Renal & UrologyPending review

Bladder Cancer

A urothelial field-change cancer, usually driven by carcinogen exposure across the whole urinary tract lining, that classically bleeds painlessly because early tumours are superficial and have not yet invaded pain-sensitive tissue.

In a nutshell

Bladder cancer is usually urothelial carcinoma from field-change carcinogen exposure across the whole urinary tract lining. Early tumours are superficial and bleed painlessly because pain fibres sit in the deeper muscle layer. The critical prognostic threshold is invasion of the muscularis propria, which is why any unexplained haematuria is urgently investigated.

Classic presentation

An older smoker with painless visible haematuria and no other urinary symptoms.

Key points

Painless visible haematuria is the classic and most important presenting feature. Pain suggests either advanced disease or an alternative diagnosis.

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Educational content pending clinical review. Not medical advice.