The majority of bladder cancer patients are diagnosed with urothelial carcinoma. While other forms of bladder cancer exist, such as adenocarcinomas and small cell carcinomas, urothelial carcinoma remains the most prevalent. Some urothelial carcinomas present with what’s known as variant histology, which can include plasmacytoid, micropapillary, or microcystic types. These variants typically increase the aggressiveness of the urothelial carcinoma.

In addition to identifying the cell type, it’s crucial to determine the grade and stage of the tumour. Bladder tumours are generally classified as either low grade or high grade, with high-grade cancers being more aggressive. The combination of grade, stage, and cancer type all play a significant role in determining the most appropriate treatment plan for each patient.

Understanding these aspects of your specific bladder cancer diagnosis is essential, as they collectively inform the treatment approach that will be recommended by your healthcare team.

Bladder cancer typically causes symptoms in earlier stages, before it has spread, making it more likely to be caught early. When it does spread, however, advanced bladder cancer symptoms can include inability to urinate, lower back pain on one side of the body, loss of appetite, bone pain, unintended weight loss, swollen feet or overwhelming fatigue.

Treatment options for bladder cancer are determined by the tumour’s grade and stage. For high-grade, non-muscle-invasive bladder cancer, the typical approach involves a transurethral resection of the bladder tumour, followed by intravesical therapy using either chemotherapy or immunotherapy, such as BCG.

In cases of invasive carcinoma, particularly muscle-invasive cancer, the standard treatment usually begins with cisplatin-based combination chemotherapy, followed by either bladder removal or radiation therapy. Each of these options has different implications for quality of life and potential side effects, and the choice between them is a personal decision for the patient.

For patients with stage 4 bladder cancer, the primary treatment is typically first-line cisplatin-based combination chemotherapy.

Adjuvant immunotherapy is another treatment option, administered after surgery to reduce the risk of cancer recurrence in the future.

It’s important to note that the specific treatment plan will be tailored to each individual patient, taking into account their overall health, the characteristics of their cancer, and their personal preferences.

A neobladder is a form of urinary diversion performed during bladder removal surgery. When the bladder is removed, urine must be rerouted. To create a neobladder, surgeons use approximately 30 centimetres of small intestine (ileum), which is detubularised or opened up. This intestinal tissue is then fashioned into a spherical shape, connected to the urethra, and linked to the kidneys.

The advantage of a neobladder is that all components are internal, unlike an ileal conduit which requires an external urine collection bag. However, neobladders are not without drawbacks. They don’t function flawlessly:

• About 25% of men and 30% of women may experience some degree of long-term incontinence
• Approximately 10% of men and 25% of women may need to use catheters to empty their neobladder

These factors are crucial considerations when choosing between a neobladder and a conduit. The decision should be made in consultation with healthcare professionals, taking into account individual circumstances and preferences.

It’s important to note that while a neobladder offers a more natural-seeming solution, it requires adaptation and may present ongoing challenges. Patients should be fully informed about both the benefits and potential complications before making their decision.

Bladder cancer statistics provide valuable insights into various aspects of the disease, including who is most commonly affected, at what stage it is typically diagnosed, and survival rates. These figures help paint a comprehensive picture of bladder cancer’s impact and prevalence in the UK.

One of the most striking statistics relates to the age of those diagnosed with bladder cancer. More than 90% of individuals who receive a bladder cancer diagnosis are over the age of 55. This figure underscores the strong correlation between advancing age and the risk of developing this particular form of cancer. Even more tellingly, the average age at diagnosis is 73 years, firmly establishing bladder cancer as a disease that predominantly affects older adults.

Encouragingly, bladder cancer is often detected in its early stages. Current data indicates that only about 4% of diagnoses occur after the cancer has already spread to other parts of the body. This high rate of early detection is crucial, as it significantly improves the prospects for successful treatment and long-term survival.

These statistics paint a picture of bladder cancer as a disease that, while serious, is often caught before it reaches advanced stages. The high proportion of diagnoses in older individuals emphasises the importance of vigilance and regular health check-ups as people age. However, it’s important to note that while less common, bladder cancer can occur in younger individuals as well.

Understanding these figures is vital for both healthcare professionals and the general public. They inform screening practices, guide resource allocation in healthcare systems, and highlight the importance of awareness campaigns targeted at older populations. As research continues and diagnostic techniques improve, these statistics may evolve, potentially revealing new patterns or trends in bladder cancer incidence and detection.