Definition Bladder cancer: A malignant tumour arising from the cells lining the urinary bladder. Etiology & Risk Factors Smoking: Significantly increases risk. Exposure to industrial chemicals: Aromatic amines (benzidine and beta-naphthylamine). Chronic bladder inflammation: Repeated urinary infections or long-term catheter use. Radiation exposure. Family history of bladder cancer. Age: Most common in older adults. Types Transitional cell (urothelial) carcinoma: Most common type. Squamous cell carcinoma. Adenocarcinoma. Clinical Presentation Painless haematuria: Most common symptom. Frequent urination or urgency to urinate. Dysuria (painful urination). Back or pelvic pain. Investigations Cystoscopy: Direct visualisation of the bladder lining. Urine cytology: Microscopic examination of urine for cancer cells. Imaging: CT urogram or MRI. Biopsy during cystoscopy. Staging Staging is crucial for determining treatment approach and prognosis. Based on TNM system: Tumour size, lymph Node involvement, and Metastasis. Management Transurethral resection: For early-stage tumours. Chemotherapy: Intravesical (directly into the bladder) or systemic. Radiotherapy: An option for some individuals. Cystectomy: Removal of part (partial) or all (radical) of the bladder. Immunotherapy: BCG vaccine directly into the bladder to stimulate an immune response. Complications Recurrence of the cancer. Chronic urinary issues post-treatment. Side effects of treatments, e.g., bladder irritation from intravesical chemotherapy. Prognosis Depends on stage, grade, and type of bladder cancer. Regular follow-up with cystoscopies is required due to a high risk of recurrence.
