Bladder Cancer Symptoms

The most common symptom of bladder cancer is painless haematuria (blood in the urine). Blood in the urine may be visible to the naked eye (gross haematuria) or invisible to the naked eye but detected on a microscopic urine examination (microscopic haematuria), often done during health screenings or checkups for people wit high blood pressure or diabetes.

It is very important to note that haematuria associated with bladder cancer may be intermittent. That is, days, weeks, or even months may pass after an episode of haematuria during which no blood is seen in the urine. It is therefore very important that any episode of gross haematuria is reported to your doctor even if it occurred days, weeks or even months ago.

Other symptoms sometimes associated with bladder cancer include:

  • A change in urination habit (unexplained urinary frequency or urgency)
  • A recent history of difficulty passing urine

Bladder cancer rarely causes pain in until it has reached an advanced stage.

Diagnostic Tests

Bladder cancer is diagnosed by looking for abnormalities inside the bladder endoscopic examination of the bladder (Flexible cystoscopy). Flexible cystoscopy can be done in the comfort and convenience of our clinic. If there is a tumour seen in the bladder, endoscopic surgery is required to remove the tumour and check if it is cancerous.

CT Urography (this is a CT scan in which intravenous contrast is injected in order to accurately assess the kidneys, the inner lining of the kidneys, the ureters and the bladder). This will 1) assess the rest of the urinary for causes of haematuria, and 2) in the case of patients found to have a bladder tumour, determine if the bladder cancer has spread to other organs in the body.

From incontinence and infections to stones and cancers, problems of the urinary tract are numerous and require targeted and prompt treatment.
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Grading and Staging

Grading

During analysis of the tumour specimen under a microscope by the Pathologist, the grade of the cancer is determined. High grade cancers behave more aggressively with higher risk of distant spread and cancer death. Low grade cancers are less likely to grow into the wall of the bladder or to spread beyond the bladder, and have better prognosis compared to high grade disease.

Staging

The stage or extent of the disease is assessed by the results of the bladder biopsy. The specimen is examined by a Pathologist who is able to accurately determine how deeply the tumour has grown into the wall of the bladder. To determine whether the cancer has spread beyond the bladder, information from the CT urography is used.

Stage
Carcinoma in situ
Ta
T1
T2
T3
T4
Description
High grade cancer cells filling the inner lining of the bladder
Cancer cells occupying part of the inner lining
Cancer cells have broken through the inner lining into lamina propria
Cancer cells have invaded the muscle of the bladder
Cancer has grown through the muscle into fat around the bladder
Cancer has grown into surrounding organs (eg rectum)

Bladder Cancer Treatment

Treatment of Non Muscle Invasive Bladder Cancer (Stages Ta, T1 and CIS)

Endoscopic removal of the bladder tumour

Endoscopic surgery - TURBT/EBRT

Intravesical therapy

Intravesical Chemotherapy (Mitomycin C)

Intravesical immunotherapy (BCG)

Treatment of Muscle Invasive Bladder Cancer (stages T2-4)

Partial Cystectomy

Radical Cystectomy

Radiation Therapy

Chemotherapy

Our Team of Urologists

Consultant Urologist

Dr Robert Tan

Dr Robert Tan is a practicing consultant urologist with over 35 years of experience. He graduated from the medical school at the University of New South Wales, Australia, and has cared for thousands of patients over the decades.

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Consultant Urologist

Dr Lincoln Tan

Dr Lincoln Tan is a consultant urologist and accredited robotic surgeon. Dr Tan is trained in all aspects of open and endoscopic urology and specialises in the minimally invasive treatment of urologic cancers.

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