We are committed to delivering a comprehensive range of bladder cancer treatments. Bladder preservation is central to our treatment regimes. With access to specialists in oncology as well as urology we can deliver all treatments options safely and effectively while preserving your quality of life.
The most common symptom of bladder cancer is blood in the urine, however this can occur from other conditions such as infection and kidney stones. The initial investigations include urine tests, blood tests, an ultrasound scan of the kidneys and a telescope test to look in your bladder (flexible cystoscopy). If a bladder cancer if discovered then an operation called transurethral resection of bladder tumour (TURBT) is required. 70% of patients will have bladder cancer growing on the surface of the bladder. This is cured with this initial operation but will always need careful and regular followup. More high risk patients will need chemical treatments into the bladder such as mitomycin C or Bacillus Calmette Guerin (BCG). Occasionally bladder cancer grows into the muscle layers of the bladder and this requires further treatment with chemotherapy and then bladder removal (open or laparoscopic radical cystectomy) or radiotherapy.
Flexible Cystoscopy
Flexible cystoscopy is a test to evaluate the lining of the bladder. It is performed under local anaesthetic and takes approximately 1-2 minutes. It is well tolerated and has minimal risks of bleeding, infection and dysuria (burning on passing urine). It is performed either for the diagnosis of bladder problems or as followup after bladder cancer has been diagnosed.
Transurethal Resection of Bladder Tumour (TURBT)
This is an operation that requires either a general or spinal anaesthetic. It involves a detailed telescopic examination of the inside of the bladder. No incisions are required. The visible tumour is then resected with a hot loop. Tumour samples are then washed out of the bladder. A catheter is required postoperatively and almost all patients will require a single chemotherapy treatment into the bladder after the operation. The risks of this operation are bleeding, infection and very rarely bladder perforation. Many patients will have dysuria (burning on passing urine) after the procedure which quickly resolves. If it doesn’t please consult your doctor.
Photodynamic Diagnosis (PDD) Cystoscopy and TURBT
Photodynamic Diagnosis (PDD) Cystoscopy or TURBT enables the surgeon to assess for tumour cells that might not be detected otherwise. It is a relatively new technique that is only available in specialist centres. It is not useful for all people with bladder tumours, but can be very important for specific patients, including those with early cancer at highest risk of progression. The technique involves a chemical (Hexvix) which is washed into the bladder 1 hour before the operation. This chemical is preferentially absorbed by cancer cells and glows under a blue light, which is used during the surgery. This can also be used during follow up cystoscopy. Your surgeon will advise whether this is necessary.
What next?
If you are worried about the possibility of having bladder cancer, especially if you have had blood in the urine, and would like to discuss investigations or treatment then please contact us and book a consultation with Mr Sam Liu, Mr Lyndon Gommersall, Mr Christopher Luscombe, or Mr Anurag Golash.
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