Wessex Bladder Cancer Support

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What is Bladder Cancer


Bladder Cancer is the growth of abnormal tissue (called a 'Tumour') that forms in the lining of the Bladder. For some people, the tumour may grow further into other layers of the bladder. As the cancer grows into other layers it becomes more advanced and harder to treat.


Types of Bladder Cancer


Bladder Cancer can be sub divided in the first instance into:


Non Muscle Invasive Bladder Cancer (NMIBC)

Muscle Invasive Bladder Cancer  (MIBC)

The most common type of Bladder Cancer is Transitional Cell Carcinoma (TCC)

There are a few rarer types of Bladder Cancer. Your specialist urology team will talk to you about which type of cancer you have, but all the inforamtion below relates to TCC


By far the largest group of people with Bladder Cancer will have NMIBC and this group is divided again into:


High Risk - e.g. G3pTa, G3pT1, CIS (Carcinoma in situ)

Intermediate Risk - e.g. G2pTa, G2pt!

Low Risk - e.g. G1/2 pTa


Ta,T1, Tis - describes where the cancer is in the bladder and if it has spread.

G1 - Cells that look normal and grow slowly and are unlikely to spread.

G2 - Cells look slightly abnormal, can grow slowly and not spread or may grow more quickly with a higher chance of spreading.

G3 - Cells look abnormal, grow quickly and are likely to spread.

p - Results found by biopsy.

Stage 4 Metastatic Bladder Cancer - Ths is where the cancer has spread through the bladder wall and has invaded the pelvic or abdominal wall. It may also have involved the lymph nodes and can even have spread to distant sites. Sadly, this type of cancer is not curable, but the Oncology team will discuss the appropriate palliative treatments.


Treatment of Bladder Cancer 


NMIBC is generally treated with what is termed 'Local Treatments', that is treatment that directly involves the bladder, this is most commonly surgery (TURBT) and /or drugs into the bladder. A Flexible cystoscopy is carried out and if patches are noticed then a TURBT under general anaesthetic to remove the tumours. If, after surgery, the biopsy shows that the cancer is high risk NMIBC, then a course of intravesical (which means into the bladder) drugs is recommended


High Risk BC is often treated with a BCG vaccine in the first instance as a course of 6 treatments, once a week for 6 weeks. This is followed by a cystoscopy, and if necessary a biopsy under a general anaesthetic. BCG can then be continued with a maintenance program of once a week for three weeks at 3/6 and 9 month intervals (Each course is  followed by a cystoscopy) This can be repeated in future years if the cancer returns.

Intermediate Risk.- Mitomycin (MMC), a chemotherapy drug is often suggested. MMC is again once a week for 6 weeks. This can be repeated in future years if required. MMC is often used during/after a TURBT as a single dose into the bladder


Recurring Cancer:


Sometimes the cancer persists despite repeated TURBT's and intracvesical drugs and in these cases consideration will have to given to having the bladder removed (Cystectomy)


MIBC - This type of cancer is always classed as high risk, in fact this is the most concerning type of bladder cancer and needs radical treatment to cure it. The main treatments are Bladder Removal (Cystectomy) and Radiotherapy. These two options are often used with chemotherapy being given for 2/4  months before cystectomy or radiotherapy.


Your Oncologist, Urologist and CNS Nursing staff will discuss all of these options with you when recommending an appropriate course of treatment for your type of cancer.

The more research you do before you see the  Doctors the more prepared you will be with the questions you need to ask