to confirm the presence of blood and to look for malignant cells), blood tests, imaging of the upper tracts (CT IVP or an ultrasound) and a cystoscopy, which is a small telescope that is placed inside the bladder. If a growth or an abnormality is encountered a biopsy is done which is then sent to a pathologist who examines the tissue under microscope to determine the nature of the growth (malignant growth or a benign growth).

 Treatment

Bladder cancer can be divided into superficial or deep (muscle invasive) bladder cancer. Superficial bladder cancer can usually be controlled with endoscopic (telescopic) resections. Bladder cancer often recurs after removal. To reduce the frequency of the recurrence rate after removal of a bladder tumour, installation of chemotherapy or immunotherapy into the bladder may be indicated.

If the bladder cancer has infiltrated into the deep muscle of the bladder (muscle invasive) removal of the whole bladder may be necessary or a combination of chemotherapy and radiation may be an option.

All cancer patients will be discussed at our fortnightly multidisciplinary meeting which includes radiation oncologists and medical oncologists to formulate an optimal and individualised plan for each patient.