The bladder cancer is described by the Grade (to determine how aggressive the cancer cell are) and Stage (to determine how much the cancer has spread from the bladder).

Grade of Bladder Cancer

Bladder cancer cells are described either as low or high grade.  High grade cancer cells are poorly organised and more aggressive in nature.  They usually require more aggressive treatment compared to low grade cancer cells.

Stage of Bladder Cancer

The stage of the bladder cancer describes the extent of spread by the cancer. 

Stage	Description
Ta	Tumour on the bladder lining that does not enter any layers of the bladder
Tis	Carcinoma in situ (CIS) which looks like a red patch on the bladder lining
T1	Tumour goes through the bladder lining, into the second layer, but does not reach the muscle layer
T2	Tumour grows into the muscle layer of the bladder
T3	Tumour goes past the muscle layer into tissue (or fat) surrounding the bladder
T4	Tumour has spread to nearby structures such as the prostate (in men) or the vagina (in females)

Treatment Options for Bladder Cancer

Over half of patients with low-grade Ta cancers will have a tumour recurrence with about 6% progressing to a higher stage.  Around 45% of high-grade T1 cancers recur.  As such, it is important to have regular follow-up with your urologist to have regular surveillance.  The good news is that survival in high-grade disease is around 70-85% at 10 years and an even much higher rate for low-grade disease.

Transurethral Resection of Bladder Tumour (TURBT)

TUBRT is suitable for low grade bladder cancer.  The procedure is done through a cystoscope without any need for incision or stitches on the abdomen.

Click to view EAU video on TURBT

Intra-vesical BCG Therapy

Bacillus Calmette-Guerin (BCG) is the immunotherapy drug which is inserted into the bladder through a catheter.  This therapy helps to trigger your immune response to attack and destroy the bladder cancer cells.  The treatment is effective for early stage bladder cancer and may require regular repeated maintenance treatments.  The number and timing of the treatments depend on the response so do discuss with your own urologist.

Click to view UCF video on Intravesical Therapy

Intra-vesical Chemotherapy

Intra-vesical chemotherapy (such as Mitomycin-C, Gemcitabine or Docetaxel) may be given after TURBT surgery so that the drugs can kill cancer cells directly in the bladder.

Laparoscopic Radical Cystectomy

Laparoscopic Radical Cystectomy is a minimal invasive procedure which may be required to remove the entire bladder in high grade or advanced stage bladder cancer.  After the surgery, your surgeon will create an ileal conduit urinary diversion (created using a piece of your intestine) to drain urine from your kidneys into a urostomy bag which you need to wear on your abdomen.

Click to view UCF video on Bladder Removal for Bladder Cancer

See a Urologist if you have any urinary issues

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