Renal & Urology

Bladder Cancer

Bladder cancer most often presents with painless haematuria; cystoscopy and TURBT establish the diagnosis and depth of invasion, separating non-muscle-invasive disease from muscle-invasive disease that needs specialist radical-treatment planning.

Definition

Bladder cancer is a malignant tumour of the bladder, most often urothelial carcinoma. It is categorised chiefly by whether it invades the detrusor muscle and by recurrence/progression risk.

First principles

The urothelium behaves as a field, not a single lesion

Urothelial carcinoma can arise at multiple sites in the urothelium, so multifocal tumours and new recurrences are clinically important even after one lesion is resected. Smoking and occupational exposure are major modifiable risk factors; cessation should be addressed as part of cancer care.

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