What is bladder cancer?

Bladder cancer develops when abnormal cells in the bladder grow and divide in an uncontrolled way.

The bladder is a small organ in the lower part of the stomach that stores urine. Most bladder cancers start in the lining of the bladder. When cancer affects only the inner bladder lining, it is called non-invasive cancer. If the cancer spreads into the deeper layers of the bladder lining or the bladder wall, it is harder to treat and more likely to spread.

The cancer cells can spread to the muscle wall of the bladder or even further to lymph nodes or other organs.

Bladder cancer is usually easier to treat if it is found at an early stage.

What are the types of bladder cancer?

The most common form of bladder cancer is called urothelial carcinoma (or transitional carcinoma). This starts in the urothelial cells in the inner lining of the bladder.

There are other types of bladder cancer, which are rarer:

• Squamous cell carcinoma starts in thin flat cells that line the bladder.
• Adenocarcinoma starts in a type of cell that produces mucus in the bladder.

What are the symptoms of bladder cancer?

The most common sign of bladder cancer is blood in your urine. It usually happens suddenly but isn't painful. If you notice blood in your urine, you should always see your doctor.

Other symptoms of bladder cancer include:

• having trouble emptying your bladder when you go to the toilet
• a burning feeling or pain when you're trying to pass urine
• needing to pass urine often
• pain in your lower stomach or back

What causes bladder cancer?

We don't fully understand why bladder cancer develops in some people.

Some factors can increase the risk, including:

• smoking
• being male
• exposure to certain chemicals
• family history of bladder cancer
• chronic urinary tract infections
• some types of chemotherapy
• previous radiotherapy treatment to the pelvic area

How is bladder cancer diagnosed?

Your doctor will examine you and may refer you for some tests, including:

• blood tests
• urine tests
• imaging scans such as a CT, ultrasound or MRI

A common test used to diagnose bladder cancer is called a cystoscopy. During a cystoscopy, the doctor — usually a specialist doctor called a urologist — looks inside your bladder with a small camera. If they see anything worrying, they will take a biopsy (a small sample of tissue) to be checked in a laboratory.

How is bladder cancer treated?

Your treatment will depend on the type of bladder cancer and how far it has spread.

A surgery called a 'transurethral resection' may be done using a cystoscope with a wire loop at the end. The cancer cells can also be burned off or treated with laser during surgery.

Some types of bladder cancer can be treated with immunotherapy. This is medicine used to stimulate your own immune system to fight the cancer.

Chemotherapy medicine is sometimes used, and can be delivered straight into the bladder through a catheter. Some people can also have radiotherapy to treat bladder cancer.

If the cancer has spread, part or all of your bladder may need to be removed with surgery. Your doctor may also remove some lymph nodes and any other affected organs. If your bladder is removed, a new 'bladder' for urine to be stored may be made for you using part of your bowel. In other cases, urine may pass through an opening in your abdomen to collect in a bag outside your body. This is known as a urostomy.

Living with bladder cancer

If your bladder is removed and you have a urostomy, it can take time to adjust. Help and support is available from your doctor, urology nurses, stomal therapists and physiotherapists.

Bladder cancer and its treatment may also affect your bowel function, sexual function and mental health. Ask your healthcare team about what you can do to relieve any symptoms and cope with the changes.

Many people feel anxious or distressed after being diagnosed with cancer. If you are struggling, it is important to seek support from your doctor, a therapist or other people who have been through cancer.

Resources and support

For more information and support, try these resources:

• The Continence Foundation of Australia provides information about bladder control. Call 1800 33 00 66.
• The National Public Toilet Map helps you find the location of the nearest public toilet. You can also download it as an app.
• Information on the social and emotional impact of cancer is available in the Cancer Australia resource, Cancer — how are you travelling?
• Cancer Council Australia provides services and support to all people affected by cancer. Call on 13 11 20.

Aboriginal and Torres Strait Islanders

• Read all about cancer for Aboriginal and/or Torres Strait Islander people.

Other languages

• General information from NSW Health about cancer is available online in many community languages.