Ed Rowe and David Gillatt are experts in treating bladder cancer. They are two of the highest volume surgeons in the UK and Europe. Each perform over 100 operations for prostate cancer each year, and over 30 bladder removal operations. These are largely performed robotically which can speed the recovery and reduce infection risk. For example over 80% of men undergoing robotic radical prostatectomy go home the day after surgery.
Both surgeons are able to offer rapid access to the latest diagnostic tests such as MRI and transperineal biopsy for bladder tumour resection, BCG and other treatments for bladder cancer.
General Information about Bladder Cancer
The bladder is an organ that can be found in the pelvis. When our kidneys filter out the waste products in our blood, these waste products are then mixed with water to make urine. This then passes down two tubes called ureters directly into the bladder. Bladder cancer is the process where there is a growth of an abnormal amount of tissue, also known as a tumour that develops in the lining of the bladder. It is not uncommon for the tumour to spread to nearby muscles. Bladder cancer occurs when there are changes to the cells of the bladder. Very often it can also be linked with exposure to certain chemicals.
Risk Factors for Bladder Cancer
Smoking is undoubtedly the biggest risk factor associated with bladder cancer. Tobacco contains cancer triggering chemicals. If you smoke over a long period of time, these chemicals will pass into your bloodstream to then be filtered by the kidneys into your urine. The bladder is unprotected against these dangerous chemicals, as its purpose is to act as a store for urine. This will inevitably cause changes to the human cells of the bladder lining that lead to bladder cancer.
Exposure to chemicals can also increase the risk of bladder cancer. The risk of bladder cancer increases if your occupation involves:
- Leather tanning
- Diesel fumes
Symptoms of Bladder Cancer
The most common symptom of bladder cancer is blood in your urine (haematuria) and it is usually painless. If you notice traces of blood in your urine or the blood is causing your urine to turn brown then you should contact your GP. The blood may not always be obvious and it may be intermittent. Other symptoms include an urge to urinate on a more regular basis or a burning sensation when urinating.
If bladder cancer reaches the advanced stage, and subsequently begins to spread, symptoms can often include pelvic pain, bone pain, weight loss and swelling of the legs.
Treatment for Bladder Cancer
Bladder cancer, like all forms of cancer is something that is treatable. However the treatment options available for bladder cancer depend on how advanced the cancer is. Treatments will usually differ between early stage, non-muscle-invasive bladder cancer and more advanced muscle-invasive bladder cancer.
Treatment will be overseen by multi-disciplinary teams (MDTs) consisting of:
- A urologist – a specialises in treating conditions that affect the urinary tract
- A clinical oncologist – a specialist in chemotherapy and radiotherapy
- A pathologist – a specialist in contaminated tissue
- A radiologist -a specialist in identifying disease using imaging methods
- A specialist cancer nurse – will usually be the person to be the first point of contact with the rest of the team
If you are diagnosed with non-muscle-invasive bladder cancer, your treatment plan will be contingent on the risk of the cancer returning or spreading. This risk is considered using a series of factors, some of which are:
- The amount of tumours that exist in your bladder
- The size of these tumours
- Whether you have had bladder cancer before
- The grade of the cancer cells
Possible treatments include:
- Trans-urethral resection of a bladder tumour:. This is a surgery performed under general anaesthetic. The surgeon uses an instrument called a cystoscope to accurately locate where the tumours are and cut them away from the lining of the bladder. The wounds will then be closed using a slight electric current.
- BCG vaccination. this involves the vaccine being passed directly into your bladder via a catheter and left inside your bladder for around two hours before being drained away.
- Radical cystectomy. This surgical option removes the bladder entirely as well as nearby lymph nodes, part of the urethra, the prostate (found in men), and the cervix and womb (found in women). During a radical cystectomy, your surgeon will create a new pathway for the urine to leave your body. This is known as urinary diversion.
- Chemotherapy (side effects can include nausea, vomiting, hair loss, lack of appetite, tiredness)
- External radiotherapy (side effects can include diarrhoea, inflammation of the bladder, tightening of the vagina, erectile dysfunction, loss of pubic hair, infertility, tiredness, incontinence)
- Palliative radiotherapy
Although it is not always possible to prevent bladder cancer, simple things such as giving up smoking, a safe workplace environment and a healthier diet can all contribute towards decreasing the risk of contracting the disease.