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Bladder cancer

TURBT, intravesical therapy and radical cystectomy with urinary diversion, staged properly from the outset.

Overview

What it is

Painless visible blood in the urine is the classic presentation of bladder cancer, and it is the single symptom that should never be dismissed — even if it happens once and then stops.

Most bladder cancers are superficial at diagnosis and can be managed by resection through a scope with follow-up surveillance. A minority invade the bladder muscle and need more definitive treatment, which makes accurate initial staging critical.

Symptoms you may notice

  • Blood in the urine, typically painless
  • Needing to pass urine urgently or frequently
  • Burning on passing urine without an infection
  • Recurrent urinary infections that keep coming back
  • Pelvic pain in advanced disease

Get seen promptly if

  • Any episode of visible blood in the urine
  • Microscopic blood found on repeated testing
  • Irritative symptoms with a negative urine culture

How it is assessed

  • Urine cytology
  • Flexible cystoscopy under local anaesthetic
  • CT urogram to assess the upper tracts
  • TURBT with detrusor muscle in the specimen, for accurate staging
  • MRI or PET where muscle invasion is suspected
Treatment

What the options actually involve

TURBTResection through a scope, both to remove the tumour and to establish the stage and grade.
Intravesical therapyBCG or chemotherapy instilled into the bladder to reduce recurrence in high-risk superficial disease.
Radical cystectomyRemoval of the bladder with urinary diversion, for muscle-invasive disease.
Surveillance cystoscopyStructured follow-up, since superficial disease recurs in a substantial proportion of patients.

Have a scan or report about this already?

Send it before your appointment. The consultation then starts from your findings rather than from scratch.

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