Q1. How common is bladder cancer?
A. Bladder cancer is more common than people realise. Over 10,000 cases are diagnosed each year in the UK. The majority of these (about 7,500) are diagnosed in men, meaning that, on average, one man in thirty will get bladder cancer at some time in his life.
Q2. How dangerous is bladder cancer?
A. Over 3000 people die from bladder cancer each year in the UK. Although the death rate amongst women has remained the same for a long time, the death rate amongst men is slowly dropping.
Q3. Who is at risk from bladder cancer?
A. There are virtually no cases of bladder cancer in people under 40 and the vast majority of cases are diagnosed after the age of 55. Caucasian (ie white) people are more at risk than others. Significantly lower levels of this cancer are found in people of African or Asian origin. There is a very high rate of bladder cancer in countries such as Iraq and Egypt, where it is associated with an infection of the bladder called schistomiasis, which is endemic in those countries. Some industrial chemicals used in dying are known to be linked with a high risk of bladder cancer. These chemicals are no longer in use.
Q4. Is smoking linked to bladder cancer?
A. Smokers are two to five times more likely to get bladder cancer than normal. The more they smoke, or the longer they smoke, the higher the risk. It is estimated that half of all bladder cancers in men, and one third in women, are the result of smoking.
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Q5. What are the symptoms of bladder cancer?
A. The most common symptom is blood in the urine, although there are many other conditions (such as bladder infections) which can cause this. The other less common symptoms (frequency of urination and pain when urinating) can also have other causes.
Q6. How is bladder cancer diagnosed?
A. First, a urine sample is taken and sent for analysis, too see if any abnormal cells can be found in it. The next test is usually cytoscopy: under local anaesthetic a thin flexible tube is passed up the urethra (the tube that carries the urine out) and into the bladder. Fibre-optics in the tube allow the doctor to inspect the inside of the bladder. In some cases, X-rays and blood tests may also be required.
Q7. How is bladder cancer treated?
A. This depends on how advanced the cancer is. For early cancer, a simple operation, using a similar thin flexible tube inserted via the urethra, is followed by drug or vaccine treatment. Some cases of early bladder cancer can be treated by adding either cancer drugs, or the BCG vaccine, directly to the contents of the bladder. More advanced cancers require either radiotherapy or an operation to remove part or all of the bladder. This type of operation has a serious side effect. The patient is unable to urinate properly afterwards and has to use a catheter and urine bag. Radiotherapy does not have this side effect, but it may not be as effective at curing the cancer. Often these treatments will be followed by a course of anti-cancer drugs.
Q8. How effective are these treatments?
A. This depends on how advanced the cancer is and the age of the patient. Patients with early bladder cancer and patients under 40 have an 80 to 90% chance of surviving for five years and longer. If the cancer has spread into the muscle wall of the bladder, or if the patient is over 80, only about half of them survive for five years after diagnosis. Unusually, men seem to survive bladder cancer better than women, although we do not understand why.
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